James A. Hoover

Experience

• Represented several Medicare Advantage Organizations in numerous arbitrations involving large multi-million dollar claims disputes.
• Represented a hospital against a false claims and anti-kickback investigation conducted by the OIG and U. S. Attorney's Office for the Northern District of Alabama that led to the government closing its investigation without action against the hospital.
• Assisted clients in responding to and addressing HIPAA breaches, including coordinating breach notification processes and extensively reviewing and revising HIPAA compliance plans and forms.
• Conducted numerous internal corporate investigations for companies suspecting violations of Stark, the Anti-kickback laws and the False Claims Act
• Defended multiple compounding pharmacies throughout the southeast regarding the Department of Justice's investigation of alleged false claims payments relating to Tricare/the Defense Health Agency.
• Represented several health care laboratories in responding to CIDs and defending qui tam lawsuits and government investigations alleging violations of Stark, the Anti-kickback laws and the False Claims Act.
• Represented a mental health provider in a qui tam/false claims lawsuit alleging, among other allegations, violation of the false claims act as a result of the provider's alleged improper use of "incident to" services.
• Represented a large specialty pharmacy company in an action brought by the Alabama Medicaid Agency involuntarily suspending Medicaid payments and successfully obtained the return of $11 million in Medicaid funds.
• Represented physician practices in a qui tam/false claims lawsuit alleging a violation of the false claims act as a result of the practice's improper use of "incident to" services.
• Obtained a summary judgment on behalf of a physician group practice resulting in a dismissal of a lawsuit filed by a former physician employee alleging submission of false credentialing information to a state medical licensing board.
• Represented numerous physician practices in multiple Office of Inspector General ("OIG") investigations related to the use of and billing for qualitative drug screen testing.
• Obtained certificate of need approval from the State Health Planning and Development Agency to construct the first Free Standing Emergency Department in Alabama.
• Obtained a summary judgment for a hospital client against a lawsuit filed by a real estate management company alleging breach of a real estate management contract and various leases and subleases.
• Obtained a judgment in excess of $800,000.00 for a hospital client against a physician on its medical staff for violating an office lease agreement.
• Represented a national hospital company with numerous hospitals in Alabama with its litigation within the State of Alabama.
• Represented a national hospital company with drafting its handbook on internal investigations.
• Represented numerous hospitals in response to CMS investigations seeking to terminate the hospitals' provider numbers within 21 days for alleged EMTALA violations.

Honors & Recognitions

Professional Activities