Richard Rose concentrates his practice in the areas of healthcare investigations and litigation, construction litigation, and commercial litigation.
He represents healthcare clients in connection with healthcare fraud and abuse issues and related civil and criminal proceedings, including litigating matters arising under the False Claims Act and responding to investigations and enforcement actions brought by government regulators, such as state Attorneys General, the U.S. Department of Justice (DOJ), and the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG). His healthcare clients include hospitals, physicians, SNFs, home health agencies, hospice providers, durable medical equipment (DME) providers, and mid-level and other healthcare providers. Mr. Rose has extensive experience defending clients in qui tam actions, managed care litigation, and administrative litigation and handling various physician disputes both in and out of the courtroom.
He also represents and counsels construction general contractors, subcontractors, and suppliers in construction litigation, lien enforcement and litigation, and contract reviews and disputes.
Additionally, Mr. Rose represents both large and small businesses in general business and commercial litigation. He counsels clients in the insurance, healthcare, retail, real estate, and manufacturing sectors regarding Information Security and Privacy, responses to major data breaches, and compliance with HITECH, HIPAA, GLBA, and other data retention and compliance laws.
Health Care Fraud and Abuse
- Represented public hospital in grand jury investigation involving alleged improper cost shifting to home health cost center on cost reports. Successfully resolved civilly on ability to pay basis.
- Represented two public hospitals in DOJ civil investigation/national pneumonia coding initiative involving alleged improper coding of bacterial pneumonia. Successfully resolved civilly.
- Represented Georgia DME supplier in criminal investigation regarding improper coding and billing of DME. Successfully resolved civilly.
- Represented therapy chain provider in joint criminal and civil investigation regarding alleged improper billing of therapy codes. Successfully resolved civilly.
- Represented public hospital in DOJ civil investigation related to ambulance ALS and BLS billings. Successfully resolved.
- Represented physician in DOJ/OIG investigation regarding alleged improper use of physician extenders and upcoding of E&M services. Successfully resolved with no repayment.
- Represented pain management practice in DOJ joint criminal and civil investigation involving TPIs allegedly billed as TOIs. Successfully resolved civilly.
- Represented physician group in OIG administrative investigation regarding alleged PDMA violations relating to sale of drug samples. Successfully resolved civilly.
- Represented behavioral health provider in joint criminal and civil investigation related to alleged case rate upcoding to MCO in TennCare program. Successfully resolved civilly.
- Represented numerous individual officers in DOJ joint civil and criminal investigations of related healthcare providers for alleged Stark, AKA, and FCA violations. No action taken against officers.
- Represented numerous SNFs, hospice, hospital, home health, DME, physicians, physician extenders, and other healthcare providers in voluntary disclosures to DOJ/OIG/MACs, compliance matters, internal investigations, CIA compliance, overpayment audits, ZPIC/RAC audits, qui tam defense, and compliance with federal healthcare laws including the FCA, Stark, and AKA.
- Represented relators in qui tam cases filed in federal district courts alleging violations of the FCA, as well as state FCAs, and corresponding retaliatory discharge provisions.
- Represented GC on large energy project arbitration between GC, owner, and subcontractors involving over $6 million in disputed change orders. Resolved successfully following mediation.
- Represented GC as co-counsel on large student dormitory project dispute involving 15 separate lawsuits between GC, owner, and subcontractors. Following two-week trial, GC was awarded $2.7 million judgment and lien claim.
- Successfully represented GC in subsequent student dormitory project disputes as co-counsel in one-week trial involving drywall subcontractor seeking $3.3 million in damages and in collateral lien priority litigation with a major bank regarding priority of GC's lien.
Managed Care Litigation/Out-of-Network Litigation
- Successfully represented large Tennessee hospital system in litigation with large managed care organization ("MCO") involving out-of-network emergency services.
- Successfully represented large MCO in trial and appellate court litigation seeking over $50 million in out-of-network billed charges. Matter resolved following appellate court decision.
- Represented large MCO in litigation seeking $16 million for alleged nonpayment of the Professional Component of pathology billings. Successfully resolved following mediation.
- Represented large MCO in declaratory judgment action seeking declaration that MCO was not liable for millions of dollars for out-of-network TennCare services. Successfully resolved.
- Represented large health insurer in the first HITECH breach case with HHS including investigation, notification, remediation, and negotiations with OCR and over 40 state AGs.
- Represented large casualty insurer in investigation of data breach by former employee.
- Represented and counseled retail and other large clients relating to compliance with civil and criminal laws governing data storage, transmission, and interception.
- J.D., University of Tennessee College of Law, 1995
- Member, Tennessee Law Review
- Law clerk to the Honorable W. Frank Crawford, Tennessee Court of Appeals, Western Section
- B.A., cum laude, University of Georgia, 1992
- Tennessee Supreme Court
- U.S. District Court, Eastern District of Tennessee
- U.S. District Court, Middle District of Tennessee
- U.S. District Court, Eastern District of Michigan
- 6th Circuit Court of Appeals
- Chattanooga Bar Foundation - Fellow, 2021
- Mid-South Super Lawyers - Health Care, since 2021
- The Best Lawyers in America® - Commercial Litigation; Health Care Law; Healthcare Litigation; Construction Litigation; Qui Tam Law, since 2013
- Best Lawyers® "Lawyer of the Year" (Chattanooga, Tennessee) - Litigation-Construction Law, 2015, 2017 & 2020
- Best Lawyers® "Lawyer of the Year" (Chattanooga, Tennessee) - Health Care Law, 2021 & 2023
- Associated General Contractors of East Tennessee, 2020-2021 Board Member/Affiliate Director
- American Inns of Court, Justices Ray L. Brock Jr. and Robert E. Cooper, Chattanooga Chapter - President, 2016
- Chattanooga Bar Association - Board Member, 2018
- Tennessee Bar Association
- 57 Miller & Martin Lawyers Recognized as Best Lawyers® Award Recipients
- 13 Miller & Martin Attorneys Named to 2022 Mid-South Super Lawyers and Rising Stars Lists
- 52 Miller & Martin Attorneys Named to 2023 The Best Lawyers in America® List
- Miller & Martin Attorneys Named Best Lawyers® 2023 "Lawyer of the Year" for Respective Practices in Chattanooga
- Richard Rose Named Best Lawyers® 2023 Health Care Law "Lawyer of the Year" in Chattanooga Show more
- Richard Rose Presents Health Care Fraud and Enforcement at TBA 2021 Health Law Forum
- 28th Annual Health Law Forum, Tennessee Bar Association
- 29th Annual Health Law Forum, Tennessee Bar Association
- Griffin and Rose will Present at the 2018 Tennessee Association of Construction Counsel Meeting
- 27th Annual Health Law Forum, Tennessee Bar Association Show more