Jose Vela Jr.

He helps his clients respond or defend effectively against government enforcement actions such as False Claims Act cases (qui tams), OIG subpoenas, or U.S. DOJ Civil Investigative Demands. Jose litigates overpayment determinations or claim denials at the administrative, state, and federal court levels. He counsels clients of all sizes including sole proprietors, small businesses, C-suite executives, and large national health systems.

An exemplary career prosecutor, Jose served more than 20 years as an Assistant United States Attorney and lead trial attorney with the U.S. Department of Justice. He investigated and prosecuted various healthcare fraud cases, including parallel criminal and multi-jurisdictional cases, committed against federally funded health insurance plans including Medicare and Medicaid. Jose settled a False Claims Act (FCA) case brought against a public hospital for $21.75 million. In another matter, he settled an FCA claim against a private children’s hospital and physician practice group for $2.3 million.

Jose worked closely, directing and collaborating, with special agents, investigators, auditors, and statisticians from the Federal Bureau of Investigation (FBI), U.S. Department of Health and Human Services’ Office of Inspector General (OIG), Federal Drug Administration (FDA), Drug Enforcement Agency (DEA), and Medicaid Fraud Control Unit (MFCU). He knows and understands how to conduct federal investigations and enforcement actions against individuals and entities in the healthcare space.

On Medicare reimbursement and program integrity matters, Jose served as lead trial counsel for the U.S. Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS). He successfully represented them in overpayment determinations, claim denials, enrollment suspensions, enrollment revocations, and recoupment actions. Jose possesses extensive knowledge and experience on healthcare billing and reimbursement litigation.

In a distinguished military career that spanned 28 years, Jose led, managed, and trained military units, command staffs, and personnel to accomplish joint military operations worldwide at the tactical, operational, and strategic levels. He is a veteran of Operation Enduring Freedom and a retired Lieutenant Colonel with the U.S. Army.