Health Care
Stetler, Duffy & Rotert, Ltd. is a national leader in producing positive results to health care providers and their employees embroiled in government or qui tam litigation alleging fraud or abuse in the provision of health care. Our clients include practitioners, hospitals, pharmaceutical and medical device manufacturers, insurers and third-party administrators. Our lawyers know and understand the sometimes esoteric practices and vocabulary of modern health care reimbursement so they can respond effectively to evolving standards in the field.
REPRESENTATIVE CASES
SDR led the trial defense effort in a nationally significant health-care fraud prosecution of eleven employees of a major pharmaceutical company accused of defrauding Medicare. The case was tried to a jury in Boston and was covered extensively by the national media and the trade press. Our client, the senior executive charged in the case, was acquitted on all charges and all defendants who stood trial with him likewise were found not guilty. United States v. MacKenzie, et al.
SDR lawyers successfully defended an executive of Blue Cross/Blue Shield in federal court on charges of Medicare fraud. Although our client’s employer previously had entered a plea of guilty and paid millions of dollars in fines and penalties, our client and her three co-defendants stood trial. After a three-month jury trial proceeding, all four defendants were found not guilty. United States v. Bartels, et al.
Joe Duffy represented a prominent Minnesota physician charged with violations of the Medicare anti-kickback statute. This physician was jointly indicted with executives of Caremark and Genentech in a case that was tried to a jury in Minneapolis. After several months of trial the jury acquitted the physician on 14 of the 16 counts in which he was charged. The remaining two counts were dismissed by the trial court during post-trial proceedings. United States v. Brown, et al.
We currently represent Illinois psychiatrists in connection with criminal and civil investigations by federal and state authorities. These matters involve controversial rules governing reimbursement for group therapy that frequently recur among mental health care providers across the country.
Many of the greatest achievements gained by SDR in health care matters go unreported, a sure sign of success in this field. Doctors, hospitals, and health care executives have successfully maintained their professional licenses, and the ability to participate in publicly funded health care programs, thanks to the guidance offered by SDR in responding to OIG, grand jury, and professional regulatory investigations.