Paul D. Werner
Member of the Firm
Paul Werner is a zealous advocate for his clients, both in and out of the courtroom. He has a varied litigation practice, representing physicians and other healthcare providers and organizations in civil litigation, criminal investigations and prosecutions, and professional licensing actions.
He regularly handles matters related to post-payment audits, overpayment disputes and litigation, insurance fraud investigations and prosecutions, benefit disputes, and allegations of professional misconduct. Paul’s post-payment audit practice places special emphasis on the unique and complicated audits conducted by the Centers for Medicare & Medicaid Services and its contractors.
In his civil litigation practice, Paul focuses on the defense of complex insurance fraud and False Claims Act investigations and appeals of Medicare audits presented to the Office of Medicare Hearings and Appeals. His civil litigation practice also extends beyond fraud and abuse allegations, and he routinely litigates disputes relating to shareholder and/or ownership disputes, commercial and contract disputes; employer/employee relations, restrictive covenants, insurance coverage and reimbursement disputes.
Paul counsels healthcare providers and entities in state and federal prosecutions, defending them against a variety of healthcare-specific crimes. Beyond the underlying gravity of a criminal prosecution, Paul understands the significant impact that a criminal prosecution, even if resolved positively, can have on licensed professionals. He counsels his clients on the ancillary consequences of criminal prosecutions and resolutions, including but not limited to navigating the pitfalls of potential exclusion by the Department of Health and Human Services and disciplinary proceedings before professional licensing boards.
Paul relies upon his substantial experience in assessing the merits of allegations of insurance fraud or professional misconduct to effectively—and realistically—counsel his clients on how to best respond to scrutiny from either third-party payers or regulatory agencies. He also assists clients with internal investigations into regulatory compliance issues and frequently advises his clients on proactive risk management and regulatory compliance, emphasizing how to proactively avoid payer or regulatory scrutiny in the first place.
In addition, Paul advises clients on multifaceted corporate transactions and structuring, as well as facility licensing matters, especially in the behavioral health space.
Paul enjoys skiing, cooking, and travel. He loathes Tom Brady.
Representative Matters
- Represented and negotiated a favorable settlement on behalf of a multistate, multi-office medical practice in a multi-year federal False Claims Act investigation and qui tam action alleging provision of medically unnecessary services, improper corporate structure and ownership, and unlawful importation of drugs and medication products from overseas.
- Representing a multistate, multi-office medical practice in a federal False Claims Act investigation alleging the provision of medically unnecessary services and the submission of false and misleading claims.
- Represented and negotiated a favorable resolution on behalf of a physician in a federal criminal prosecution alleging improper kickbacks, patient steering, and falsification of records.
- Represented a durable medical equipment company in a federal False Claims Act investigation involving the provision of medically unnecessary services.
- Represented a clinical laboratory in a federal False Claims Act investigation alleging improper testing protocols, improper control of medical decision-making, and the provision of medically unnecessary services.
- Represented and negotiated a favorable settlement on behalf of a physician in a federal False Claims Act violation alleging sham medical director services.
- Represented a clinical laboratory in a federal criminal investigation alleging sham ownership, kickbacks, and other violations of federal law, which ended without the government bringing charges.
- Represented and negotiated favorable settlements on behalf of multiple physicians and practice groups in federal False Claims Act investigations in several federal districts alleging the improper use of external medical devices.
- Represented a specialist physician in a federal False Claims Act investigation regarding the allegedly improper performance of complicated dermatological procedures that resulted in the government’s decision not to intervene in the action.
- Representing a physician in a federal criminal investigation centering around alleged violations of the Food, Drug & Cosmetic Act.
- Represented a health care provider and several related entities in a multi-year federal False Claims Act case alleging improper management services agreements.
- Representing a pharmacy in a federal False Claims Act and qui tam action alleging, among other things, violations of the Antikickback Statute.
- Represented a health care management company in a state-based fraud litigation that ended in a dismissal of all claims with prejudice.
- Represented a hospice provider in a multi-year joint federal and state False Claims Act investigation involving allegations of improper patient steering and the provision of medically unnecessary services.
- Represented and negotiated favorable settlements on behalf of multiple health care providers and health care entities in various state and federal litigations alleging violations of RICO, the Insurance Fraud Prevention Act, and other fraud-based statutes.
Honors & Awards
Super Lawyers®, part of Thomson Reuters
- Included in New Jersey Super Lawyers, 2022-2027
- Included in New Jersey Rising Stars, 2013-2021
Professional Memberships & Affiliations
Member, American Health Law Association
Member, New Jersey State Bar Association
Publications
“Protect Yourself Against Payer Audit Liability: Begin with a Compliance Program,” BLW Health Law Blog (January 2025)
“Healthcare Law Update On Facilitation Of Fair Reimbursement: IFPA Claims Asserted By GEICO Subject To Compulsory Arbitration Under The FAA And NJ PIP Laws,” BLW Health Law Blog (April 2024)
Speaking Engagements
“Legal Insight Into Regulatory Issues Impacting Age Management Medicine: Peptides, Hormones & Supplements,” Age Management Medicine Conference (April 2024)
“Compliance with Federal and State Regulations as You Begin Your Age Management Practice,” Age Management Medicine Group Conference (November 2020)
“Compliance with Federal and State Regulations as You Begin Your Age Management Practice,” Age Management Medicine Group Conference (April 2020)
“Role of DEA and FDA in Use of CBD and THC,” Age Management Medicine Group Conference (November 2019)
“Legal Issues in Age Management Medicine: A Discussion of Legal Compliance for Age Management Physicians,” Age Management Medicine Group Conference (April 2019)
“Stark Realities: Understanding the Laws Prohibiting Self-Referrals, Kickback, and Inducements,” American Academy of Podiatric Practice Management, Summer Boot Camp and New Practitioner Workshop (August 2011)
“Compliance Basics: The Anatomy of an Effective Compliance Program” American Academy of Podiatric Practice Management, Summer Boot Camp and New Practitioner Workshop (August 2011)
“The Dark Side of Reform: Understanding the Broad Scope of the Healthcare Reform Law’s Numerous Anti-Fraud Provisions,” American Academy of Podiatric Practice Management, Summer Boot Camp and New Practitioner Workshop (August 2011)
“Employment Contracts 101: A Primer on Workplace Laws and Employment Contracts for Podiatric Practices,” American Academy of Podiatric Practice Management, Summer Boot Camp and New Practitioner Workshop (August 2011)
“How Safe is Your Office: The Impact of OSHA Guidelines on Podiatric Practices,” American Academy of Podiatric Practice Management, Summer Boot Camp and New Practitioner Workshop (August 2011)
“Legal Issues Associated with DPM/PT Integration,” American Academy of Podiatric Practice Management, Summer Boot Camp and New Practitioner Workshop (August 2011)
“Claim Appeals 101: A Primer on Responding to Major Medical Claims Denials in a NJ Chiropractic Office,” Association of New Jersey Chiropractors Convention (Fall 2010)
“Employment Law 101: A Primer on Workplace Laws for NJ Chiropractic Practices,” Association of New Jersey Chiropractors Convention (Fall 2010)
“Increased Freedom, Increased Responsibility: Legal Issues Associated with the New Chiropractic Scope of Practice in New Jersey,” Association of New Jersey Chiropractors Convention (Fall 2010)
Community Involvement
Mentor, Seton Hall University School of Law Interscholastic Moot Court Team
Clerkship
Law Clerk to the Honorable Frederick J. Theemling, J.S.C., Superior Court of New Jersey
Media Mentions
Part B News, “Subletting a doctor’s office? Make sure you’re covered, not coasting,” March 2, 2026
Part B News, “Shutdown Slows Claims, Blocks Telehealth; Plan Now, Alert Patients,” October 08, 2025
Bloomberg, “Big 2025 FCA Cases Ponder Constitution, Causation, Cybersecurity,” December 31, 2024
Part B News, “Will Fla. Ruling Mean the End of Qui Tam? Not Right Away,” October 28, 2024
Healthcare Risk Management, “New DOJ Whistleblower Program Greatly Increases Risk,” October 01, 2024
Part B News, “Prepare: New DOJ pilot pushes non-FCA fraud reporting, with an online form,” August 26, 2024
Part B News, “Go the Extra Mile to Onboard New Providers and Keep Them Happy,” August 12, 2024
Part B News, “Be Careful of Patients Seeking Wegovy with Suspect Heart Complaints,” July 8, 2024
Healthcare Risk Management, “Patient Termination Requires Right Steps, Good Documentation,” July 1, 2024
Part B News, “Are no-shows fees legal? Yes, in most cases, but you still may want to avoid,” June 17, 2024
Healthcare Risk Management, “Patient and Family Complaints Require Careful Response,” April 1, 2024
Part B News, “Hit With a Subpoena? Court Order? Know the Difference, Respond Accordingly,” March 4, 2024
Healthcare Risk Management, “Knowing When to Call a Lawyer Can Help Avoid Bigger Problems,” February 1, 2024
Part B News, “Expect Compliance Hotspots, G2211 Boom, Telehealth ‘Super Bowl’ and More,” December 28, 2023
Part B News, “Be Proactive About Discrimination Support – Or Risk Liability,” December 18, 2023
Law360, “FCA Chases ‘Shrewder’ Kickbacks As 50-Year Hunt Intensifies,” May 10, 2023
Law360, “Landmark FCA Showdown Looking Like Defense Bar Letdown,” April 19, 2023
Law360, “FCA Bar Jittery As ‘Game-Changing Case’ Goes To Justices,” April 14, 2023
In the News
Paul Werner Discusses DOJ’s New Approach to the False Claims Act with Law360
2027 Best Lawyers® Lists Recognizes Four Buttaci Leardi & Werner LLC Attorneys
Hospice News Quotes Paul Werner on Uptick in Regulatory Oversight, Need for Better Compliance
Vincent N. Buttaci, Esq. Named to Mindful Choices for ADHD Steering Committee
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