Michael E Paulhus (Mike)

Mike Paulhus is a partner in King & Spalding’s Healthcare Group in the firm’s Atlanta office.  Mr. Paulhus represents healthcare industry clients in False Claims Act cases, internal investigations, and complex business litigation.  He also provides compliance advice on healthcare regulatory issues.  He speaks and publishes regularly on FCA developments, defending whistleblower cases, and government investigations. 

In September 2009, Nightingale’s Healthcare News named Mr. Paulhus one of twelve Outstanding Young Healthcare Lawyers, highlighting his work in defending clients in various government investigations and FCA cases.  Georgia Super Lawyers also listed Mr. Paulhus as a Rising Star in the field of Healthcare in 2010, 2011, and 2012.

Mr. Paulhus’s clients have included academic medical centers; regional hospital systems; a publicly-traded hospital corporation; multi-national pharmaceutical, medical device, and biologics manufacturers; health insurers; physician group practices; retail and long term care pharmacies; and a disease management provider. 

His healthcare expertise is diverse and includes representation in matters concerning off-label promotion of pharmaceuticals, medical devices, and biologics; quality of care allegations; Medicare and Medicaid billing; radiation oncology; supplemental Medicaid funding programs (DSH and UPL); FDA 510(k) approval for medical devices; clinical trial billing; pharmacy reimbursement; Medicare Part D prescription drug program; peer review litigation; and the rights of residents of mental health facilities.

Presentations

• Georgia Indigent Care Trust Fund—Ensuring Participant Compliance, Georgia Hospital Association TelNet (November 1, 2011).
  
  
• Trends in Fraud & Abuse Enforcement After Healthcare Reform, Georgia Chapter of the Association of Certified Fraud Examiners (August 5, 2011).
  
  
• Turning up the HEAT:  Healthcare Fraud Enforcement in the Current Environment, Georgia Academy of Healthcare Attorneys (May 12, 2011).
  
  
• Defending False Claims Act and Whistleblower Cases, K&S University (April 14, 2011).
  
  
• Nuts & Bolts of Conducting Government and Internal Investigations, K&S University (April 12, 2011).
  
  
• Spoliation, Lies, and Magnetic Tape:  Best Practices for Successfully Handling Documents in a Healthcare Investigation, American Health Lawyers Association, Hospitals and Health Systems Law Institute (February 11, 2011).
  
  
• Best Practices for Conducting a Compliance Audit, HCCA SE Regional Conference (January 21, 2011).
  
  
• False Claims, Overpayments, and Audits, American Health Lawyers Association, Fundamentals of Health Law (October 24, 2010).
  
  
• Recent Changes to the False Claims Act, Navigant Consulting (July 13, 2010).
  
  
• Healthcare Reform Legislation, Part IV: Reform Driven Strategies and Tactics, K&S Healthcare Roundtable (May 21, 2010).
  
  
• Civil False Claims Act:  Basic Principles and Issues for Litigators, K&S University (November 19, 2009).
  
  
• A “Perfect Storm” in Fraud Enforcement?  False Claims Act Expansion, Audit Contractor Development, Self-Disclosure Developments and Fortified Enforcement Priorities, K&S Healthcare Roundtable (July 17, 2009).
  
  
• Nuts & Bolts Litigation Skills:  Discovery Conferences and Initial Disclosures (March 28, 2007).
  
  
• Public Corruption Cases and Lobbying Compliance in the Post-Abramoff World (March 27, 2007).

Publications

• Michael E. Paulhus,  Northern District of New York Rejects Whistleblower Allegations, Finding Certain Regulatory Violations Are Not Conditions of Payment That Trigger False Claims Act Liability, Health Briefs, AHLA Healthcare Liability & Litigation E-Newsletter (February 22, 2011).
  
  
• Michael E. Paulhus, False Claims Act:  Key Concepts, Recent Changes, and Effective Defense Strategies, American Health Lawyers Association, 2010 Fundamentals of Health Law.
  
  
• Richard L. Shackelford & Michael E. Paulhus,  Recent Changes to the False Claims Act:  The Impacts of FERA and the FCA Provisions of PPACA on Health Care Entities, American Health Lawyers Association/Health Care Compliance Association, 2010 Fraud & Compliance Forum.
  
  
• Christopher C. Burris, Michael E. Paulhus, & Louisa B. Childs, Converging Events Signal a Changing Landscape in False Claims Act and Whistleblower Litigation and Investigations, The Federal Lawyer, Nov/Dec 2009, at 59.
  
  
• Michael E. Paulhus, Fraud Enforcement and Recovery Act of 2009:  Recent Amendments to False Claims Act Highlight Need for Heightened Focus on Obligations to Repay Overpayments, Dennis Barry’s Reimbursement Advisor, Oct. 2009, at 1.
  
  
• Richard L. Shackelford, Michael E. Paulhus, & Jordan Stringer, Litigating FCA Cases:  Recent Decisions and Developments, American Health Lawyers Association, 2009 Annual Meeting.
  
  
• Sara Kay Wheeler and Michael Paulhus, The Revised PhRMA Code: Implications For Provider Conflict-of-Interest Policies, Compliance Today (Dec. 1, 2008).
  
  
• Non-Participating Provider Disputes: An Overview of Theories, Arguments, Defenses and Results, American Health Lawyers Association, 2008 Payors, Plans and Managed Care Law Institute (contributing author).
  
  
• King & Spalding Health Headlines (July 2008-December 2011) (numerous entries reporting on False Claims Act and healthcare fraud litigation developments).