PART 3 OF 3

Protecting Your Practice — Before It's Too Late

The good news is that FCA exposure is largely manageable with discipline and the right advice. The practices that fare best are not the ones that never make mistakes — they are the ones that find and fix mistakes before a whistleblower or auditor does.

Build a compliance program that actually runs

•    Adopt written policies and code-of-conduct standards, and review them annually rather than filing them away.

•    Designate a compliance officer or point person with real authority to investigate and correct problems.

•    Conduct periodic internal billing and coding audits — documented, so you can show the program is more than paper.

•    Train clinical and billing staff regularly, and keep records of that training.

•    Maintain a confidential internal reporting channel so concerns surface to you first, not to the government.

Mind your financial relationships

Review every arrangement that touches referrals — leases, medical director agreements, equipment deals, and compensation formulas — against the Anti-Kickback Statute and Stark Law. Have counsel confirm that each fits within an applicable safe harbor or exception, and make sure the arrangement is at fair market value and properly documented.

Handle overpayments and disclosures correctly

When an audit reveals an overpayment, treat the 60-day clock as live. Where appropriate, voluntary self-disclosure to the government can significantly reduce damages multipliers and signal good faith. These decisions are fact-specific and carry real strategic trade-offs — they should be made with counsel, not unilaterally.

Know what to do when the government calls

If you receive a Civil Investigative Demand, a subpoena, or a contractor audit notice, the early hours matter. Do not destroy or alter records, do not let staff give informal interviews without guidance, and preserve all relevant documents immediately. Contact experienced healthcare counsel before responding. How a practice conducts itself in the first days of an inquiry often shapes the entire outcome.

Talk to us before there's a problem

A proactive compliance review costs a fraction of defending an FCA action — and it is far more effective. If you own or manage a practice that bills government payers, we can help you assess your exposure, tighten your billing and referral arrangements, and respond if an investigation has already begun.

West Coast Health Law offers a FREE consultation which you may schedule by clicking the button on our website.

West Coast Health Law — [email protected]

This series is provided for general informational purposes only and does not constitute legal advice or create an attorney-client relationship. Penalty figures reflect amounts in effect for 2026 and are subject to change. Consult qualified counsel regarding your specific circumstances.