Brian Michael Oloughlin

I am a healthcare attorney with Health Law Alliance, representing healthcare providers, professionals, and organizations in regulatory, compliance, reimbursement, audit, and enforcement matters.

My practice includes Medicare and Medicaid audits and appeals, UPIC investigations, overpayment demands, payment suspensions, payer and PBM disputes, fraud and abuse matters, healthcare regulatory compliance, business disputes, and select professional-liability matters.

Before practicing law, I worked as a Registered Nurse in emergency and critical care, later moving into healthcare operations, quality improvement, and auditing. I then worked as a Qlarant UPIC healthcare fraud investigator, reviewing Medicare and Medicaid claims, medical records, billing patterns, and potential fraud, waste, and abuse.

I also served in law enforcement and later as a New Jersey Deputy Attorney General investigating and prosecuting public corruption matters.

That background gives me a practical view of healthcare disputes from several angles: clinical care, billing and operations, government auditing, investigations, and litigation. I regularly work claim by claim and record by record to understand what happened, what the governing rule required, how an auditor or investigator is likely to view the evidence, and how best to protect the provider going forward.

Healthcare matters rarely stay in one category. A documentation problem can become an overpayment demand. An audit can develop into a payment suspension or investigation. A reimbursement dispute can create regulatory or business consequences.

My goal is to help healthcare clients understand the real risk, build a defensible factual record, and respond strategically before an administrative problem becomes a larger enforcement matter.

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