Healthcare Fraud Class Actions

Our Consumer Protection practice offers a unique expertise in addressing healthcare fraud class actions under state and federal consumer laws across the United States. We bring to bear a rare combination of state attorneys general experience, having worked hand-in-glove with state attorneys general in some of the largest healthcare fraud investigations and litigation to date; class action leadership experience; and significant jury trial experience, having tried Chipps v. Humana, recognized by the American Association for Justice as one of the most influential healthcare lawsuits of its kind.

    Our primary objective is to bring a full measure of justice to healthcare participants through the courts, while holding corporate wrongdoers responsible.

    We are recognized by the judiciary and co-counsel alike for leading, managing, and collaborating on large, complex class actions. We co-counsel nationwide.

    Scope of Practice

    We represent healthcare participants in a range of healthcare fraud-related class actions against hospitals, health maintenance organizations (HMOs), and other healthcare providers, as well as insurance companies, pharmacies, and third-party administrators, such as:

    • Billing Schemes, including Excessive, Hidden, or Inflated Fees
    • Diagnostic Testing Facility Fraud
    • Co-Pay and Insurance Premium Increases
    • Delay or Denial of Care (class only)
    • Deceptive Marketing, including “Off-label” Marketing of Non-FDA Approved Pharmaceuticals and Medical Devices
    • False Advertising and Non-Disclosure Claims
    • False Medical Claims and Records Management Fraud
    • Hospice and Homecare Fraud
    • Hospital and Health System Fraud
    • Insurance Fraud
    • Medicaid and Medicare-related Fraud
    • Nursing Home and Skilled Nursing Fraud
    • Pharmacy Schemes
    • Telehealth Fraud
    • Other Unfair Business Practices

    Litigation Resources

    We have found that consumer-based healthcare fraud claims often involve a complicit system of healthcare entities, leading to exacerbated claims that extend into other legal disciplines, such as fraud against the government and other unfair competition and health plan claims. We have legal resources across our Whistleblower/False Claims Act, Antitrust, ERISA practices at the ready to assist in providing clients and co-counsel alike any additional legal perspective.

    As a result of decades of experience investigating and litigating healthcare fraud class action claims, we are familiar with how fraud may reveal itself across the industry, including fraud that may be propelled by economic or health crisis, such as COVID-19. Furthermore, we have an extensive network of third-party industry experts and other specialized service providers, nationwide, who are able to assist in addressing myriad investigation, fact-pattern, and discovery requirements. We also have the internal resources to efficiently handle complex discovery, ensuring streamlined, efficiencies of scale, in large class actions.

    Representative Matters

    • Herrera v. JFK Medical Center and HCA, Inc. (M.D. Fla.): Cohen Milstein successfully oversaw a state-wide consumer class action, in which plaintiffs alleged that post-car accident emergency room patients were billed inflated fees for emergency radiology services, in excess of the amount allowed by law, covered in part by their mandatory Florida Personal Injury Protection (PIP) insurance. In December 2018, the court granted final approval of an injunctive relief settlement of $220 million.
    • Chipps v. Humana (Cir. Crt., Palm Beach Cty., Fla.): Mr. Leopold tried one of the first managed care abuse cases in the country after Humana wrongfully denied physical and occupational therapy for a 6-year-old child with cerebral palsy. The jury returned the largest punitive damage award on behalf of an individual in Florida history. The American Association for Justice, the nation’s preeminent plaintiffs’ trial association, lists Chipps v. Humana as one of the most influential lawsuits to mitigate corruption in the healthcare industry. This seminal case was featured in the movie Damaged Care.
    • Nationwide (N.D.N.Y.) and Country Life (Cook Cty. Ill. Cir. Ct.): Cohen Milstein helped lead two consumer class actions against two of the largest insurance companies, in which plaintiffs asserted that the insurers participated in sales marketing abuses in the marketing of so-called “vanishing premium policies.” Plaintiffs claimed that insurance agents sold insurance policies to unsuspecting consumers promising that after a relatively short time the dividends generated from the policy would be so high as to be able to fully pay the premiums. In fact, the calculations of the policies were based on unrealistic interest rate projections and, therefore, the premiums never “vanished.” Nationwide resulted in a settlement valued at between $85 million and $103 million, while a settlement with Country Life made $44 million in benefits available to policyholders.
    • Nursing Home Fraud: Representing the State of New Mexico in litigation related to Medicaid fraud and deceptive marketing by skilled nursing facilities that promised, but failed to provide, basic care to their elderly residents.
    • Opioids Fraud: Representing the states of Indiana, New Jersey, and Vermont in consumer protection, Medicaid fraud, and nuisance litigation on behalf of their state constituents against opioid manufacturers and distributors.

    We are regularly recognized for our work in consumer litigation: