Michael W. Paddock is a member of the firm's Health Care Group and a resident in the Washington, D.C. office. His practice primarily involves health care fraud and abuse matters, particularly those relating to federal false claims, physician self-referral (Stark Law), and anti-kickback issues. He often advises clients on compliance matters, the conduct of internal investigations related to potential fraud and abuse issues, and responding to and defending against government anti-fraud and abuse enforcement efforts and regulatory inquiries, including qui tam and government allegations of False Claims Act violations. Michael is an active member of the American Health Lawyers Association, serving as a member of the 2011 and 2012 Fraud and Compliance Forum Planning Committees, as a former Vice-Chair of the Fraud and Abuse Practice Group's Steering Committee, and as a member of that Practice Group's Enforcement Committee. Michael was named by Nightingale's Healthcare News as one of the Outstanding Young Healthcare Lawyers of 2006.
Michael received an LL.M. in Health Law from Loyola University Chicago's Institute for Health Law, a J.D. with Honors in a Concentration in Health Law from Boston University School of Law, and an undergraduate degree from Miami University of Ohio. Michael is a member of the bars of Illinois (inactive) and the District of Columbia.
Publications
· "Summary Analysis of U.S. ex rel. Singh v. Bradford Regional Medical Center, et al.," AHLA Fraud and Abuse Practice Group Alert (March 21, 2011). Co-Author: Michael W. Paddock.
· "Health Reform Legislation Promises Significant Limitations On New and Continued Physician Ownership and Investment in Specialty and Other Hospitals," ABA Health eSource, Vol. 6, No. 5 (January 2010). Co-Authors: Michael W. Paddock and Matthew T. Fornataro.
· "The False Claims Act Correction Act: Key Provisions and Implications," Payors, Plans & Managed Care, AHLA, Vol. 12, Issue 1 (January 2009). Co-Authors: Chris Flynn, David W. O'Brien, Michael W. Paddock and Amy S. Lee.
· "Stark Marches On: The 2009 IPPS Rule," AHLA Member Briefing, Fraud and Abuse Practice Group (October 14, 2008). Co-Author: Michael W. Paddock.
· "Limitations on the Use of the False Claims Act to Enforce Quality of Care Standards," J. Health & Life Sci. L. (October 2008, at 37). Co-Authors: John T. Brennan, Jr. and Michael W. Paddock.
· "OIG Opines On Propriety Of ED On-Call Coverage Arrangements," Health Lawyers Weekly (October 2007). Co-Authors: Michael W. Paddock and Lauren Kim.
· "FTC Finds Evanston Hospital Merger Unlawful, But Refuses To Order Spin-Off," American Health Lawyers Association Health Lawyers Weekly (September 2007). Co-Authors: Arthur N. Lerner and Michael W. Paddock.
· "Medicaid and United States Citizenship: What Happened, Why It Won't Go Away, and The Need for a Fail-Safe," AHLA's Health Lawyers Weekly (November 10, 2006). Author: Michael W. Paddock.
· "HHS Proposals Update: Stark, E-Prescribing and EHR Technology," M.D. News (December 2005/January 2006). Co-Author: Michael W. Paddock.
· "DHHS Proposes Anti-Kickback Safe Harbor and Stark Exceptions for the Donation of E-Prescribing & Electronic Health Record Technology," AHLA Health Lawyers Weekly (November 4, 2005). Co-Authors: Benjamin T. Butler and Michael W. Paddock.
· "Legal Approaches to Waiving Co-Payment Obligations as an Out-of-Network Provider," M.D. News (November 2005). Co-Author: Michael W. Paddock.
· "The Hospital Board at Risk and the Need to Restructure the Relationship with the Medical Staff: Bylaws, Peer Review and Related Solutions," 12 Annals Health L. 179 (Summer 2003). Author: Michael W. Paddock.
· "Safeguard Records When Closing Practice," American Academy of Orthopaedic Surgeons Bulletin (October 2001). Author: Michael W. Paddock.
· "Managed Care Under the Gun: Suing Your Managed Care Plans," Managed Care Quarterly (Spring 2001). Author: Michael W. Paddock.
Alerts & Newsletters
· "Fourth Circuit Enforces Employee's Pre-Filing Release of Qui Tam Action under the False Claims Act, Dismisses Suit," Labor & Employment Law Alert - US (April 21, 2010). Contacts: Kris D. Meade, Michael W. Paddock.
· "Reporting and Repayment of Medicare and Medicaid Overpayments Must Be Made by May 22, 2010 Under Section 6402(a) of the Patient Protection and Affordable Care Act," Health Provider Alert (March 30, 2010). Contacts: Michael W. Paddock, Arthur N. Lerner.
· ""Retroactive" Amendments to False Claims Act Found Unconstitutional," Health Law 'In The News' (October 28, 2009). Contact: Michael W. Paddock.
· "New False Claims Act Amendments Significantly Impact Health Care Entities And Their "Obligations" Regarding Overpayments," Health Law 'In The News' (May 28, 2009). Contacts: Robert T. Rhoad, Michael W. Paddock.
· "OIG Issues New Advisory Opinion Identifying Acceptable and Risky On-Call Physician Payment Arrangements," Health Law 'In The News' (May 22, 2009). Contacts: Kathleen M. Stratton, Michael W. Paddock.
· "HHS OIG Identifies Potential Violation of Anti-Kickback Laws In Proposed "Block Lease" Arrangements Between Physician Groups," Health Provider Alert (September 3, 2008). Contact: Michael W. Paddock.
· "CMS Issues 2009 Proposed Physician Fee Schedule Rule: Proposed Changes Would Impact Anti-Markup Rule, Add New Stark Law Exception," Health Provider Alert (July 2, 2008). Contacts: Kathleen M. Stratton, Michael W. Paddock.
· "Managed Care Lawsuit Watch - June 2008," Managed Care Lawsuit Watch (June 5, 2008). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "OIG "Open Letter" Delivers Welcome News to Health Care Providers," Health Provider Alert (April 16, 2008). Contacts: Kathleen M. Stratton, Michael W. Paddock.
· "Managed Care Lawsuit Watch - February 2008," Managed Care Lawsuit Watch (February 11, 2008). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "Managed Care Lawsuit Watch - January 2008," Managed Care Lawsuit Watch (January 4, 2008). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "STARK II PHASE III: A Detailed Section-By-Section Analysis of the Long-Awaited "Final" Rule," Health Provider Alert (October 2, 2007). Contacts: Kathleen M. Stratton, Michael W. Paddock.
· "OIG Opines On Propriety of ED Call Coverage Arrangements," Health Provider Alert (October 1, 2007). Contacts: Kathleen M. Stratton, Michael W. Paddock.
· "Long-Awaited Stark Law Phase III Final Rule Released By CMS," Health Provider Alert (August 28, 2007). Contacts: Kathleen M. Stratton, Michael W. Paddock.
· "FTC Finds Evanston Hospital Merger Unlawful, But Refuses to Order Spin-Off," Health Law 'In The News' (August 14, 2007). Contacts: Arthur N. Lerner, Barbara H. Ryland, Michael W. Paddock.
· "2008 Physician Fee Schedule Proposes A Host of Stark Law Revisions - And It Isn't Even Phase III... ," Health Provider Alert (July 5, 2007). Contacts: Michael W. Paddock, Kathleen M. Stratton.
· "Managed Care Lawsuit Watch - June 2007," Managed Care Lawsuit Watch (June 30, 2007). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "OIG Advisory Opinion 07-05: How a Fair Market Value Deal Can Place Hospital-Physician Joint Venturers at Risk of Kickback Violation," Health Provider Alert (June 21, 2007). Contacts: Kathleen M. Stratton, Michael W. Paddock.
· "Managed Care Lawsuit Watch - May 2007," Managed Care Lawsuit Watch (May 11, 2007). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "Managed Care Lawsuit Watch - April 2007," Managed Care Lawsuit Watch (April 11, 2007). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "CMS Extends Deadline For Publication of Final Stark II, Phase III Rule," Health Provider Alert (March 21, 2007). Contacts: Kathleen M. Stratton, Michael W. Paddock.
· "Managed Care Lawsuit Watch - March 2007," Managed Care Lawsuit Watch (March 20, 2007). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "CON Laws Pose Threat to Health Care Markets, DOJ Antitrust Division Official Tells Georgia Legislative Committee," Health Law 'In The News' (February 28, 2007). Contact: Michael W. Paddock.
· "CMS Takes a Step Back on Recently Published Guidance on the New IDTF Quality Standards," Health Provider Alert (February 22, 2007). Contacts: Kathleen M. Stratton, Michael W. Paddock.
· "Managed Care Lawsuit Watch - February 2007," Managed Care Lawsuit Watch (February 13, 2007). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "Managed Care Lawsuit Watch - January 2007," Managed Care Lawsuit Watch (January 24, 2007). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "Managed Care Lawsuit Watch - December 2006," Managed Care Lawsuit Watch (December 7, 2006). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "Ernst & Young Report to IRS Reveals Tax-Exempt Hospitals' Community Benefits Justify Their Tax Exemptions," Health Provider Alert (December 5, 2006). Contact: Michael W. Paddock.
· "New Hospital Conditions of Participation to Take Effect January 26, 2007," Health Provider Alert (December 1, 2006). Contacts: Kathleen M. Stratton, David W. O'Brien, Michael W. Paddock.
· "Managed Care Lawsuit Watch - November 2006," Managed Care Lawsuit Watch (November 20, 2006). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "Managed Care Lawsuit Watch - Sept./Oct. 2006," Managed Care Lawsuit Watch (October 9, 2006). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "Managed Care Lawsuit Watch - July/Aug. 2006," Managed Care Lawsuit Watch (August 1, 2006). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "CMS Comes Down Hard on State Medicaid Fraud Enforcement Efforts," Health Provider Alert (June 14, 2006). Contacts: Kathleen M. Stratton, David W. O'Brien, Michael W. Paddock.
· "New Provider and Supplier Enrollment Requirements To Take Effect June 20, 2006," Health Provider Alert (June 7, 2006). Contacts: Kathleen M. Stratton, Michael W. Paddock.
· "Managed Care Lawsuit Watch - June 2006," Managed Care Lawsuit Watch (June 7, 2006). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "Managed Care Lawsuit Watch - May 2006," Managed Care Lawsuit Watch (May 5, 2006). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "OIG Opines on Nominal Value, Federal Health Care Program Carve-Outs, and Applicability of Safe Harbors in Context of Multi-Layered Relationships," Health Law 'In The News' (April 14, 2006). Contact: Michael W. Paddock.
· "Managed Care Lawsuit Watch - April 2006," Managed Care Lawsuit Watch (April 7, 2006). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "Managed Care Lawsuit Watch - March 2006," Managed Care Lawsuit Watch (March 7, 2006). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "Managed Care Lawsuit Watch - February 2006," Managed Care Lawsuit Watch (February 2, 2006). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "Managed Care Lawsuit Watch - January 2006," Managed Care Lawsuit Watch (January 10, 2006). Contacts: Arthur N. Lerner, Michael W. Paddock.
· "Arbitrators Dismiss United Healthcare's Antitrust Claims against Chicago Health Care System," Health Law 'In The News' (December 2, 2005). Contacts: Michael W. Paddock, Arthur N. Lerner.
· "Legal Approaches To Waiving Co-Payment Obligations As An Out-Of-Network Provider," Health Law 'In The News' (November 11, 2005). Contact: Michael W. Paddock.
· "HHS Proposes Anti-Kickback Safe Harbor and Stark Exceptions For The Donation of E-Prescribing & Electronic Health Record Technology," Health Law 'In The News' (November 3, 2005). Contact: Michael W. Paddock.
· "FTC ALJ Order Hospital Merger Undone," Health Law 'In The News' (October 28, 2005). Contact: Michael W. Paddock.
Speaking Engagements
· AHLA Annual Conference, Counseling Clients in an Environment of Increased Enforcement (live event) (June 27, 2011). Presenter: Michael W. Paddock.
· "AHLA Medicare ACOs: Details From the Fraud and Abuse Perspective," (webinar) (May 24, 2011). Presenter: Michael W. Paddock.
· "C&M Recent Release of the Proposed Accountable Care Organization Regulations and Related CMS, OIG, FTC, DOJ and IRS Content: Piecing the Puzzle Together," (April 21, 2011). Presenter: Michael W. Paddock.
· "AHLA Seven Months Later: Experiences and Practical Advice in Dealing with CMS' SRDP," (roundtable discussion) (April 11, 2011). Presenter: Michael W. Paddock.
· "Executives and Counsel In the Crosshairs: What Recent Government Efforts to Prosecute Individuals Mean For Your Organization (And You!)," Crowell & Moring webinar (April 7, 2011). Co-Presenters: Robert T. Rhoad, Michael W. Paddock and Chandra K. Westergaard.
· "C&M Executives and Counsel in the Crosshairs: What Recent Government Efforts to Prosecute Individuals Mean for Your Organization (and You!)," (webinar) (April 7, 2011). Presenter: Michael W. Paddock.
· "Healthcare Fraud & Abuse In A Tougher Enforcement Environment: Lessons Learned From Recent DOJ/HHS Fraud Investigations, Prosecutions and Settlements," Strafford Publications Teleconference (April 8, 2010). Presenter: Michael W. Paddock.
· "Stark Law Overpayments and False Claims Act Implications," American Health Lawyers Association, Institute for Medicare & Medicaid Payment Issues (March 25 & 26, 2010). Presenter: Michael W. Paddock.
· "Fraud In Healthcare Under Heightened Scrutiny: Effective Compliance Strategies in the Face of New DOJ / HHS Fraud Initiatives," Strafford Legal Teleconference (July 14, 2009). Co-Presenter: Michael W. Paddock.
· "CMS' Stark Law Audits Are Coming: The "Disclosure of Financial Relationships Report" and Its Requirements and Considerations." National Constitution Center teleconference (April 2, 2009). Presenter: Michael W. Paddock.
· "CMS' Stark Law Audits Are Here: Preparing to Respond to the Government's 'Disclosure of Financial Relationships Report,'" AHLA Institute on Medicare and Medicaid Payment Issues (March 26 and 27, 2009). Presenter: Michael W. Paddock.
· "The Stark Morass In Academic Medicine," AHLA Operationalizing Stark: From Complexity to Reality (March 24, 2009). Co-Presenter: Michael W. Paddock.
· "CMS' Stark Law Audits Are Coming: The "Disclosure of Financial Relationships Report" and Its Requirements and Considerations," AHLA Hospitals and Health Systems Law Institute (February 10-11, 2009). Presenter: Michael W. Paddock.
· "Highlights Of H.R. 4854 'The False Claims Act Correction Act of 2007' and DOJ's Views," The Future of the False Claims Act: Recent Judicial and Legislative Highlights - Crowell & Moring's HOOPS 2008 (October 2008). Co-Presenters: David W. O'Brien and Michael W. Paddock.
· "New Stark Rules Effective October, 2008: Are You In Compliance?", National Constitution Center teleconference (September 11, 2008). Presenter: Michael W. Paddock.
· "A Stark Reality: New Rules We Need To Know, Part I," AHLA Teleconference (August 14, 2008). Presenter: Michael W. Paddock.
· "Overpayments: If, When and How to Self-Disclose," Part B News Teleconference (July 9, 2008). Presenter: Michael W. Paddock.
· "With No Contract, What Is A Fair Rate? The Non-Participating Provider Reimbursement Conundrum," Blue Cross and Blue Shield Association 42nd Annual Lawyers' Conference (May 9, 2008). Presenters: Chris Flynn and Michael W. Paddock.
· "Managed Care Litigation Developments: Legal and Practical Considerations for Health Plan Counsel," UHG Attorney and Regulatory Affairs Senior Leadership Retreat (March 14, 2008). Co-Presenters: Chris Flynn and Michael W. Paddock.
· "The Use of Information and Incentives in the Pursuit of Better Healthcare," 2008 AHIP Law Forum (March 2008). Co-Presenters: Christine C. Rinn, Michael W. Paddock and William I. Kramer (Aetna).
· "What's a Doc to Do? Stark Phase III & Anti-Markup Rules: The Impact on Physician Relationships and Ventures," Beyond Anti-Markup: "Stand In The Shoes" and Other Practical Implications - The ABA Health Law Section and the ABA Center for Continuing Legal Education (February 6, 2008). Presenter: Michael W. Paddock.
· "U.S. v. Sulzbach: Government Theories, Potential Defenses, and Lessons Learned," Crowell & Moring's 2007 Healthcare Ounce of Prevention Seminar (HOOPS) (October 2007). Co-Presenters: David W. O'Brien, Christine C. Rinn and Michael W. Paddock.
· "U.S. v. Sulzbach: What Every Compliance Officer Needs to Know," AdvaMed Device and Diagnostics Compliance Group Meeting (October 4, 2007). Co-Presenters: David W. O'Brien and Michael W. Paddock.
· "U.S. v. Sulzbach: Government Theories, Potential Defenses, and Lessons Learned," Crowell & Moring U.S. v. Sulzbach Webinar (September 26, 2007). Co-Presenters: David W. O'Brien, Christine C. Rinn and Michael W. Paddock.
· "Managed Care Litigation Developments: Legal and Practical Considerations for Health Plans and Providers," AHLA Teleconference (July 24, 2007). Co-Presenters: Tracy A. Roman, Michael W. Paddock and Glenn E. Solomon.
· "Safe Harbors and Exceptions for E-Prescribing and Electronic Health Records: What Now?," Blue Cross and Blue Shield Association 41st Annual Lawyers' Conference (May 3, 2007). Co-Presenters: Benjamin T. Butler and Michael W. Paddock.
· "Managed Care Litigation Developments: Legal and Practical Considerations for Health Plans and Providers," AHLA Teleconference co-sponsored by the HMOs and Health Plans and In-House Counsel Practice Groups (March 20, 2007). Co-Presenters: Julie A. Barnes, Michael W. Paddock and Glenn E. Solomon.
· "Giving IT Away: Promoting the Use of Electronic Health Record and E-Prescribing Technology," Crowell & Moring Healthcare Ounce of Prevention Seminar (October 27, 2006). Co-Presenters: Benjamin T. Butler and Michael W. Paddock.
· "New Trends in Managed Care Litigation - Class Actions, Non-Par Provider Payment Issues, and More," Crowell & Moring Healthcare Ounce of Prevention Seminar (October 26, 2006). Co-Presenter: Michael W. Paddock.
· "The Fraud & Abuse Issues That Keep Our Physician-Clients Up at Night... and What They Are Doing About It," BRK Health Care Conference (June 2006). Presenter: Michael W. Paddock.
· "Whistling While You Work: Dangers of a Qui Tam Lawsuit and How to Avoid Them," Crowell & Moring Healthcare Ounce of Prevention Seminar (October 27, 2005). Co-Presenters: John T. Brennan, Jr., David W. O'Brien and Michael W. Paddock.