Jose Vela Jr.
Jose Vela Jr. represents clients in the healthcare industry on compliance, insurance payment and reimbursement, and information technology issues.
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.
Fellow, American Bar Foundation
Service Award (3 awards), U.S. Department of Justice
Volunteer Service Award, U.S. Department of Justice
2015 Big Money Wins, No. 4 Settlement in the United States & No. 1 Settlement in Texas (Health Care False Claims Act), The National Law Journal
Army Meritorious Medal (2 awards), U.S. Army
Army Commendation Medal (4 awards), U.S. Army
Army Superior Unit Award, U.S. Army
Armed Forces Reserve Medal (M Device), U.S. Army
Global War on Terrorism Service Medal, U.S. Army
National Defense Service Medal (Bronze Service Star), U.S. Army
Order of De Fluery Medal, U.S. Army Engineer Association
Outstanding Leadership Award, Student Body President, University of Michigan Law School
U.S. Army R.O.T.C., Student Liaison – University Board of Trustees, University of Notre Dame
American Bar Association, Health Law Section, Editorial Board – eSource, Litigation Section
American Health Law Association
Chicago Bar Association
Houston Bar Association, Health Law Section
Illinois State Bar Association, Health Law Section
State Bar of Texas, Health Law Section
State Bar Licenses
Lieutenant Colonel, U.S. Army, Retired
- Chief of Plans / Chief Compliance Officer, G3, Major U.S. Army Command
Led and managed the development, preparation, and publication of military orders, plans, and directives to 5 Divisions and 15 Brigades with 22,500 soldiers.
- Executive Officer (Chief of Staff), U.S. Army Division
Planned, prepared, and supported more than 180 joint military battle staff exercises involving more than 550 Army Reserve and National Guard units and more than 17,500 soldiers.
- Company Commander (CEO), U.S. Army Garrison Support Unit
Led, managed, and trained 350 soldiers in support of 30,000 soldiers, and 8,000 Army R.O.T.C. Cadets stationed at Ft. Lewis, Washington.
- Platoon Leader, U.S. Army Engineer Company (Combat Heavy)
Led, managed, and trained 300 soldiers and managed $2 million in heavy engineer equipment, in support of engineer construction projects at Army National Guard Bases.
- Fraud and Enforcement Trends for 2020 and Beyond, CBI: 10th Annual Life Sciences West Coast Compliance Congress in San Francisco, California (October 2019)
- Preserving Privilege & Avoiding Common Mistakes in Internal Investigations, RILA Retail Law Conference 2018 in Austin, Texas (October 2018)
- The Medical Staff: On the Front Line of Healthcare Compliance, 2018 GHSMSS Annual Conference in Houston, Texas (September 2018)
- The New Low-Volume Appeals Settlement Option, Health Law Section C.L.E., Houston Bar Association in Houston, Texas (July 2018)
- Medicare Fraud: What Every CRNA Should Know, TxANA 2018 Practice Management & Governance Summit in Austin, Texas (January 2018)
- Department of Justice Civil Health Care Fraud Update, 2017 TAHFA & HFMA South Texas Fall Symposium in San Antonio, Texas (October 2017)
- Perspectives from Washington – What Can We Expect?, CBI: PAP Legal Update / Navigate Legal Challenges and Opportunities to Build Sustainable Patient Programs in Arlington, Virginia (September 2017)
- The Civil False Claims Act, Patient Protection and Affordable Care Act (2010), U.S. Attorney’s Office Annual CLE Conference (September 2011)
- Medicare Part D: An Uncertain Prescription for Reducing Drug Pricing Fraud, Health Law Perspectives, University of Houston Law Center (April 2006)