Insurance Regulatory Info
This link leads to the machine-readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.
Health law matters move quickly and carry real exposure for providers facing a subpoena or audit, and for the individuals who come forward with evidence of fraud. We represent clients on both sides of these disputes, and that dual perspective gives us a sharper understanding of how these cases are actually built, defended, and resolved.
Our attorneys represent physician practices, medical groups, and other healthcare providers in government investigations, False Claims Act litigation, and internal compliance matters, as well as whistleblowers who come forward with knowledge of fraud against government healthcare programs.
The practice is led by partner Will Rosenzweig, a former Assistant United States Attorney in the Southern District of Florida who spent five years prosecuting fraud and financial crimes through trial and appeal, including three years as part of South Florida’s federal health care fraud strike force. This experience gives him a practical understanding of how federal investigations unfold and what it takes to navigate them, on either side of a case.
When a provider receives a subpoena, civil investigative demand, or notice of a government inquiry, the early response often shapes everything that follows. We represent medical groups, physicians, and other healthcare providers in investigations by the Department of Justice, HHS-OIG, state Medicaid Fraud Control Units, and other regulators, and we work closely with referring counsel to bring in health law-specific experience when it’s needed most. Our team gives clients a rare advantage here, as partner Will Rosenzweig has sat on the government’s side of these investigations and knows how they are built, what draws scrutiny, and how to respond effectively.
We represent clients on both sides of False Claims Act and qui tam matters. On the defense side, we represent providers named in whistleblower actions, working to resolve or defeat claims before they escalate into full-blown litigation.
One of the most challenging areas of health law involves compliance with the federal Anti-Kickback Statute and the Physical Self-Referral Law, commonly called Stark Law. These laws broadly prohibit financial relationships in the referral of patients from and to health care providers and suppliers. We represent companies and individuals in need of front-end advice on potential contracts or other arrangements and also advice, remediation, and defense on the back-end.
Providers often need answers before regulators come knocking, or once they have. We conduct internal investigations and compliance audits for medical groups and other providers, helping clients understand their exposure and respond to regulators from a position of knowledge.
We represent individuals, physicians, office staff, and other insiders who have first-hand knowledge of healthcare fraud or anti-kickback violations and are considering or pursuing a whistleblower claim. We help clients evaluate their evidence and pursue claims under the False Claims Act’s qui tam provisions.
Our team represents health care clients in commercial litigation, including partnership and ownership disputes, contract disputes, and other conflicts particular to the health care industry.
Our team handles the real estate side of health care operations, including leases for medical practices and other health care-related businesses. We also represent clients in the acquisition, sale, and leasing of medical office buildings.
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