Alexander Kirkpatrick has been engaged in healthcare law since 1978 when as a deputy attorney general in the California Department of Justice in the Criminal Law Division, he was invited to join a newly-formed team of attorneys prosecuting Medi-Cal fraud charges against a broad range of providers. He was promoted to supervising deputy attorney general in 1981. Alex left the Attorney General’s Office in 1983 to enter private practice, initially with a law firm in Pasadena focusing on acute care hospitals and medical staff issues. Subsequently, Alex formed a small boutique firm that focused on representing health care providers in professional discipline, medical staff, reimbursement and litigation matters. Later, Alex reunited with a litigator and continued to work principally in health care and administrative law. After that firm dissolved, Alex continued to work in healthcare law as a sole practitioner.
Alex’s practice focuses on three related fields of practice in healthcare law: reimbursement, enrollment and sanctions including Medicare and Medi-Cal audits, exclusions, suspensions and fraud and abuse allegations affecting providers in medicine, pharmacy, psychology, and other fields; professional disciplinary matters representing licensees before agencies including the Medical and Dental Boards and the Boards of Pharmacy, Psychology, Registered Nursing and Behavioral Sciences; and writs and appeals and civil litigation on behalf of licensees in contractual and reimbursement-related matters.
Alex has successfully represented many physicians, psychologists, pharmacists, nurses and other healthcare providers in myriad matters pertaining to their licensure, reimbursement, and professional status. Examples of matters within these practice focuses include:
Reimbursement, Enrollment and Sanctions
- Represented an orthopedic surgeon whose Medicare billing privileges were summarily revoked due to minor errors in enrollment documentation submitted by billing company, resulting in Noridian’s withdrawal of revocation and reinstatement retroactively.
- Extensive settlement negotiations with the Department of Health Care Services in two Medi-Cal audits for recovery demanding a total of $4.9 million from a pharmacist due to an enrollment error, attaining a settlement of under one-third of the demand.
- Counsel for a large hospice in Northern California in a seven-figure Medi-Cal audit, settling for under one-fourth of the audit demand.
- Represented a home health agency against a Medi-Cal audit for recovery, settling for under 5% of the potential demand.
- Represented an orthopedic surgeon allegedly overpaid by Medicare for physical therapy services due to insufficient documentation. After a contested administrative hearing, the overpayment was reduced by about 70%.
- Counsel for a neurologist in two Medicare statistical sampling audits totaling $1.5 million. Following two contested hearings, the overpayment was substantially reduced.
- Counsel for a pharmacy in a $25 million Medi-Cal audit based on alleged overcharges for antihemophilic factor, ultimately settling for a small fraction of the demand.
- Counsel for three family practice clinics audited by Medi-Cal, obtaining a favorable settlement.
- Persuaded prosecutors with the California Bureau of Medi-Cal Fraud and Elder Abuse that there was no basis to bring criminal charges against a psychiatrist who allegedly billed up to and in excess of 24 hours per day of psychotherapy and related E&M services, where Medi-Cal had paid the physician for nearly 10,000 hours’ work over a two-year period.
- Represented a pharmacist in a Board of Pharmacy investigation into whether the pharmacist permitted a non-pharmacist to use his license to obtain over 90,000 bottles of Phenergan. Despite that all other participants in that matter pleaded guilty to federal criminal offenses and were sentenced to federal prison, obtained a Public Reproval for the pharmacist.
- Defended an OB/GYN who served as the Medical Director of a medical clinic in Downtown Los Angeles which was paid over $3.2 million by Medi-Cal for claims allegedly rendered to non-existent women under the Presumptive Eligibility Program.
- Advised a Physician Assistant in a federal criminal investigation into issues whether her employer orthopedic clinic had illegally re-imported viscosupplements that were intended only for export to Canada, as a result of which no adverse actions were taken.
- In several unrelated matters where criminal charges were brought against a licensee, Alex was able to persuade the Superior Court to not impose practice restrictions as a condition of bail.
- Acted as counsel for three registered dental hygienists in alternative practice in criminal investigations commended by the Bureau of Medi-Cal Fraud and Elder Abuse, persuading the Attorney General not to file any criminal charges against any of them.
- Represented an ENT physician against disciplinary charges brought by the Medical Board of California following the physician’s multiple arrests for driving under the influence of alcohol without convictions, ultimately obtaining an order for probation that allowed the physician to return to work.
- Represented a high-risk anesthesiologist who sustained a second conviction for driving under influence of alcohol; after interview, the Medical Board elected not to file any disciplinary charges.
- Assisted an out-of-state psychiatrist after a DUI and two psychiatric holds on his application for licensure, resulting in the Medical Board issuing an unrestricted license.
- Assisted a Registered Nurse in her application for licensure after a DUI; obtained an unrestricted license from the Board of Registered Nursing.
- Represented the owner of a family day care facility against charges by the Department of Social Services seeking to revoke her license on the basis of a charge of sexual abuse allegedly committed against a former enrollee. Following a contested hearing, all charges were found to be meritless.
Writs and Appeals; Civil Litigation
- Representation of numerous professional licensees in petitions for writ of mandate challenging decisions of the Director of the Department of Health Care Services on audits for recovery and decision of the Medical Board of California imposing professional discipline.
- Represented a neuroradiologist following a conviction for animal abuse (in which the animal was actually not hurt) after which the Medical Board placed the physician on probation and Medi-Cal imposed a summary suspension; on mandate, obtained a court order prohibiting Medi-Cal suspension.
- Represented a general surgeon who was placed on probation by the Medical Board of California after hospital peer review found the surgeon had departed from the applicable standard of care in two cases. Upon a petition for writ of administrative mandate, the Superior Court ruled there was no evidence of professional negligence and ordered the probationary order to be set aside.
- Represented an OB/GYN where, following abdominal surgery for lysis of adhesions the patient later obtunded and died and the Medical Board asserted cause for discipline in three acts or omissions in the physician’s care and treatment of the patient and imposed probationary terms. On mandate, the Superior Court found no merit to the negligence findings and ordered dismissal of the discipline.
- Represented a family practice physician who had twice pleaded guilty to lewd and lascivious conduct in a public place. After the Medical Board placed the physician on probation on the ground of alleged narcissistic disorder, obtained a peremptory writ of mandate commanding the Medical Board to vacate the discipline on the ground narcissism is not a mental illness.
- Counsel for an IPA defending against a lawsuit by a group of eleven emergency physicians which demanded entitlement to reimbursement for treating out-of-plan enrollees at rates ranging from 300% to 500% of the prevailing Medicare rate for the services. Binding arbitration resulted in an Award of a unified “case rate” that was affirmed by the Superior Court and the Court of Appeal.
- Counsel for an IPA sued by a group of neurologists for alleged insufficient reimbursement, ultimately settling the claims on terms favorable to the IPA.
- Counsel for several unrelated pharmacies notified of exclusion as pharmacy service providers based on Pharmacy Benefit Manager reviews, resulting in withdrawal of termination decisions.
- Counsel for a local IPA against a series of lawsuits by clinical laboratories claiming underpayment for lab services, resulting in very favorable outcomes.
- Defense counsel for several physicians and others who were sued by various national insurance carriers under the federal Racketeer Influenced and Corrupt Organizations Act (“RICO”) which case cumulatively lasted over 15 years.
- People v. Peter Shrier, M.D. (2010) 190 Cal.App.4th 400
- Louis Watson, M.D. v. Superior Court (2009) 143 Cal.App.4th 1407
- Hemady v. Long Beach Unified School District (2006) 143 Cal.App.4th 566
- Michael Fitzgibbons, M.D. v. Integrated Healthcare Holdings, Inc. (2006) 140 Cal.App.4th 515
- Robert Meyers, M.D. v. Columbia/HCA Healthcare Corp. (6th Cir. 2003) 341 F.3d 461
Associations, Memberships & Awards
- California Academy of Attorneys for Health Care Professionals
- Los Angeles County Bar Association – Healthcare Law Section
- State Bar of California
- United States Court of Appeal for the Fifth, Sixth and Ninth Circuits
- Sixth and Ninth Circuit Courts of Appeals
- United States District Court, Southern, Central and Eastern Districts of California; Eastern District of Texas; Northern District of Georgia
- United States Tax Court
- Named to 2011 – 2017 “Super Lawyers” for Health Care Law
- Martindale-Hubbell – AV rated
- UCLA School of Law, 1974
- Northwestern University, B.A., Philosophy, Pre-med, 1971
Life Outside the Firm
Alex is married to a radiologist and has three adult children. His hobbies include golf and travel.