Michael E. Paulhus (Mike)

• United States ex rel. Senters v. Quest Diagnostics, Inc. et al., No. 1:10-cv-02202-SCJ (N.D. Ga.); No. 24-12998 (11th Cir.). Secured dismissal of successive amended complaints with court rejecting novel theory and confirming a relator must plead the actual submission of a claim that was not medically necessary to satisfy the falsity element of an FCA violation. Eleventh Circuit upheld the ruling and the Supreme Court denied cert.
• State ex rel. Rapier v. SRCC Assocs., LLC, et al., Case No. BC 641254 (Cal. Super. Ct). Won a complete defense verdict 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. This win was confirmed on appeal.
• Regional Hospital in qui tam complaint alleging violations of the False Claims Act, Anti-Kickback Statute (AKS), and Stark Law, based on hospital purchase of medical devices from entity related to a physician. The Court dismissed all federal claims with prejudice for failure to state a claim and dismissed corporate parent. The opinion included important holdings favorable to defendants on scope of Stark and AKS
• National Hospice Provider: in DOJ investigation concerning improper medical director relationships. Engaged with the government and was successful in obtaining a declination and dismissal.
• 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.
• 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.
• 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.

Michael Paulhus has defended a wide range of healthcare and life science clients in more than 65 high-stakes federal and state healthcare false claims and qui tam matters in courts and U.S. Attorney's Offices across the country as well as parallel criminal and administrative investigations. Chambers USA recognizes Mike nationally for False Claims Act defense work and as a Band 1 Healthcare attorney in Georgia, describing him as \"a go-to attorney for providers facing external investigations and enforcement actions, as well as False Claims Act suits.\" 

Mike represents a wide range of healthcare and life sciences clients including academic medical centers, national and regional hospital systems, health IT software developers, pharmaceutical, medical device and biologics manufacturers, physician group practices, retail, wholesale, and long-term-care pharmacies, laboratory companies, skilled nursing operators, assisted living facilities, behavioral health facilities, home health, hospice and palliative care providers, and durable medical equipment suppliers. 

Consulting firm, BTI, named Mike a Client Service All-Star in 2024 and 2022 as one of the attorneys nationwide “who stand above all the others in delivering the absolute best in client service.”  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 and established key precedent for future litigants, establishing no right to a jury trial for California Insurance Fraud Prevention Act cases (i.e., state private insurance False Claims Act). 

Mike also teaches a Healthcare Fraud & Abuse seminar at Georgia State University School of Law, and he serves as a member of the Board of Directors of the American Health Law Association. He is actively involved in the community, serving on the Board of Directors of The Atlanta Opera.  

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