A nationally recognized leader in healthcare fraud and abuse issues, Howard J. Young leads the Morgan Lewis healthcare practice where he counsels a range of healthcare clients on government investigations, regulatory, and transactional matters. Healthcare organizations turn to Howard to address their most critical compliance and strategic business issues and to assist with internal investigations and government self-disclosures. Howard helps healthcare clients develop compliant and effective solutions to legal issues and advises investors, including private equity firms, on transactions, affiliations and joint ventures.
Howard’s clients include community hospitals and academic medical centers, hospices, home health agencies, retail and specialty pharmacies, behavioral health providers, physician practices, vision care providers, medical suppliers, telehealth providers, healthcare vendors, pharmacy benefit managers (PBMs), insurers, and distributors. He also counsels private equity firms and lenders as well as pharmaceutical, biologic, and medical device manufacturers.
Howard represents healthcare clients that are the target of federal and state investigations involving the False Claims Act (FCA), the Anti-Kickback Statute, the Civil Monetary Penalty Law, and the Stark Law, as well as quality of care, medical necessity, coding, and billing matters. He has successfully avoided Department of Justice (DOJ) intervention on many FCA investigations, and has also successfully litigated FCA matters.
Howard has experience advising and litigating on US Department of Health and Human Services, Office of Inspector General (OIG) and state exclusion matters, and was successful as co-counsel on the only mandatory exclusion matter overturned in federal court. He also works with clients in connection with Centers for Medicare and Medicaid Services (CMS) contractors, such as recovery audit contractors and zone program integrity contractors (ZPICs), and OIG audits.
From 1997 to 2002, Howard was a senior attorney and deputy branch chief with the OIG. There he coordinated with the DOJ, state attorneys general, and CMS on criminal and civil healthcare fraud matters. He negotiated, developed, and monitored hundreds of corporate integrity agreements (CIAs), and supervised a staff of OIG lawyers and analysts.
Howard frequently writes and presents on fraud and abuse and healthcare regulatory issues to major healthcare trade and professional associations as well as to clients’ executive teams, boards of directors, and sales and marketing personnel.
Mr. Young's recent representative client matters include the following:
Ongoing FCA litigation for a hospice in federal district court following DOJ intervention on allegations related to clinical ineligibility of hospice patients, improper physician billing and improper face-to-face compliance.
Represented a hospice seller in a complex arbitration proceeding related to sale of a hospice company to a private equity-backed hospice company, including a highly favorable resolution of an OIG self-disclosure related to various hospice compliance issues.
Represent retail and specialty pharmacies on a wide range of state and federal regulatory matters, including board of pharmacy and DEA oversight, Medicare and Medicaid reimbursement matters, exclusion matters, internal investigations and compliance program matters.
Obtained a declination and complete dismissal of a federal qui tam investigation of a dental management company following an innovative response to a DOJ civil investigative demand.
Representing providers in accountable care organizations (ACOs)–shared savings program and bundled payment arrangements, including negotiation of agreements and assessment of regulatory, fraud, and abuse matters.
Representing numerous hospices and home health agencies in connection with ongoing DOJ investigations related to eligibility, levels of care (GIP and CHC), OIG self-disclosures, ZPIC audits, and related overpayment appeals.
Representing hospice and home health providers on purchase and sale transactions.
Advising various private equity investors and other companies in the pain management, home health, hospice, pharmacy, vision care, hyperbaric oxygen and wound care, sleep lab, and telehealth sectors.
Served as lead counsel in the successful representation of two hospitals in a large healthcare system to settle a qui tam investigation for considerably less than the government was seeking, and with no CIA, of Medicare inpatient short stays for kyphoplasty.
Conducted independent compliance program assessments for various healthcare providers, investors, and lenders in connection with a large, national investor-owned hospital chain, home health agency chain, behavioral health companies, several large and midsized hospice organizations, and multiple retail and specialty pharmacy companies.
Represented a national PBM organization in connection with a first of its kind CIA and resolution of a government investigation.
Advising healthcare providers, pharmaceutical companies, and medical device manufacturers on CIA matters on compliance and fraud and abuse matters.
Served as lead counsel to a not-for-profit hospital on CMS Physician Self-Referral Protocol disclosure (Stark Law).
Secured summary judgment dismissal of a major False Claims Act lawsuit, following intervention by the DOJ, for a durable medical equipment supplier of wound care mattress overlays after extensive discovery. The decision was upheld on appeal to the U.S. Court of Appeals for the Fifth Circuit. (U.S. ex rel. Carter v. Medica-Rents).
Defending physicians and other individuals, including healthcare executives, on OIG exclusion matters, including before ALJs and in federal district court.
Duke University School of Law, J.D.
Tufts University, B.A., Magna Cum Laude
District of Columbia
Awards and Affiliations
Listed, Chambers USA: America's Leading Lawyers for Business (2006–2015)