Elizabeth-Ann S. Foley is a Shareholder in the firm’s Litigation and Dispute Resolution practice, where she brings thirty years of specialized experience in health care corporate and litigation actions involving health care fraud and abuse, Medicare, Medicaid and third- party payer billing and coding audits, white-collar civil and criminal investigations, physician and other health care practitioner disciplinary matters and corporate compliance.
Elizabeth is uniquely situated to represent her health care clients as she served as an assistant attorney general in the Commonwealth of Massachusetts Office of the Attorney General for over ten years, five of which were with the Medicaid Fraud Control Unit. She also held the position of senior counsel in Blue Cross Blue Shield of Massachusetts, Inc.’s Fraud Investigation and Prevention Unit.
Elizabeth has a wide range of experience handling complex health care fraud and abuse matters and employment issues before the trial courts throughout the Commonwealth of Massachusetts. She counsels hospitals, physician and dental practices, health care and behavioral health providers, pharmacists, clinical laboratories, durable medical equipment suppliers, ambulance companies, and skilled nursing and assistive living facilities with issues involving employment, billing and coding, compliance with reporting and self-disclosure protocols, data security breaches, DEA investigations, HIPAA privacy and security issues, the Anti-Kickback Statute, and state and federal false claims acts, among others.
Elizabeth has expertise in advising health care practitioners with licensing and/or disciplinary actions before various professional boards, such as the Massachusetts Board of Registration in Medicine. She also guides clients through all phases of state and federal governmental inquiries and investigations involving health care, including responding to subpoenas and civil investigative demands, the rendering of grand jury testimony, and addressing the execution of search warrants.
Awards & Honors
Best Lawyers in America, Health Care Law, 2021
Recipient of Attorney General Francis X. Bellotti Award for Excellence
- Represent and defend health care providers in complex Medicare, Medicaid and commercial payor audits and criminal and civil investigations; navigate clients through the audit, recoupment, appeals and settlement processes
- Represent providers in investigative and disciplinary matters before professional licensing authorities, such as the Board of Registration in Medicine, Board of Registration in Pharmacy, and the Bureau of Health Professions Licensure
- Conduct internal investigations, identify areas of vulnerability and develop comprehensive compliance plans specific to the unique needs of health care facilities and large physician organizations to ensure compliance with state and federal rules and regulations
- Successfully resolved a two-year DEA investigation of a long-term care pharmacy, resulting in no criminal charges and a restitution settlement with a corrective action plan
- Successfully challenged a preliminary injunction and multi-count civil complaint against a medical marijuana dispensary resulting in a dismissal of the client as a named party
- Secured a 100% reduction of a six figure monetary demand issued by a health plan against a physician, with no additional compliance obligations imposed
- Successfully defended a physician in a Medicaid proceeding that sought the immediate suspension of the physician from the Medicaid program
- Successfully defended a hospital in Office for Civil Rights and Office of the Attorney General investigations of alleged violations of the HIPAA Privacy and Breach Notification Rules and the Data Breach Notification Law, respectively
Articles & Talks
- Moderator, “Credible Allegations of Medicaid Fraud and Mandatory Payment Suspensions”, Boston Bar Association
- Presenter, “Medical Billing and Coding Audits and Investigations”, University Medicine Foundation Leadership Academy/Bryant University Executive Development Center, CE
- Presenter, “Dental Billing & Coding Audits and Investigations”, Yankee Dental Congress, CE
- Moderator, “Practicing before the Massachusetts Board of Registration in Medicine”, Boston Bar Association, CLE
- Presenter, “Payer Audits and Payment Recoupments”, Massachusetts Medical Society, CME
- Co-author, “Practice Tips for Handing Overpayments, Payer Audits & Demands for Payment Recoupments”, Massachusetts Medical Society
- Presenter, “Medical Billing & Coding Audits and Investigations”, Massachusetts Academy of Dermatology Spring Meeting, CME
- Presenter, “Medical Billing & Coding Audits and Investigations, Massachusetts Medical Society, Interspecialty Committee
- Suffolk University School of Law, J.D., cum laude, 1990
- College of the Holy Cross, B.A., 1984
- U.S. District Court for the District of Massachusetts
- United States Court of Appeals for the First Circuit
Outside the Office
Elizabeth served as the first dean of students at her alma mater Suffolk University Law School. She unwinds by cooking, practicing yoga, and traveling.