Erica Kraus is special counsel in the Corporate Practice Group in the firm's Washington, D.C. office.
Erica represents healthcare entities in regulatory compliance matters. She advises clients on reaching their goals in compliance with federal and state fraud and abuse laws, assists clients in responding to government investigations, and represents clients in False Claims Act litigation. Erica also assists clients with regulatory due diligence in transactional matters, and through advocacy with federal and state regulators, and leverages her background in health policy to help clients maximize opportunities in the changing healthcare landscape. Representative matters include:
- Assisting in internal investigations of reported potential regulatory non-compliance
- Responding to government Civil Investigative Demands
- Representing defendants in False Claims Act litigation
- Advising clients in preparation for and during transactions in evaluating regulatory compliance and making related strategic decisions
- Advising clients on compliance with the Civil Monetary Penalties Law, Stark Law, and Anti-Kickback Statute
- Drafting and submitting self-disclosures through CMS' Self-Referral Disclosure Protocol
- Assisting clients with CMS Innovation Center model participation and compliance with applicable waivers
- Assisting clients in developing value-based compensation and support strategies and care coordination initiatives in compliance with applicable laws
- Advising clients on HCC strategy and compliance
- Preparing CMS Hearing Officer appeals of Medicare Advantage and Prescription Drug Plan application denials
- Appealing Medicare Administrative Contractor claim denials
- Advising clients on the implications of drug pricing reform
- Preparing filings with the Provider Reimbursement Review Board
- Advising clients on regulatory waivers and compliance during the COVID-19 pandemic
- Advising clients on the evolving MACRA implementation landscape and transition toward value-based care
Prior to joining the firm, Erica acted as a Perspective Reports intern for the New England Journal of Medicine, where she reviewed and summarized health law and policy news, and worked as an intern for the U.S. Department of Health and Human Services, focusing particularly on employment law projects, including preparing for EEOC, MSPB and federal district court litigation. Erica currently serves as an Adjunct Professorial Lecturer at American University's Washington College of Law, teaching on the False Claims Act in the Healthcare Industry.
