AHLA Best Practices Handbook for Advising Clients on Fraud and Abuse Issues (Non-Members)

Charles B. Oppenheim, Esquire, is a principal in the Los Angeles, CA office of Hooper, Lundy & Bookman, P.C., and has been practicing health law for more than 30 years. His practice includes all aspects of transactional, operational, and regulatory health care law, including acquisitions, joint ventures, and integrated delivery systems.

Mr. Oppenheim is a nationally recognized expert on anti-kickback and Stark Law issues and has served as an expert on them in arbitration and litigation in both civil and criminal proceedings. He is a frequent lecturer on Stark Law developments as well as other health care law subjects. He has served as a guest lecturer at the UCLA School of Law, Loyola Law School and at the UCLA School of Public Health. He is a past Chair of the Health Law Committee of the Business Law Section of the State Bar Association of California and a past President of the Healthcare Law Section of the Los Angeles County Bar Association. Mr. Oppenheim is a member of the American Health Law Association and the California Society for Healthcare Attorneys, and he donates time and legal services to a number of Los Angeles-area charities. He is listed in Best Lawyers in America, Who’s Who in American Law, and Who’s Who in America. He is included in the Guide to the Leading U.S. Healthcare Lawyers, is identified by Chambers as an outstanding California health law attorney, and has repeatedly been named one of Los Angeles Magazine’s Southern California Super Lawyers.

Paul W. Shaw is a member of the litigation and health law departments of Verrill Dana LLP in Boston, MA, where he concentrates in representing businesses and professionals in health care fraud and abuse investigations. Paul has represented numerous health care clients subject to criminal fraud and abuse and civil false claims act investigations by the federal government and state Medicaid Fraud Control Units. These clients include academic medical centers, pharmaceutical service providers, hospitals, physicians, medical practice groups, behavioral health providers, clinical laboratories, durable medical equipment suppliers, home health agencies and other health care providers. He has also represented The New England Journal of Medicine for many years in connection with litigation involving the Journal.

Paul has lectured and written extensively in the area of fraud and abuse before the American Health Law Association, state medical societies, and bar associations. He is Editor-in-Chief of the AHLA publication, Best Practices Handbook for Advising Clients on Fraud and Abuse Issues. He is also co-author of the handbook jointly published by the American Medical Association and AHLA, entitled Avoiding Fraud and Abuse in the Medical Office. Paul is a member of the Editorial Board of the Journal of Health & Life Sciences Law. Paul has been consistently recognized in Chambers USA: America’s Leading Lawyers for Business under Healthcare. Paul graduated from Georgetown University Law Center in 1975.

Kristin M. Bohl is a Shareholder in the Baltimore office of Baker Donelson where she practices as part of the Baker Ober Health Law Group. Her practice focuses on regulatory guidance related to fraud and abuse and Medicare and Medicaid law and policy. The clients she works with include hospitals and health care systems, physicians and providers. Her health care experience includes advising these clients on fraud and abuse compliance reviews and addressing issues identified which can include the submission and resolution of voluntary disclosures to the government. Additionally, she assists clients in analyzing and implementing bundled payment programs developed by the Centers for Medicare & Medicaid Services (CMS). Ms. Bohl worked at CMS prior to entering private practice. While at CMS, she worked on the team that developed and implemented aspects of the physician self-referral (Stark) law, including regulatory updates, development of the CMS Voluntary Self-Referral Disclosure Protocol, and collaboration with the Office of Inspector General in drafting the initial Stark waivers for the Medicare Shared Savings Program.

Before earning her law degree, Ms. Bohl was a registered nurse. She received her BSN from Georgetown University and her J.D. from the University of Maryland Francis King Carey School of Law where she was received a Certificate in Health Law and was a member of the Journal of Health Care Law & Policy.

Kristin C. Carter is a Shareholder in the Baltimore Office of Baker, Donelson, Bearman, Caldwell & Berkowitz, PC. As part of the BakerOber Health Law Group, she focuses her practice on advising clients regarding federal and state fraud and abuse laws, including the federal Anti-Kickback Statute and Stark law, and regulatory compliance issues. Kristin represents a broad spectrum of health care providers, including hospitals, clinical laboratories, physicians and other ancillary providers. She frequently assists clients with internal investigations, self-disclosures to government entities, acquisition due diligences, and corporate compliance matters.

Ms. Carter received her J.D., cum laude, as part of the Law & Health Care Program from the University of Maryland School of Law in 2006 where she served as the Executive Editor of the Journal of Health Care Law & Policy. Active in the community, Kristin was selected for The Daily Record's Leading Women in 2011. She has also been named a Maryland Rising Star on a number of occasions by Maryland Super Lawyers in the area of Health Care Law.

Renee M. Howard is a partner in the Seattle, WA office of Davis Wright Tremaine, LLP. She has nearly two decades of experience in health care regulatory and litigation matters and counsels a wide range of health care providers and suppliers, including hospitals, health systems, physicians, imaging centers, laboratories, medical device manufacturers and distributors, skilled nursing facilities, hospices, and behavioral health agencies. Renee represents clients in federal False Claims Act, Anti-Kickback, and Stark law matters, Medicare and Medicaid reimbursement litigation, and professional licensing investigations and complaints. She also advises on internal investigations pertaining to fraud and abuse and routinely counsels on compliance-related policies and procedures.

Prior to joining Davis Wright Tremaine, she was a partner in the Seattle office of Perkins Coie, LLP and a shareholder at a health care boutique law firm in Seattle. She spent her associate years at the Washington, D.C. office of Jones Day. Renee graduated magna cum laude from the Notre Dame Law School in 1999 and received her undergraduate degree from the University of Notre Dame in 1996. Renee is a frequent speaker and lecturer on health care fraud and abuse topics and is a member of AHLA, the Washington State Health Care Attorneys, and the ABA Health Law Section.

Amy M. Joseph, co-author of Chapter 6, is a partner in the Boston office of Orrick, Herrington & Sutcliffe. She advises a wide variety of health care providers and related entities, including telehealth platforms and startups, health systems, health care information technology companies, management organizations, physician groups, pharmacies, and health care investors on business and regulatory matters. A significant portion of Ms. Joseph’s practice is focused on fraud and abuse compliance, including counseling and advice regarding compliance of potential business structures with federal and state anti-kickback and self-referral laws, health information privacy and security, mergers and acquisitions, and other strategic affiliations. She earned a J.D. from UCLA School of Law.

Jordan Kearney is an associate in the San Francisco office of Hooper, Lundy & Bookman, P.C. Ms. Kearney's practice focuses on regulatory and litigation counseling for a range of providers, including hospitals, long-term care providers, home health and hospice companies, and pharmaceutical and medical device companies. Her areas of focus include False Claims Act and other government investigations, fraud and abuse laws, internal investigations and self-reporting requirements, compliance counseling, and Medicare/Medicaid reimbursement issues. Ms. Kearney graduated magna cum laude from Duke University and received her J.D. with high honors from Emory University.

Laura Koman is an associate in the Health Care and Life Sciences practice group at Jones Day in Washington, D.C. Laura represents health systems, hospitals, and other health care industry clients in various matters relating to regulatory compliance and health care transactions with an emphasis on digital health topics. Laura received her JD, summa cum laude, in 2015 from the University of Maryland Carey School of Law and her BA, magna cum laude, in 2012 from the University of Maryland, College Park. She is admitted to practice in Maryland and the District of Columbia. She is a member of the American Health Lawyers Association.

Ingrid S. Martin is a partner at Collora LLP where she is co-chair of the firm's health care practice group. She specializes in representing health care providers facing government investigations, audits, disciplinary proceedings, and other types of criminal and civil litigation. Her clients include individual health care providers, as well as health care entities such as medical practices, pharmacies, physical therapy businesses, home health agencies, adult day care centers, and medical device distributors. She handles all types of federal and state government investigations including matters brought by the United States Department of Justice, the FDA, the DEA, the Office of the Inspector General of Health & Human Services, and the Massachusetts Attorney General's Office. She assists her clients with audits by government payors such as Medicare as well as by private insurers. She regularly handles disciplinary matters before state licensing boards, including the Massachusetts Board of Registration in Medicine.

Before entering private practice, Ms. Martin was an Assistant Attorney General at the Massachusetts Attorney General’s Office in the Corruption, Fraud and Computer Crime Unit. She also clerked at the United States District Court in Boston for the Honorable George A. O’Toole. She received her J.D. from Harvard Law School and her B.A. from Yale University.

Elizabeth G. Myers is a Partner in the Austin, Texas office of Thompson & Knight LLP. Ms. Myers focuses her practice on high-stakes litigation, representing clients in state and federal courts around the country in commercial disputes and product defect, consumer fraud, and securities fraud class actions. She also routinely represents special committees of public companies conducting internal investigations regarding alleged regulatory violations and executive misconduct. Ms. Myers has represented and counseled companies and their officers and directors on matters related to several billion dollars in potential exposure. She routinely participates in conferences and lectures regarding complex litigation strategy, with a special focus on litigation within the healthcare industry.

Ms. Myers received her J.D. with high honors from The University of Texas School of Law in 2005 and her B.A. in Political Science, summa cum laude, from Southern Methodist University in 2001.

William Pezzolo is an associate in Holland & Knight's Boston office. He is a member of the firm's Healthcare & Life Sciences Team and advises clients on healthcare regulatory matters, fraud, abuse and compliance matters, and corporate transactional matters in various sector s of the healthcare industry. His clients includes pharmaceutical and medical device manufacturers, pharmacies (retail, specialty, long-term care and mail order), pharmacy benefits managers, insurers, e-health and wholesale drug distributors.

Tamara Senikidze is an Associate in the Washington DC office of Jones Day. She advises clients on health care fraud, waste, and abuse laws; HIPAA and state privacy and security laws; overpayment recoupment efforts; and Medicare and Medicaid coverage. Tamara assists clients with developing comprehensive compliance plans and counsels on the evolving regulatory, licensing, and reimbursement issues related to delivery of health care via digital means. She has guided clients on structuring transactions and regulatory due diligence and has advised on issues such as change of ownership, joint ventures, and arrangements for the provision of professional, practice management, or other administrative services.

She received MA in 2007 from the Johns Hopkins University School of Advanced International Studies, and JD, magna cum laude, in 2011 from University of Miami.

Gina L. Simms is a Shareholder at Baker Donelson Bearman Caldwell & Berkowitz. Her practice focuses on white collar criminal defense and civil False Claims Act defense. She represents individual and corporate clients facing state and federal government investigations of possible civil and criminal violations, including fraud, false claims and kickbacks. She has conducted numerous internal investigations on behalf of health care providers, including hospital systems, physicians practice groups, and long-term care and post-acute care providers. She also defends clients responding to search warrants, grand jury subpoenas, civil investigative demands, and administrative subpoenas and other document demands. She has defended clients from the beginning of a state or federal government investigation through resolution of the same. Prior to joining the firm, she served as an Assistant U.S. Attorney both in the U.S. Attorney's Office for the District of Maryland and for the District of Columbia, where she tried many cases.

Ms. Simms is co-chair of the Health Law Forum of the Women's Bar Association of D.C. She is a member of AHLA, HCCA and the ABA's Criminal Justice and Health Law sections. She has lectured extensively and published articles on issues related to white collar crime, health care fraud, the False Claims Act, and corporate compliance.

Jeremy Sternberg (Chapter 7: Self Disclosure and Voluntary Disclosure) is a partner in Holland & Knight's Boston office. He practices in the area of litigation with a particular emphasis on white collar criminal defense, government enforcement and complex business disputes. He focuses his practice on representing clients involved in criminal and civil investigations and prosecutions by government enforcement agencies. He regularly counsels clients on healthcare enforcement and compliance matters.

Prior to joining Holland & Knight, Mr. Sternberg was a federal prosecutor in the U.S. Attorney's Office in Boston, and served in the Health Care Fraud Unit and later the Economic Crimes Unit in that Office. In addition to trying a number of cases to verdict, Mr. Sternberg has also argued civil and criminal cases before the U.S. Court of Appeals for the First Circuit.