People

Mike Paulhus, a healthcare litigation partner, specializes in defending providers in government investigations, False Claims Act litigation, and crisis management. He also brings to bear his fraud and abuse defense expertise in proactive compliance assessments, regulatory counseling, and the submission of self-disclosures to regulators. A regular author and presenter, Mike also serves as an adjunct faculty member, teaching a Healthcare Fraud & Abuse seminar at Georgia State University School of Law.

Chambers USA has recognized Mike from 2017 to 2020, describing him as “a go-to attorney for providers facing external investigations and enforcement actions, as well as False Claims Act suits.”  In 2019, Mike took to trial and won a significant healthcare fraud case against the California Department of Insurance (CDI) and a relator in a major Insurance Frauds Prevention Act trial in Los Angeles County Superior Court, which was recognized as one of the Daily Journal’s 2019 Top California Verdicts.

Mike represents a wide range of clients across the healthcare delivery spectrum.  His clients have included academic medical centers, national and regional hospital systems, schools of medicine, pharmaceutical, medical device and biologics manufacturers, physician group practices, retail and long-term-care pharmacies, laboratory companies, skilled nursing facility operators, behavioral health facilities, home health, hospice and palliative care providers, and durable medical equipment suppliers. 

Mike is actively involved in the community, serving as Secretary to the Board of Directors of The Atlanta Opera and Chairman of the American Health Law Association Fundamentals of Health Law Conference.

He served as a law clerk to the Honorable Kenneth F. Ripple, U.S. Court of Appeals for the Seventh Circuit.

Full Bio

Credentials

J.D., Washington and Lee University, summa cum laude, Order of the Coif

B.A., Boston College, summa cum laude, Phi Beta Kappa

District of Columbia

Georgia

Supreme Court of the United States

U.S. Court of Appeals for the Eleventh Circuit

U.S. Court of Appeals for the Second Circuit

U.S. Court of Appeals for the Seventh Circuit

U.S. District Court for the Central District of Illinois

U.S. District Court for the Middle District of Georgia

U.S. District Court for the Northern District of Georgia

Law Clerk, Honorable Kenneth F. Ripple, U.S. Court of Appeals for the Seventh Circuit

American Bar Association

American Health Law Association

Federal Bar Association

Georgia Academy of Healthcare Attorneys

LEAD Atlanta, Class of 2012

Leadership Atlanta, Class of 2016

Order of the Coif, Washington & Lee University School of Law, 2002

Phi Beta Kappa, Boston College, 1999

Band 4


Chambers USA 2020

"Up and Coming"


Chambers USA 2017, 2018, 2019

Healthcare: Georgia


Super Lawyers, 2017-2019

Healthcare Rising Star: Georgia


Super Lawyers, 2010–2016

MVP of Healthcare


Law360, 2014

Rising Star in Healthcare


Law360, 2013

40 Under 40 Georgia Attorneys On the Rise


The Daily Report, 2013

Outstanding Young Healthcare Lawyers


Nightingale’s Healthcare News, 2009

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Recognition

Band 4


Chambers USA 2020

"Up and Coming"


Chambers USA 2017, 2018, 2019

Healthcare: Georgia


Super Lawyers, 2017-2019

Healthcare Rising Star: Georgia


Super Lawyers, 2010–2016

MVP of Healthcare


Law360, 2014

Rising Star in Healthcare


Law360, 2013

40 Under 40 Georgia Attorneys On the Rise


The Daily Report, 2013

Outstanding Young Healthcare Lawyers


Nightingale’s Healthcare News, 2009

Matters

State ex rel. Rapier v. SRCC Assocs., LLC, et al., Case No. BC 641254 (Cal. Super. Ct). Won a complete defense verdict on behalf of Prime Healthcare, a 45-hospital system, and its affiliate, Encino Hospital, against the California Department of Insurance (CDI) and a relator in a significant Insurance Frauds Prevention Act (IFPA) trial in Los Angeles County Superior Court. The Court rejected the CDI’s claims, finding no evidence of fraud and establishing a precedent-setting verdict for healthcare providers.

Representing multiple healthcare providers in various stages of government investigations as well as False Claims Act litigation with private relators and the U.S. Department of Justice.

Won three successive cases for long-term-care pharmacy Omnicare defending against FCA allegations by serial relator Fox Rx:

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Matters

State ex rel. Rapier v. SRCC Assocs., LLC, et al., Case No. BC 641254 (Cal. Super. Ct). Won a complete defense verdict on behalf of Prime Healthcare, a 45-hospital system, and its affiliate, Encino Hospital, against the California Department of Insurance (CDI) and a relator in a significant Insurance Frauds Prevention Act (IFPA) trial in Los Angeles County Superior Court. The Court rejected the CDI’s claims, finding no evidence of fraud and establishing a precedent-setting verdict for healthcare providers.

Representing multiple healthcare providers in various stages of government investigations as well as False Claims Act litigation with private relators and the U.S. Department of Justice.

Won three successive cases for long-term-care pharmacy Omnicare defending against FCA allegations by serial relator Fox Rx:

United States ex rel. Fox Rx., Inc. v. Omnicare, Inc., No. 1:11-cv-962-WSD, 2014 WL 2158412 (N.D. Ga. May 23, 2014). Won complete summary judgment and award of costs (and preceding successive motions to dismiss) for Omnicare in FCA qui tam litigation regarding the scope of Medicare Part D drug coverage. In the first order, five of eight claims were dismissed with prejudice and three with leave to replead. See 2012 WL 8020674 (Aug. 29, 2012). In its second order, the Court dismissed two counts and significantly restricted the remaining theories, dismissing relator’s attempt to proceed with purported nationwide claims on behalf of all Part D plans. See 2013 WL 2303768 (May 17, 2013).

United States ex rel. Fox Rx., Inc. v. Omnicare, Inc., No. 1:12-cv-00275-DLC, 2014 WL 3928780 (S.D.N.Y. Aug. 12, 2014). Won motion to dismiss for Omnicare in FCA qui tam litigation regarding generic drug substitution and National Drug Codes.

United States ex rel. Fox Rx., Inc. v. Dr. Reddy’s Inc. et al., No. 1:13-cv-3779-DLC, 2014 WL 6750277 (S.D.N.Y. Dec. 1, 2014). Won motion to dismiss for Omnicare in FCA qui tam litigation regarding Medicare Part D dispensing fees and Anti-Kickback Statute allegations regarding generic drug rebates.

United States ex rel. Stephens v. Tissue Science Laboratories, Inc., 664 F. Supp. 2d 1310 (N.D. Ga. 2009). Won dismissal for medical device manufacturer in False Claims Act litigation regarding allegations of off-label promotion of hernia repair mesh. The decision created important precedent advancing the principle that Medicare DRG payments for inpatient services can preclude a finding of materiality under the FCA for products bundled within the DRG payment.

Secured declination to intervene by the DOJ and subsequent dismissal of the complaint by the plaintiff/relator following an investigation in parallel FCA qui tam suits against two regional healthcare systems.

Represented leading pharmaceutical companies in investigations into physician interaction practices, off-label promotion, and safety of various prescription drugs by the DOJ, multiple state attorneys general and private litigants.

Matters

State ex rel. Rapier v. SRCC Assocs., LLC, et al., Case No. BC 641254 (Cal. Super. Ct). Won a complete defense verdict on behalf of Prime Healthcare, a 45-hospital system, and its affiliate, Encino Hospital, against the California Department of Insurance (CDI) and a relator in a significant Insurance Frauds Prevention Act (IFPA) trial in Los Angeles County Superior Court. The Court rejected the CDI’s claims, finding no evidence of fraud and establishing a precedent-setting verdict for healthcare providers.

Representing multiple healthcare providers in various stages of government investigations as well as False Claims Act litigation with private relators and the U.S. Department of Justice.

Won three successive cases for long-term-care pharmacy Omnicare defending against FCA allegations by serial relator Fox Rx:

See more
Icon close

Close

Matters

State ex rel. Rapier v. SRCC Assocs., LLC, et al., Case No. BC 641254 (Cal. Super. Ct). Won a complete defense verdict on behalf of Prime Healthcare, a 45-hospital system, and its affiliate, Encino Hospital, against the California Department of Insurance (CDI) and a relator in a significant Insurance Frauds Prevention Act (IFPA) trial in Los Angeles County Superior Court. The Court rejected the CDI’s claims, finding no evidence of fraud and establishing a precedent-setting verdict for healthcare providers.

Representing multiple healthcare providers in various stages of government investigations as well as False Claims Act litigation with private relators and the U.S. Department of Justice.

Won three successive cases for long-term-care pharmacy Omnicare defending against FCA allegations by serial relator Fox Rx:

United States ex rel. Fox Rx., Inc. v. Omnicare, Inc., No. 1:11-cv-962-WSD, 2014 WL 2158412 (N.D. Ga. May 23, 2014). Won complete summary judgment and award of costs (and preceding successive motions to dismiss) for Omnicare in FCA qui tam litigation regarding the scope of Medicare Part D drug coverage. In the first order, five of eight claims were dismissed with prejudice and three with leave to replead. See 2012 WL 8020674 (Aug. 29, 2012). In its second order, the Court dismissed two counts and significantly restricted the remaining theories, dismissing relator’s attempt to proceed with purported nationwide claims on behalf of all Part D plans. See 2013 WL 2303768 (May 17, 2013).

United States ex rel. Fox Rx., Inc. v. Omnicare, Inc., No. 1:12-cv-00275-DLC, 2014 WL 3928780 (S.D.N.Y. Aug. 12, 2014). Won motion to dismiss for Omnicare in FCA qui tam litigation regarding generic drug substitution and National Drug Codes.

United States ex rel. Fox Rx., Inc. v. Dr. Reddy’s Inc. et al., No. 1:13-cv-3779-DLC, 2014 WL 6750277 (S.D.N.Y. Dec. 1, 2014). Won motion to dismiss for Omnicare in FCA qui tam litigation regarding Medicare Part D dispensing fees and Anti-Kickback Statute allegations regarding generic drug rebates.

United States ex rel. Stephens v. Tissue Science Laboratories, Inc., 664 F. Supp. 2d 1310 (N.D. Ga. 2009). Won dismissal for medical device manufacturer in False Claims Act litigation regarding allegations of off-label promotion of hernia repair mesh. The decision created important precedent advancing the principle that Medicare DRG payments for inpatient services can preclude a finding of materiality under the FCA for products bundled within the DRG payment.

Secured declination to intervene by the DOJ and subsequent dismissal of the complaint by the plaintiff/relator following an investigation in parallel FCA qui tam suits against two regional healthcare systems.

Represented leading pharmaceutical companies in investigations into physician interaction practices, off-label promotion, and safety of various prescription drugs by the DOJ, multiple state attorneys general and private litigants.

Credentials

J.D., Washington and Lee University, summa cum laude, Order of the Coif

B.A., Boston College, summa cum laude, Phi Beta Kappa

District of Columbia

Georgia

Supreme Court of the United States

U.S. Court of Appeals for the Eleventh Circuit

U.S. Court of Appeals for the Second Circuit

U.S. Court of Appeals for the Seventh Circuit

U.S. District Court for the Central District of Illinois

U.S. District Court for the Middle District of Georgia

U.S. District Court for the Northern District of Georgia

Law Clerk, Honorable Kenneth F. Ripple, U.S. Court of Appeals for the Seventh Circuit

American Bar Association

American Health Law Association

Federal Bar Association

Georgia Academy of Healthcare Attorneys

LEAD Atlanta, Class of 2012

Leadership Atlanta, Class of 2016

Order of the Coif, Washington & Lee University School of Law, 2002

Phi Beta Kappa, Boston College, 1999

Band 4


Chambers USA 2020

"Up and Coming"


Chambers USA 2017, 2018, 2019

Healthcare: Georgia


Super Lawyers, 2017-2019

Healthcare Rising Star: Georgia


Super Lawyers, 2010–2016

MVP of Healthcare


Law360, 2014

Rising Star in Healthcare


Law360, 2013

40 Under 40 Georgia Attorneys On the Rise


The Daily Report, 2013

Outstanding Young Healthcare Lawyers


Nightingale’s Healthcare News, 2009

Icon close

Close

Recognition

Band 4


Chambers USA 2020

"Up and Coming"


Chambers USA 2017, 2018, 2019

Healthcare: Georgia


Super Lawyers, 2017-2019

Healthcare Rising Star: Georgia


Super Lawyers, 2010–2016

MVP of Healthcare


Law360, 2014

Rising Star in Healthcare


Law360, 2013

40 Under 40 Georgia Attorneys On the Rise


The Daily Report, 2013

Outstanding Young Healthcare Lawyers


Nightingale’s Healthcare News, 2009