Michael Shaheen

ADD Representative Matters

• Representative Private Practice Matters

  • • Jointly leading internal investigation of a health insurance company regarding alleged kickbacks paid to induce referrals related to an investigation by the U.S. Department of Justice (DOJ) and the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG). The investigation is ongoing.
    • Jointly leading internal investigation of a health insurance company regarding falsified actuarial assumptions related to an investigation by DOJ and HHS-OIG. 
    • Jointly leading internal investigation of a health insurance company regarding alleged upcoding related to an investigation by DOJ and HHS-OIG. 
    • Leading internal investigation into alleged upcoding and kickbacks paid by a large provider to referring physicians and to third party marketers related to an investigation by DOJ and HHS-OIG. 
    • Defending testing lab against allegations that its tests were not medically necessary. 
    • Jointly leading internal investigation of a holding company that owned a large portfolio of ambulatory surgical centers regarding allegations of violations of the Anti-Kickback Statute and Stark Law related to an investigation by DOJ and HHS-OIG. The investigation took place over several years and involved dozens of witnesses.

• Representative Government Matters

  • • First-chaired jury trial in Federal District Court in South Carolina: S. ex rel. Mayes v. Berkeley Heartlab, Inc., No. 9:14-cv-00230 (D.S.C.)
      • • Case involved allegations that blood testing laboratories were paying kickbacks to physicians and to sales people in order to induce medically unnecessary blood testing.
        • At trial, took direct testimony from witnesses and conducted cross examinations; successfully argued evidentiary motions; and delivered closing argument.
    • Led DOJ’s Blood Labs Initiative, including investigations into a number of blood testing laboratories that allegedly paid kickbacks to physicians in exchange for referrals.
    • Co-led DOJ’s Big Lender Initiative, including investigations into a number of mortgage firms that allegedly recklessly approved loans prior to the mortgage crisis in 2008. 
    • Led more than 60 investigations at DOJ and secured more than $250M in settlements, including but not limited to:
      • • $48 million from large hospital network to settle claims that facilities falsely diagnosed patients in order to maintain elevated billing status.
        • $47 million from Health Diagnostic Laboratory, Inc. (HDL) to settle claims that HDL paid kickbacks to induce medically unnecessary blood testing.
        • $22 million from the University of Miami (UM) to settle claims that UM submitted false claims through its laboratory and off campus hospital based facilities.
        • $13.5 million from Hilltop Holdings, Inc. to settle claims relating to the origination of mortgage loans that were insured by the Federal Housing Administration.
        • $13.1 million from Singulex, Inc. to settle claims that Singulex paid kickbacks to induce medically unnecessary blood testing.
        • $6 million from Quest Diagnostic, Inc. to settle claims that Quest paid kickbacks to induce medically unnecessary blood testing.
        • $4.995 million from Pine Creek Medical Center (PCMC) to settle claims that PCMC paid kickbacks in the form of marketing materials for referring physicians.
        • $2.715 million from large durable medical equipment company to settle claims that defendant violated the FCA by falsely marketing certain devices as durable medical equipment.