About Kathy P. Josephson

Kathy Josephson counsels insurers regarding claims handling and litigation strategies to combat fraud and abuse. She advises insurers about all aspects of health care fraud investigations involving patterns of systemic fraud, including billing for unnecessary medical services or services not rendered, upcoding, unbundling, violating anti-kickback and patient brokering laws, as well as violating state licensure laws and prohibitions against corporate practice of medicine. In addition, she represents insurers in litigation across the country to pursue remedies through claims for fraud and Racketeer Influenced and Corrupt Organizations Act (RICO) violations.

The remedy for health care fraud

Kathy has successfully represented insurers in litigation involving claims for fraud, conspiracy, RICO, unjust enrichment and violations of the Illinois Insurance Claims Fraud Prevention Act and California Insurance Fraud Prevention Act against health care providers and others engaged in insurance fraud. The lawsuits in which Kathy has represented insurers have resulted in jury verdicts, summary judgments, default judgments and favorable settlements for insurers.

In addition to her litigation work, Kathy also counsels insurers on best claims-handling practices and strategies to reduce exposure to fraud. She has worked with insurance companies across the country to discover fraudulent claim trends and identify parties driving systemic fraudulent claims before they are made. With that information in hand, she works with her clients to formulate recovery strategies, if necessary.

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Practice Focus

  • Insurance fraud litigation
  • Health care fraud litigation
  • RICO
  • Claims handling practices
  • Whistleblower actions

Representative Experience

  • Represent worker's compensation insurer in RICO and fraud action in Texas against physician and compounding pharmacy. Alleges they performed and billed for medically unnecessary pain management injections and topical compounds.
  • Represent property and casualty insurer in RICO and fraud action in Florida against physician, clinics and others. Alleges clinics billed for medically unnecessary physical therapy services.
  • Represent property and casualty insurer in RICO and fraud action in Florida against chiropractors, physician and others. Alleges they performed and billed for medically unnecessary mobile electrodiagnostic and ultrasound tests.
  • Represent property and casualty insurer in RICO and fraud action in Michigan against physician and professional corporation. Alleges they performed and billed for electrodiagnostic tests that were medically unnecessary or not performed.
  • Represent property and casualty insurer in RICO and fraud action in Michigan against attorney and adjuster. Alleges they conspired to cause the insurer to pay millions of dollars more than was owed regarding catastrophic injury claims.
  • Represent property and casualty insurer in RICO and fraud action in Michigan against physicians, chiropractors and clinics. Alleges they performed and billed for chiropractic and medical services that were medically unnecessary or not performed.
  • Represent property and casualty insurer in RICO and fraud action in New York against wholesalers and retailers of durable medical equipment and orthotics. Alleges they billed for items that were not provided, were not medically necessary and were supported by fraudulent wholesale invoices.
  • Represent property and casualty insurer in RICO and fraud action in Michigan against physicians, clinics, MRI providers and others. Alleges they performed and billed for medical, physical therapy and MRI services that were medically unnecessary or not performed.
  • Represent health insurer in fraud action alleging that physician-owned entities in Texas fraudulently billed for facility fees performed in ambulatory surgery centers by the physician-owners based upon kickback arrangements between the centers and physicians.
  • Represent multimedia entertainment company that publishes internationally circulated magazine, operates television networks, and distributes programming via mobile and online platforms in obtaining judgment against evasive international publishers for breaching international trademark license agreement.