Brian Michael Oloughlin

Brian is the attorney who has been on all sides of the healthcare audit and investigative process. As a former healthcare fraud investigator for Qlarant, Brian used to put together UPIC Medicare and Medicaid investigations. Now Brian, who is also a registered nurse and former state prosecutor, takes those cases apart for clients.

Brian's experience as a former healthcare fraud investigator for Qlarant, CMS's largest Unified Program Integrity Contractor (UPIC), state Deputy Attorney General, and registered healthcare provider, gives clients unmatched perspective and experience in defending Medicare, Medicaid, and UPIC audit demands, fraud, waste and abuse (FWA) investigations, administrative hearings, civil and criminal enforcement matters, and related regulatory proceedings. Brian knows how to defend these cases because he used to build them for federal and state governments.

Inside the UPIC
As a Qlarant healthcare fraud investigator, Brian assembled and referred cases involving hundreds of millions of dollars in Medicare and Medicaid billing to CMS, HHS-OIG, and federal law enforcement. Brian also oversaw Qlarant's investigative pipeline and processes, including audits, document demands, investigative interviews, data mining and analytics, and statistical modeling. Whether it be Qlarant, or another UPIC like SafeGuard Services or CoventBridge, Brian has the inside knowledge and experience necessary to neutralize these inquiries at an early stage, before risks grow.

Clinical practice, not just the billing record
Brian also knows and understands the clinical practice of medicine and still maintains an active New York Registered Nurse license. Prior to law school, Brian worked in Emergency Departments and Intensive Care Units before transitioning into Quality Assurance/Improvement and Program Auditor roles. These roles provide critical insights on understanding medical necessity, documentation sufficiency, and underlying clinical rationale in ways that an auditor's clinical review rarely captures.

State prosecution
As a state prosecutor, Brian was responsible for investigating and prosecuting public corruption and other white-collar frauds. Health Law Alliance is built by former prosecutors, and enforcement pressure now runs through federal and state channels alike, with Medicaid administered at the state level. Brian's Deputy Attorney General experience sits directly on that track.