Sam Perrone is a partner in Ropes & Gray’s health care group. He advises clients across the health care and life sciences industry—including hospitals and health systems, physician groups and other providers, health plans, laboratories, medical device and pharmaceutical companies, and investors—on regulatory, enforcement, and transactional matters.
Drawing on a broad background in regulatory compliance and government enforcement, Sam has deep regulatory expertise, including in the False Claims Act, the Anti-Kickback Statute, the Stark Law, and payor reimbursement and coverage requirements. He regularly advises clients on fraud and abuse matters and has defended a number of federal and state investigations involving alleged False Claims Act and state law violations, including matters led by the U.S. Department of Justice, the U.S. Attorney’s Offices for the Southern, Eastern, and Northern Districts of New York, and the Office of the New York State Attorney General. Sam also leads internal investigations arising from whistleblower complaints and other compliance concerns, regularly prepares and negotiates self-disclosures to federal and state agencies, and negotiates and implements corporate integrity agreements and assurances of discontinuance.
In addition, Sam advises clients on proactive compliance strategies, including through fraud and abuse counseling, compliance program design and assessment, and billing and coding audits. He also counsels health care companies and investors on strategic acquisitions, joint ventures, and services arrangements, with a focus on regulatory structuring, diligence, and post-acquisition compliance and risk mitigation.
Experience
Government Enforcement
- Defended health system in DOJ investigation alleging violations of the Stark Law and the False Claims Act related to physician compensation and improper billing and coding.
- Defended managed long-term care plan in joint DOJ and attorney general investigations alleging violations of the False Claims Act related to member eligibility and disenrollment.
- Defended assertive community treatment (ACT) program provider in joint DOJ and attorney general investigations alleging violations of the False Claims Act related to improper billing and service delivery.
- Defended health system in attorney general investigation alleging violations of state law concerning billing for Covid-19 testing.
- Represented health system in negotiating, implementing, and successfully completing a corporate integrity agreement (OIG) with the Office of Inspector General for the U.S. Department of Health and Human Services.
- Negotiated settlement and corrective action plan with the Office for Civil Rights (OCR) for the U.S. Department of Health and Human Services on behalf of academic medical center to resolve alleged violations of the Health Insurance Portability and Accountability Act (HIPAA).
Regulatory Compliance
- Lead numerous internal investigations for health care clients in response to whistleblower complaints and compliance concerns, including into matters implicating the False Claims Act, Anti-Kickback Statute, Stark Law, Civil Monetary Penalties Law, Controlled Substances Act, HIPAA, and Medicare and Medicaid conditions of payment and participation.
- Prepared and negotiated numerous self-disclosures of compliance issues and potential overpayments, including through the Self-Disclosure Protocol for the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services, the Self-Referral Disclosure Protocol (SRDP) for the Centers for Medicare & Medicaid Services (CMS), and state Medicaid agency disclosure processes.
- Advised multiple health systems on physician engagement and compensation strategies, including development of Stark Law-compliant compensation methodologies.
- Provided regulatory advice on structuring clinical and management services joint ventures, including among health systems, academic medical centers, management companies, physicians, and investors.
- Counseled health care providers in developing, implementing, and assessing compliance programs.
Health Care Transactions
- Represented 1Life Healthcare, Inc., which operates under the name “One Medical,” in its sale to Amazon and its acquisition of Iora Health.
- Represented Cardinal Health in its acquisition of Integrated Oncology Network.