Kenneth M. Abell

Ken is a seasoned litigator, tireless advocate and trusted advisor to his clients. His practice focuses on parallel civil and criminal government investigations and enforcement matters, qui tam defense and False Claims Act (FCA) litigation, white collar criminal defense, healthcare regulatory and compliance counseling, internal investigations and securities litigation.

Since founding AEL in 2020, Ken has successfully guided scores of entities and individuals through high-stakes government investigations, enforcement actions, and parallel criminal and civil proceedings. Ken takes great pride in providing incisive, efficient and economical counsel to his clients, who are often going through one of the most harrowing experiences of their lives. In recognition of these efforts, Ken has been ranked by Chambers USA as a leading attorney in the Healthcare category where his clients have described him as being “an excellent lawyer,” “incredibly responsive” and “very good at understanding a client’s needs.” Based on AEL’s now-established reputation as an elite boutique in New York city, several institutions – including publicly-traded companies – have entrusted Ken and the AEL team to perform highly-sensitive internal investigations into healthcare and securities matters, and to provide detailed findings and recommendations to boards of directors. Ken is also regularly engaged by companies as pool counsel to represent their employees in connection with government investigations.

Before co-founding AEL, Ken served as Chief of Healthcare Fraud for the U.S. Attorney’s Office for the Eastern District of New York (EDNY), Civil Division. In his ten years as an Assistant United States Attorney, Ken litigated and resolved some of the EDNY’s most significant fraud matters, successfully tried several cases and argued numerous cases before the U.S. Court of Appeals for the Second Circuit. Ken supervised more than twenty AUSAs handling healthcare fraud matters and oversaw a diverse practice group that included cases against pharmaceutical companies, laboratories, hospital systems, home health agencies, physician practice groups, medical device companies, billing entities and individual physicians. In investigating and prosecuting these actions, Ken worked closely with federal agents from the Department of Health and Human Services Office of Inspector General, the Federal Bureau of Investigation and the Food & Drug Administration. Ken also worked in close partnership with attorneys from the Medicaid Fraud Control Unit within the New York State Attorney General’s Office (NYAG).

Ken began his legal career as a commercial litigator at a prominent litigation boutique in Chicago. Thereafter, he was a law clerk to the Honorable Theodore H. Katz in the Southern District of New York (SDNY), before joining the United States Attorney’s Office in 2008.

Representative Matters

Ken represents entities and individual clients in complex fraud cases and, along with his partners, is an expert in parallel criminal and civil cases involving, among other things, violations of the federal and state FCA, the Antikickback Statute (AKS), and securities laws. Ken and the firm have developed a well-deserved reputation of excellence for operating at the intersection of healthcare and government enforcement. Below are examples of Ken’s representative matters:

Parallel Criminal and Civil Investigations:

  • Obtained dismissal of federal criminal indictment alleging healthcare fraud against physician and negotiated civil-only global resolution of the charges. AEL also resolved the underlying qui tam complaint. Read more about the case here.
  • Secured a favorable plea agreement and below-Guidelines sentence for the former CFO of a publicly-traded pharmaceutical company charged with insider trading. Subsequently, secured a dismissal of a related civil case by the SEC and a Second Circuit appellate victory in a class action securities fraud suit against the client, his former company and its former officers and directors. Read more about the case here.
  • Successfully resolved a multi-year investigation involving a prominent New York-based obstetrician/gynecologist with a highly favorable civil-only resolution with the NYAG. Read more about the case here.
  • Representing nursing homes and affiliated entities in an investigation under the FCA alleging improper billing of rehabilitation therapy services under the now-replaced RUG model.
  • Representing a not-for-profit agency healthcare agency in connection with joint criminal and civil investigations by the EDNY and SDNY regarding receipt and distribution of Medicaid funds.
  • Representing a health care company in connection with an investigation under the FCA alleging an improper billing relationship with a genetic lab that violated the AKS.
  • Representing nursing homes in an investigation under the FCA involving allegations of improper disenrollment from managed care plans and attendant billing of Medicare Part A.
  • Obtained closure of a joint criminal and civil investigation by the NYAG into a pharmacy for alleged inventory fraud in connection with the distribution of HIV drugs.
  • Steered parallel criminal and civil fraud and FCA investigation involving a chiropractor to a global civil-only resolution.
  • Achieved a civil-only resolution for a New York-based contracting and development company after long-running, multi-district (EDNY and SDNY) parallel criminal and civil investigations relating to the client’s work on certain projects.
  • Successfully represented a publicly-traded company in connection with a joint investigation by DOJ’s Consumer Protection Bureau, the EDNY and the NYAG into potential adulteration of food products.
  • Representing cardiologist in an investigation under the FCA alleging improper billing for certain stress tests and billing for services under the incorrect National Provider Identification number.
  • Successfully represented large hospital in connection with allegations of improper use of government funds under the federal and state False Claims Acts, as well as related state Medicaid regulations.
  • Representing physician with specialization in radiology in an investigation under the FCA alleging improper billing for certain vein procedures and services provided by physicians assistants.

White Collar Criminal Defense:

  • Secured a favorable plea agreement and a below-Guidelines sentence for a NYC-based pain management physician for his role in an alleged fraud scheme in the SDNY. Read more about the case here.
  • Obtained dismissal of a felony healthcare fraud indictment for physician, who pled guilty to a superseding information charging him with a non-intent misdemeanor offense related to misbranded drugs. Doctor received a sentence of 1 year probation. Read more about the case here.
  • Successfully steered a federal felony investigation regarding potential criminal violations of the Food Drug and Cosmetic Act (FDCA) to a misdemeanor resolution and a probationary sentence with no fine. Read more about the case here.
  • Obtained closure of a felony investigation into a wholesaler of commercial goods, which the government alleged had violated certain environmental regulations. In the same matter, successfully obtained the return of more than $600,000 of cash seized from the client’s premises.
  • Obtained closure of a criminal investigation into alleged Paycheck Protection Program (PPP) fraud by a prominent physician at a local hospital.
  • Representing a telehealth company and its principal in connection with a grand jury subpoena from the EDNY.

Internal Investigations and Pool Counsel Representations:

  • Conducted an internal investigation for a publicly-traded company into allegations of insider trading by its former CEO, which included a thorough review and analysis of the company’s insider trading policies and provision of recommendations under new SEC rules.
  • Conducted a thorough and comprehensive investigation for a NY-based healthcare company into the activities of its former CEO, and thereafter presented detailed findings and recommendations to the Board of Directors.
  • Repeatedly served as pool counsel for employees of a large hospital system in investigations by federal and state authorities involving allegedly improper diversion of controlled substances under the Controlled Substances Act (CSA).

Healthcare Services Provider Representation:

  • Successfully navigated multiple physicians through FCA actions, federal HIPAA subpoenas, grand jury subpoenas, and civil investigative demands (CIDs).
  • Provide ongoing regulatory and compliance counsel to numerous healthcare institutions, including labs, hospitals, long-term care facilities and software companies.
  • Successfully represented numerous physicians and healthcare providers in hearings and testimony before New York State’s Office of Professional Medical Conduct (OPMC) and Office of Professional Discipline (OPD).
  • Presently guiding dozens of healthcare providers through audits and overpayment requests by CMS, ZPICs, UPICS, Medicaid MCOs and private carriers, often beating back million dollar plus demands and/or negotiating major reductions from the initial demands.

Expert Testimony and Thought Leadership:

  • Testified as an expert witness in litigation alleging violations of the AKS and Eliminating Kickbacks in Recovery Act (EKRA).
  • Frequently speak on healthcare issues, having spoken at conferences and symposiums more than three dozen times on issues such as Medicare and Medicaid fraud, drug diversion, qui tam actions under the FCA, matters under the AKS and government enforcement priorities.
  • Provide analysis in healthcare and FCA matters, including:
  • Wrote article entitled “FCA Ruling Deepens Circuit Split Over Qui Tam Dismissals”
  • Wrote article entitled “FCA Ruling Shows Importance Of Relator As Original Source”
  • Quoted in article entitled “7th Circ. FCA Ruling Deepens Circuit Split On DOJ Dismissals”