Tony Maida

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Tony Maida counsels health care and life sciences clients on government investigations, regulatory compliance and compliance program development. Having served as a government official, Tony has extensive experience in health care fraud and abuse and compliance issues, including the federal and state Anti-Kickback and Stark Laws and Medicare and Medicaid coverage and payment rules. He represents clients in False Claims Act (FCA) qui tam matters, government audits, civil monetary penalty and exclusion investigations, and Centers for Medicare and Medicaid Services (CMS) suspension, and revocation actions, negotiating and implementing corporate integrity agreements, and making government self-disclosures. Read Tony Maida's full bio.

HHS OIG Develops Toolkit to Analyze Telehealth Claims to Assess Program Integrity Risks

By , , , , and on Jun 13, 2023
Posted In Employee Benefits, Health and Welfare Plans

The US Department of Health and Human Services Office of the Inspector General (HHS OIG) recently unveiled a new toolkit that seeks to help analyze telehealth claims for federal healthcare program integrity risks. It is based on methodologies highlighted in OIG’s September 2022 data brief; the data brief identified billing practices by Medicare providers that...

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Pandemic Response Accountability Committee Report Highlights Telehealth Program Integrity Concerns

By , , and on Jan 18, 2023
Posted In Digital Health, Employee Benefits, Health and Welfare Plans

On December 1, 2022, the Pandemic Response Accountability Committee (PRAC) Health Care Subgroup issued its report on fraud, waste and abuse risks that arose as a result of the dramatic increase in telehealth services provided during the COVID-19 pandemic. The PRAC was created under the CARES Act to oversee the historic spending that was part of the...

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US Supreme Court to Hear Whistleblower’s False Claims Act Suit

By on Oct 20, 2022
Posted In Uncategorized

The US Supreme Court will hear a whistleblower’s False Claims Act suit that the US Department of Justice (DOJ) had previously moved to throw out. In this Law360 article, McDermott Partner Tony Maida offers perspective about the DOJ’s 2018 Granston memo. “It does not make sense for the government to need to justify its decision to...

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Healthcare Enforcement in the Post-Pandemic Era

By , and on Jun 28, 2022
Posted In Digital Health, Employee Benefits, Health and Welfare Plans

As the world emerges from the COVID-19 pandemic, healthcare fraud enforcement remains a top priority for the US Department of Justice (DOJ) and other government agencies with enforcement authority. In this Westlaw Today article, McDermott Partners Laura McLane, Tony Maida and Dana M. McSherry describe some of the areas that have assumed particularly high enforcement...

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Update to Fraud Self-Disclosure Rules for Regulated Healthcare Entities

By , and on Jan 6, 2022
Posted In Employee Benefits, Health and Welfare Plans

On November 8, 2021, the US Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued an update to the Health Care Fraud Self-Disclosure Protocol (SDP). This update revises and renames the Provider Self-Disclosure Protocol last updated by OIG in 2013. The changes are mostly procedural in nature and update the SDP...

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One Year Later: The Yates Memo, False Claims Act and Director & Executive Liability

By and on Oct 7, 2016
Posted In Executive Compensation

On September 19 and 27, 2016, the US Department of Justice announced two False Claims Act settlements that required corporate executives to make substantial monetary payments to resolve their liability. How will director and executive liability be impacted by the Yates Memo and False Claims Act in an evolving health care climate? Read the full...

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