North America - United States • Healthcare
O'Melveny & Myers LLP
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Primarily based in California, the practice at O'Melveny & Myers LLP stands out for handling a vast array of disputes and regulatory issues for health plans and insurers, and healthcare companies. Practice co-head David Deaton has ample experience in conducting internal investigations and acting in both federal and state enforcement inquiries. Lee Blalack, a seasoned commercial litigator, co-heads the team from Washington DC, acting for insurance and physician staffing companies. Caitlin Bair is an expert in FCA and Anti-Kickback matters, while Stephen Sullivan focuses on handling Medicare Advantage issues for managed care organizations. Elizabeth Bock is a key name within the practice for ACA and Medicare Advantage risk adjustment matters.
Legal 500 Editorial commentary
Testimonials
Collated independently by Legal 500 research team.
- 'The firm tries to find business solutions to complicated processes.'
- 'What makes them standout is their availability. Your problems are their problems and they take them seriously.'
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Key clients
- America's Health Insurance Plans
- American Hospital Association
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Work highlights
- Representing Kaiser Foundation Health Plan, Inc. and various Kaiser Permanente entities in FCA litigation which originated after the filing of six FCA qui tam actions, which were consolidated in the Northern District of California under United States ex rel. Osinek v. Kaiser Permanente. The DOJ intervened in part in all six qui tams, alleging that the parties submitted false claims for Medicare Advantage payments by improperly adding diagnosis codes through medical record amendments.
- Representing Elevance Health, Inc. and its Florida subsidiary, HealthSun Health Plans, Inc., in a criminal investigation by the DOJ involving alleged Medicare fraud at HealthSun, which has focused on HealthSun’s submission of allegedly fraudulent risk adjustment data to CMS, resulting in approximately $53m in overpayments from CMS. The DOJ formally declined to prosecute HealthSun.
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