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Edwin D. Rauzi

Ed Rauzi knows how government programs pay the health care industry and the “compliance” the programs exact as part of the exchange. He can speak in code (e.g., CPT, ICD-9, HCPCS, NDC) when necessary. Ed designs and implements corporate compliance plans, investigates allegations of “false” claims, defends organizations in whistleblower lawsuits, and negotiates and implements Corporate Integrity Agreements. Ed monitors emerging health care issues and advises clients of the potential implications for their operations.

Practice Highlights
  • Assisted hospital in responding to pneumonia upcoding investigation and negotiating and implementing Corporate Integrity Agreement
  • Assisted hospital system in investigating Stark issue, drafting and submitting voluntary disclosure, and negotiating and implementing Corporate Integrity Agreement
  • Assisted oncology contractor in investigation of modifier use in claims submission, negotiation of settlement with assistant U.S. attorney (with no Corporate Integrity Agreement)
  • Assisted hospital in responding to whistleblower complaint and member of team that obtained summary judgment dismissing lawsuit
  • Assisted hospital in investigating disproportionate share payments issue and negotiating Corporate Integrity Agreement

Professional & Community Activities

  • American Health Lawyers Association (AHLA)
  • Health Care Compliance Association (HCCA)