About John W. Reale

With deep experience in matters involving insurance and health care litigation, John Reale helps his clients combat fraudulent and abusive claims practices. From identifying and evaluating suspected fraud to developing and implementing effective litigation and deterrent strategies, insurers turn to John to help them reduce exposure and recover payments obtained by fraud.

Confronting health insurance fraud, waste and abuse

John represents large health and property and casualty insurers across the country, as well as others impacted by fraud, helping them confront the business and litigation challenges associated with suspected claims fraud. Through early stage collaboration and leveraging available technology, John helps his clients develop and implement litigation, claims handling and fraud deterrent strategies.

John has a wide range of industry experience, and he handles complex litigation and consulting involving systemic fraud. He has extensive experience pursuing fraud recoveries in federal and state courts in civil RICO and qui tam suits involving a wide range of issues, including medical necessity, corporate practice of medicine, licensing, kickbacks, self-referrals and manipulation of billing codes.

John has also helped clients in federal and state litigation involving alleged federal and state False Claims Act violations, disputes under ERISA and the federal securities laws, commercial class actions and toxic torts.

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Practice Focus

  • Health care and insurance fraud
  • Litigation, including federal and state RICO and federal and state False Claims Act litigation
  • Investigating and evaluating suspected claims fraud activity
  • Developing and implementing fraud deterrent and claims handling strategies

Representative Experience

  • Represent property and casualty insurer in civil RICO and fraud action in the US District Court for the Middle District of Florida against a patient referral network, network of medical clinics and medical imaging centers, and a group of medical doctors and chiropractors, alleging medically unnecessary services, unlawful patient brokering and kickbacks.
  • Represent property and casualty insurer in a large-scale fraud action in the US District Court for the Southern District of Florida against chiropractic and physical therapy clinics, medical imaging centers, and a group of medical doctors and chiropractors, alleging medically unnecessary services and self-referral statute violations.
  • Represent property and casualty insurer in fraud action in the US District Court for the District of Minnesota against a chiropractor and clinics, alleging unlawful kickbacks and services that either were not performed or not medically necessary.
  • Represent property and casualty insurer in complex fraud action in the US District Court for the District of Maryland against medical doctors, chiropractors, and medical clinics, alleging services were not medically necessary or not performed.
  • Represent property and casualty insurer in civil RICO and fraud action in the US District Court for the Eastern District of Michigan against a medical doctor and professional corporation, alleging medically unnecessary pain management injections, and upcoding and unbundling of billing codes to inflate charges.
  • Represent property and casualty insurer as qui tam plaintiff under the Illinois Insurance Fraud Claims Prevention Act (ICFPA) against clinics and medical providers, alleging provision of medically unnecessary services and the use of unbundling and upcoding of billing codes to inflate charges.
  • Represent health insurer in civil RICO and fraud action in the US District Court for the Eastern District of Texas against a surgical supply vendor and billing company, alleging billing and coding fraud.
  • Represent property and casualty insurer in civil RICO and fraud action in the US District Court for the District of Oregon against chiropractors, acupuncturist, and medical clinics, alleging medically unnecessary services.
  • Defense counsel for health insurer in an ERISA action in the US District Court for the Northern District of Texas brought by an anesthesia and surgical supply vendor.
  • Represent property and casualty insurer in complex civil RICO and fraud action in the US District Court for the Southern District of Florida against a surgery center, medical management company, and a group of medical doctors, alleging medically unnecessary surgical and diagnostic procedures.
  • Represent durable medical equipment manufacturer in federal False Claims Act qui tam litigation related to off-label marketing allegations.
  • National defense counsel for nationwide federal and state False Claims Act qui tam litigation in federal and state courts related to pharmaceutical product classifications and alleged false claims paid by state and federal health care programs. *
* Experience prior to Katten