Mr. Mathias represents clients across the country in all areas of the health care industry, with a focus on fraud and abuse, internal and government investigations and corporate compliance matters.
Bill has extensive experience counseling clients on compliance with the federal Anti-kickback Law, the Stark Physician Self-Referral Statute and the federal Civil Monetary Penalty provisions. With the changing nature of the health care system, Bill works with hospitals and health care systems to develop physician alignment strategies, including joint ventures, co-management agreements, and gainsharing arrangements. He also advises health systems and GPOs on compliance with the discount and GPO safe harbors as well as strategies for reducing legal risks associated with cutting edge supply chain management and purchasing programs.
Bill regularly works with investors and health care companies to evaluate potential opportunities, identify risks and structure transactions in an effort to mitigate risk. He directs health care due diligence efforts for clients and transactions counsel. Bill conducts internal investigations; defends against government investigations and qui tam false claims cases. He has extensive experience working with clients to resolve matters through the OIG and CMS voluntary self-disclosure protocols. Bill has successfully obtained several OIG advisory opinions. He also has experience advising health care providers facing exclusion from Medicare and other federal health care programs as well as health care companies that have employed excluded providers.
Over the years, Bill has gained significant experience in negotiating Corporate Integrity Agreements (CIAs) and helping health care companies to navigate the complexities of operating under a CIA. In addition, he regularly assists clients with developing and monitoring the effectiveness of compliance programs.
Bill has a deep understanding of the reimbursement, licensing and compliance issues affecting DME/HME suppliers, pharmacies, infusion companies and other "Part B" suppliers. He has assisted suppliers in addressing issues under the DMEPOS Competitive Bidding Program. He also works with companies on compliance strategies under the Physician Payment Sunshine Act and the CMS Open Payments Program.
Mr. Mathias is a national leader on health care fraud and abuse and compliance matters. In 2008, he was selected by Nightingale's Healthcare News as an "Outstanding Healthcare Fraud and Compliance Lawyer." He is a past vice chair of the American Health Law Association's Fraud & Abuse Practice Group and the American Bar Association Health Law Section's Business & Transactions Interest Group.