Frank E. Sheeder III

Frank has advised clients from virtually all segments of the health care industry, such as health systems, hospitals, academic medical centers, physician groups, DME providers, long-term care providers, ancillary providers, pharmacies, laboratories, and allied health professionals. Those cases generally involve Medicare, Medicaid, and other federally funded health care programs. He also has defended putative class actions and civil cases involving parallel criminal proceedings. He has been counsel of record in more than 30 criminal cases in federal district court.

Texas; U.S. Supreme Court; U.S. Court of Appeals for the Fifth Circuit; and U.S. District Courts for the Western, Eastern, Northern, and Southern Districts of Texas

Boston University (J.D. 1987); Duke University (B.A. cum laude 1984)

Civil Litigation

Defense of federal False Claims Act case against hospital, physicians, and related entities and individuals alleging false billings to Federal health care programs. Achieved dismissal of the claims brought by relators, who were physicians and others formerly affiliated with the defendants, on the first motion to dismiss. Thereafter, the parties reached a mutually agreeable settlement.

Defense of federal False Claims Act case against a physician and a hospital alleging billings for unnecessary surgeries.  Achieved dismissal of the claims brought by relator, who was a physician formerly affiliated with the defendants.

Defense of federal False Claims Act case against a health system and its hospitals alleging inappropriate billings to Federal health care programs for pharmacy items. Resolved claims brought by relator, a former nurse employed by one of the defendant hospitals, prior to trial with no liability to our client.

Defense of federal False Claims Act case against a hospital alleging improper billings to Federal health care programs for physician and physician extender services. Resolved claims prior to trial on terms that were highly favorable to our client.

Defense of federal False Claims Act case against a health system and other related defendants in which a former Chief Financial Officer alleged inappropriate billings to Federal health care programs for professional services.

Defense of putative state class action against a health system and its hospitals alleging inappropriate billings to private pay patients for pharmacy items.

Resolved claims brought by putative plaintiffs, who were former patients of one of the defendant hospitals, prior to trial with no liability to our client.

Defense of federal False Claims act case involving the alleged improper receipt of federal Medicaid matching funds.

Defense of health care provider in litigation involving billings for services that were allegedly medically unnecessary.

Defense of provider of Medicaid services to children and families regarding allegations that services were not necessary and appropriate.

Defense of physician group in parallel civil and criminal cases involving allegations of improper coding and billing for services that were not rendered.

Defense of pharmacy provider relating to allegations of non-compliance with DEA record keeping regulations and controlled substance diversion issues.

Defense of physician who was alleged to have diverted controlled substances and violated DEA record keeping regulations.

Internal Investigations

Multiple internal investigations related to hospital documentation, coding, and billing issues.

Numerous internal investigations related to physician documentation, coding, and billing issues.

Investigations relating to potential non-compliance with physician supervision standards.

Various investigations related to potential non-compliance with regard to documentation, coding and billing for long-term care services.

Several investigations relating to potential non-compliance with the Stark Law and the Anti-Kickback Statute.

Voluntary Disclosures

Internal investigation and subsequent disclosure regarding potential upcoding.

Internal investigation and subsequent disclosure regarding potential upcoding.

Internal investigation and subsequent disclosure regarding potentially inappropriate billing for services that were not rendered.

Several internal investigations and subsequent disclosures regarding claims for services that were not properly coded.

Compliance Advice and Counsel

Advice and counsel to virtually all types of health care providers about potential non-compliance with Federal and State health care laws and regulations, including, but not limited to:

Advice and counsel to virtually all types of health care providers about potential non-compliance with Federal and State health care laws and regulations, including, but not limited to:

• Health systems
• Hospitals
• Clinics
• Physician groups
• Mental health providers
• Providers of services to children
• Durable medical equipment suppliers
• Ancillary service providers
• Physician extenders
• Therapists
• Imaging providers

Criminal Matters

Representation of hospital system executives before the Federal Grand Jury.

Representation of hospital system executives before the Federal Grand Jury.

Defense of durable medical equipment provider regarding Federal search warrant.

Defense in Federal District Court of a physician charged with billing Federal health care programs for services that were not necessary and services that were not provided.

Defense in Federal District Court of individual charged with insurance fraud and related offenses.

Defense of former chairman of a savings and loan institution in Federal District Courts charged with bank fraud and related offenses.

Representation of former chairman of a savings and loan institution in successful effort to obtain a Federal District Court order reducing his sentence.

Defense of attorney charged in Federal District Court with mail fraud, wire fraud, and related offenses.

Defense of individual charged in Federal District Court with tax evasion and related offenses.

Defense of individual charged in Federal District Court with obstruction of justice.

Defense of various defendants in several cases in which they were charged with bank fraud in Federal District Court.

Representation of Criminal Justice Act clients in over a dozen Federal criminal proceedings.