Christopher J. “CJ” Frisina

• Representing health care providers and suppliers in operational and regulatory matters, including arrangements that implicate the Stark Law and Anti-Kickback Statute.
• Drafting and evaluating compliance program policies and procedures for pharmaceutical manufacturers, mental health providers, and other health care and life sciences companies.
• Represented Medicare Advantage plans in an Administrative Procedure Act challenge to a plan-rating decision of the Centers for Medicare & Medicaid Services (CMS). UnitedHealthcare Benefits of Texas, Inc. v. Centers for Medicare & Medicaid Services, No. 6:24-cv-357 (E.D. Tex. 2024).
• Advising a Medicare Advantage organization (MAO) is revising and bolstering its risk adjustment practice in preparation for Risk Adjustment Data Validation (RADV) audits.
• Representing health care providers and suppliers, including medical device manufacturers, who are targets of criminal investigations led by the U.S. Department of Justice (DOJ).
• Defended a health system against False Claims Act (FCA) allegations, including allegations of violations of the Stark Law.
• Conducting internal compliance investigations addressing potential FCA violations.
• Served as interim compliance officer for a remote patient monitoring provider.
• Drafting self-disclosures and advisory opinion requests to the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG).
• Responding to government investigations and conducting internal investigations for skilled nursing facilities and other senior living providers on issues including documentation and coding, physician certifications, MDS requirements, laboratory testing (including COVID-19), and employment of excluded persons.
• Advising pharmaceutical manufacturers on promotional labeling practices and review.
• Representing health care entities and excluded providers before the HHS OIG Departmental Appeals Board (DAB) and in federal court.
• Represented public health scholars as amicus curiae in Administrative Procedure Act challenges to (1) CMS’s imposition of work requirements on the Medicaid program in Kentucky and New Hampshire and Homeland Security’s revision of the “public charge” rule. See, e.g., City & Cty. of S.F. v. U.S. Citizenship & Immigration Servs., 408 F. Supp. 3d (N.D. Cal. 2019) and Philbrick v. Azar, 397 F. Supp. 3d 11 (D.D.C. 2019).

Pro Bono Representation

• Appealed a provider’s exclusion from federal health programs before an HHS administrative law judge, the DAB, and in federal court.
• Appealed a district court’s denial of a petition for a writ of habeas corpus before the U.S. Court of Appeals for the Seventh Circuit.
• Appealed a district court’s denial of a motion to exclude evidence, arguing that law enforcement stopped the defendant’s vehicle without the reasonable articulable suspicion required by the Fourth Amendment.

Christopher J. (“CJ”) Frisina focuses his practice on health care fraud, abuse, and compliance matters. CJ works with hospitals and health systems, telehealth providers, skilled nursing facilities, pharmaceutical manufacturers, group purchasing organizations, pharmaceutical benefit managers, retail and specialty pharmacies, and Medicare Advantage organizations (MAOs), amongst several others.

CJ assists his clients in avoiding fraud, waste, and abuse liability by bolstering corporate compliance programs, investigating potential instances of non-compliance, and defending clients during government criminal, civil, and administrative investigations, including False Claims Act (FCA) investigations, led by the U.S. Department of Justice (DOJ), the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG), and other federal agencies related to the Federal health care programs (e.g., Medicare, Medicaid, Tricare, etc.).

CJ also advises MAOs in navigating the Centers for Medicare & Medicaid Services’ (CMS) risk adjustment regulations and guidance, including preparing for Risk Adjustment Data Validation (RADV) audits. He also assists MAOs in building, maintaining, and overseeing relationships with risk-bearing provider groups (including Independent Physician Organizations), plans, and other vendors.

CJ also represents clients in challenging unlawful government regulations, funding decisions, and other agency actions under the Administrative Procedure Act (APA) in federal courts.

Bar Admissions

• District of Columbia
• U.S. Supreme Court

Education

• American University (J.D., 2015)
• American University (M.P.P., 2015)
• Emmanuel Christian Seminary (M.A.R., 2011)
• Johnson University (B.A., 2008)

Memberships