Carol Abernathy
Counsel
Carol Abernathy is a counsel in O’Melveny & Myers LLP’s Los Angeles office and a member of the White Collar Defense and Corporate Investigations and Health Care Practices.
Drawing upon more than seven years’ experience in the medical device industry and at an academic medical center in both in-house counsel and business roles, Carol offers a unique ability to help health care industry clients navigate complex litigation and regulatory matters. Carol’s practice at O’Melveny focuses on representing pharmaceutical and medical device companies, hospitals, managed care organizations and other health care providers in a variety of civil and criminal matters, including two large matters involving federal investigations of alleged hospital cost report and physician billing fraud. Carol routinely advises companies regarding various health care compliance issues, including state and federal anti-kickback laws, Medicare and Medi-Cal reimbursement, and the implementation and management of compliance programs.
Carol’s experience also includes representing managed care companies and employer benefit insurance companies in nationwide class action litigation. Carol’s recent engagements have included defending one of the nation’s largest health insurers in a series of multi-district class actions filed against every major health insurer in the country.
Prior to rejoining O’Melveny in 2012, Carol worked for six years in the medical device industry, including Advanced Bionics LLC, a global leader in the development of cochlear implant devices, serving as associate general counsel and subsequently as senior quality systems director. In that capacity, she was responsible for legal and regulatory compliance, including quality system compliance with the U.S. Food and Drug Administration and international regulatory requirements for implantable medical devices.
Carol’s experience also includes having served as University Counsel for the University of Southern California, Keck School of Medicine, where she advised senior management on legal issues affecting a major teaching, research, and health care institution.
Carol began her legal career as a summer associate at O’Melveny and practiced at the Firm for almost six years before gaining her industry experience.
Illustrative Professional Experience
- Representing a biologics manufacturer in a federal investigation concerning average wholesale price reporting, and advising the client regarding best price and drug classification issues related to compliance with the Medicaid Rebate Program
- Representing a managed healthcare company in nationwide class action litigation alleging RICO violations by the nation’s leading managed care companies with respect to physician compensation
- Representing a biologics manufacturer in federal investigation concerning AWP price reporting, and advising the client regarding best price and drug classification issues related to compliance with the Medicaid Rebate Program
- Representing a county healthcare agency in a Department of Justice/HHS Office of Inspector General (“OIG”) investigation alleging the submission of false claims to the Medicare program for physician services
- Advising medical device manufacturers regarding product pricing practices, Medicare coverage and reimbursement issues, and state Medicaid product compliance issues
- Representing a hospital and other healthcare providers in connection with developing and implementing effective OIG compliance programs
- Representing various healthcare providers in connection with healthcare compliance internal audits and investigations, disclosure obligations, and other legal ramifications of compliance
- Advising a pharmacy benefits manager in connection with regulatory risk areas
- Represented a hospital in a Department of Justice joint criminal/civil fraud investigation involving Medicare and Medicaid cost reporting practices
- Advised a large hospital system regarding compliance with anti-kickback laws and physician self-referral prohibitions
Professional Activities
Member, American Bar Association, Health Care Law Section; Los Angeles County Bar Association, Health Care Law Section; and American Health Lawyers Association