Medical Necessity on Trial: Defending Physician Practices and Hospitals in the 2026 False Claims Act Enforcement Wave

Brandon C. Helms, Shareholder | Hall, Render, Killian, Heath & Lyman, P.C

Brandon C. Helms spent eight years as an Assistant U.S. Attorney (civil and criminal) in the Eastern District of Michigan, where he ran grand jury investigations and civil False Claims Act investigations focused on health care fraud and white-collar crime. He is now a shareholder in Hall Render’s health regulatory section in Detroit, where he defends health care clients in federal False Claims Act investigations and litigation, conducts internal investigations, prepares self-disclosures to CMS and HHS-OIG, and answers subpoenas and civil investigative demands. His career spans more than 17 years across government and private practice.

• Education & Credentials

Brandon earned his J.D. summa cum laude from DePaul University College of Law in 2007, where he was elected to the Order of the Coif. He received his B.A. from Carthage College in 2004. He is admitted to practice in Illinois, Michigan, and the District of Columbia, and before the U.S. Supreme Court, the U.S. Courts of Appeals for the Sixth Circuit, the D.C. Circuit, and the Federal Circuit, the U.S. District Courts for the Eastern and Western Districts of Michigan, and the Trial Bar of the Northern District of Illinois. He is also registered to practice before the U.S. Patent and Trademark Office.

• Recognition & Leadership

Brandon serves as a vice-chair of the American Health Law Association’s Fraud and Abuse Practice Group, a national community of more than 1,500 health lawyers and professionals.

• Professional Involvement

He wrote “Compliance Program Lessons from the Complete Health Settlement” (2026) and appeared on AHLA’s Speaking of Health Law podcast in the episode “Behind the Seal: Why DOJ Investigations Drag On—and When They Shouldn’t” (2026). He is a member of the American Health Law Association, the Federal Bar Association’s Eastern District of Michigan Chapter, the Richard Linn American Inn of Court, and the Michigan IP Inn of Court.

• Experience

As a federal prosecutor, Brandon prosecuted or settled investigations involving the Anti-Kickback Statute, the Stark Law, and other false claims submitted to Medicare. In private practice, he served as co-lead counsel in persuading DOJ not to intervene in a qui tam action alleging medically unnecessary vascular studies. He has also served as lead counsel in securing DOJ non-intervention in a qui tam action against a hospital system over provider-based billing and in a qui tam action alleging laboratory kickbacks, and as lead counsel in a DOJ investigation of Stark physician payment issues.

He has submitted self-disclosures to HHS-OIG and CMS involving physician compensation and lease arrangements that exceeded fair market value. Over his career he has first- or second-chaired more than 10 federal trials. He began his practice in Chicago, representing companies in patent infringement litigation, including generic pharmaceutical companies in Hatch-Waxman cases.

J. Taylor Chenery, Member | Bass, Berry & Sims PLC

J. Taylor Chenery defends health care providers in Department of Justice investigations and False Claims Act lawsuits, including physician practices, health systems, hospice and home health providers, and Medicare Advantage organizations. A Member of Bass, Berry & Sims PLC in Nashville, he focuses on government investigations and the litigation that follows, with an emphasis on health care fraud and abuse. He also handles complex commercial litigation, from class actions to private arbitrations.

• Education & Credentials

Taylor received his J.D. from Emory University School of Law in 2008, where he was elected to the Order of the Coif, served as Notes and Comments Editor of the Emory Law Journal, and received the Charles E. Watkins Scholarship. He earned his B.A. from the University of Virginia in 2003. After law school, he clerked for the Honorable Samuel H. Mays, Jr. of the U.S. District Court for the Western District of Tennessee from 2008 to 2009. He is admitted to practice in Tennessee and before the U.S. District Court for the Eastern District of Wisconsin.

• Recognition & Leadership

Taylor is listed in The Best Lawyers in America© for Commercial Litigation (2027). The Tennessee Supreme Court named him an Attorney for Justice for 2021–2022, and he was recognized as a Mid-South Super Lawyers “Rising Star” from 2017 to 2019.

• Professional Involvement

Taylor writes and speaks regularly on False Claims Act enforcement. He contributes to the firm’s annual Healthcare Fraud & Abuse Review, including the 14th edition (2026), and to the Fraud and Abuse chapter of the Health Law Handbook, including the 2025–2026 edition. He authored the Tennessee chapter of AHLA’s Health Care Fraud Law: A 50 State Survey and has written for Bloomberg Law, Law360, and the Inside the False Claims Act blog. He has spoken at the AHLA Winter Institute (2026) and the Nashville Healthcare Fraud Conference and has been quoted on rising False Claims Act enforcement in health care (Chief Healthcare Executive, 2026) and on the constitutionality of the qui tam provision (Bloomberg Law, 2024).

He is a member of the American Health Law Association’s Fraud and Abuse Enforcement Committee, the Nashville Bar Association’s Federal Courts Committee, and the Tennessee Bar Association.

• Experience

Taylor represented MultiCare Health System in intervened False Claims Act litigation in which DOJ alleged that medically unnecessary neurosurgical procedures were performed (U.S. ex rel. Palmer v. MultiCare Health System, E.D. Wash.). He successfully defended the largest orthopaedic physician practice in Tennessee in responding to Civil Investigative Demands (U.S. and State of Tennessee ex rel. McKeon v. Tennessee Orthopaedic Alliance P.A., E.D. Tenn.), and secured dismissal with prejudice of a False Claims Act lawsuit against physician services provider U.S. Medical Management LLC.

He represented Caris Healthcare, a multi-state hospice provider, in a DOJ investigation involving False Claims Act allegations, and served as lead counsel for a home health company in a DOJ investigation that ended in a negotiated resolution (U.S. ex rel. Herbold v. Nurse on Call, Inc., M.D. Fla.). In an OIG audit of a regional hospice, he reduced the overpayment claimed from $7.3 million to $79,000 on appeal. He also represented the largest health system in Memphis in an intervened Anti-Kickback Statute case (U.S. ex rel. Liebman v. Methodist Le Bonheur Healthcare, M.D. Tenn.), and clients in U.S. ex rel. Benaissa v. Trinity Health (8th Cir.) and U.S. ex rel. Ramsey v. Censeo Health, L.L.C. (N.D. Tex.).

Beyond health care fraud, he has conducted internal investigations, including a Fortune 100 company’s investigation of a congressional whistleblower, and litigated class actions, arbitrations, RICO claims, and Fair Credit Reporting Act matters.

SESSION 1 – How the Government Builds Medical-Necessity Cases Against Physician Practices and Hospitals in 2026 | 12:00pm – 1:00pm

This session looks at the tools, teams, and legal theories the government uses to build False Claims Act medical-necessity cases against physician practices, hospitals, or health systems. Attorneys will learn how the DOJ-HHS False Claims Act Working Group, the Health Care Fraud Data Fusion Center, and the FOCUS data-mining initiative have changed where cases come from and how damages are calculated, using recent large settlements as examples. Attendees will leave understanding how statistical sampling, electronic health record evidence, billing analytics, and the post-SuperValu standard for proving intent fit together into the government’s case.

BREAK | 1:00pm – 1:10pm

SESSION 2 – Settling and Litigating Medical-Necessity False Claims Act Cases for Physician Practices and Hospitals | 1:10pm – 2:10pm

This session gives defense counsel the strategy and tactics needed to resolve or litigate medical-necessity False Claims Act cases against physician practices, hospitals, or health systems. Attorneys will see how settlements are put together — cooperation credit, self-disclosure, and Corporate Integrity Agreement terms — and how to build defenses at the motion-to-dismiss and trial stages using intent, materiality, and damages arguments. Participants will leave with a practical way to measure exposure, manage parallel criminal risk, and negotiate an outcome that keeps the provider running.