James Segroves is a Senior Counsel in the Health Care Department of Proskauer, resident in the Washington, D.C. office. His litigation-focused practice covers a diverse range of subject matters at both the trial and appellate levels of court systems throughout the United States, as well as matters before administrative tribunals. In 2013, Law360 recognized James as a "Rising Star" in the health care area, naming him as among the nation's top legal talent under 40. According to The Legal 500 United States, James goes “above and beyond the call” and is “extremely knowledgeable and very customer focused.”
James regularly represents defendants in litigation brought under the federal False Claims Act (FCA) and similar state legislation. For example, in 2011, James helped convince the United States District Court for the Southern District of New York to dismiss an FCA action brought against a major academic medical center seeking penalties and treble damages exceeding $1.5 billion. In dismissing the case with prejudice, the district court agreed that federal Medicare regulations did not expressly prohibit the accounting practice in question. “The worst that can be said of [the defendant-hospital],” the district court concluded, “is that it took advantage of the uncertainty in the regulations to maximize its Medicare billings. This is not fraud.” In 2012, the district court denied the relator's motion to reopen the case based on supposed "newly discovered" evidence, finding that the motion was untimely and lacked substantive merit. The United States Court of Appeals for the Second Circuit affirmed the district court’s refusal to reopen the case in 2013.
In addition to serving as defense counsel in false-claims cases, James regularly advises clients in federal and state appellate matters presenting significant questions of first impression. For example, James recently helped convince the Supreme Court of Illinois to issue a unanimous ruling finding that the Federal Arbitration Act preempts a state statute precluding the enforcement of nursing facilities’ arbitration agreements. James also recently represented the Chamber of Commerce of the United States, the American Health Care Association, the American Hospital Association, and the Pharmaceutical Research and Manufacturers of America as amici curiae in an important FCA matter before the Supreme Court of the United States, which resulted in a determination that public disclosures by non-federal actors deprive courts of subject-matter jurisdiction over actions brought by private whistleblowers.
A significant portion of James’s practice involves litigation against federal agencies under the Administrative Procedure Act (APA). For example, James recently represented the American Bar Association in litigation challenging the Federal Trade Commission’s application of its controversial Red Flags Rule to lawyers engaged in the practice of law. In late 2009, the United States District Court for the District of Columbia awarded the American Bar Association summary judgment after finding that the Commission exceeded its statutory authority by seeking to impose cumbersome identity-theft requirements on the legal profession. In 2011, the United States Court of Appeals for the District of Columbia Circuit dismissed the Commission's appeal on mootness grounds after Congress enacted legislation rejecting the Commission's logic for applying the Red Flags Rule to lawyers.
In addition, James advises a number of States on matters involving federal funding of state health care programs and disputes with the Centers for Medicare & Medicaid Services (CMS). For example, James served as a deputy attorney general for the State of Alabama in its litigation challenging a nationwide “Dear State Health Official” letter issued by CMS in 2008, which would have required States to pay the Federal Government hundreds of millions of additional dollars stemming from Medicaid-related fraud recoveries. In 2011, the United States District Court for the Middle District of Alabama vacated CMS's letter after finding that CMS violated the APA by failing to subject the letter to notice-and-comment rulemaking. CMS later dismissed its appeal before the United States Court of Appeals for the Eleventh Circuit.
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