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.
