Biola Macaulay is a litigation associate in O’Melveny’s Washington, DC office. She rejoined the firm after clerking for the Honorable Gershwin Drain of the United States District Court for the Eastern District of Michigan.
Biola represents clients in litigation matters and internal investigations, with a focus on clients in the health care industry. Her experience includes disputes involving state and federal false claims laws, state and federal anti-kickback laws, Stark Law, Medicare and Medicaid reimbursement laws, and state and federal privacy laws.
In addition, Biola has a robust pro bono practice representing indigent clients in criminal matters as well as providing legal assistance to a bipartisan non-profit focused on safeguarding the electoral process.
- Representing a national managed care organization in False Claims Act litigation against the DOJ and qui tam relators regarding compliance with Medicare Advantage regulations.
- Advised the United States’ largest customer-owned health insurer on the healthcare regulatory aspects of its agreement to acquire the Medicare Advantage, Medicare Supplemental Benefits, and Medicare Part D business from a global health company.
- Represented a leading healthcare provider in an investigation by the DOJ and HHS, Office of Inspector General into allegations of false claims submitted as a result of allegedly improper diagnosing and coding of various medical conditions.
- Represented the State of California in two separate transactions with Verify Health Systems of California, a non-profit hospital operator, to make full use of the St. Vincent Medical Center in Los Angeles and Seton Medical Center in the Bay Area to increase California's hospital capacity in the wake of the COVID-19 pandemic.
- Conducted an internal investigation of the coding practices of the subsidiary of a leading managed care organization and obtained a declination of criminal heath care fraud charges from the DOJ’s Corporate Enforcement Policy.
- Represented a major health insurer in regulatory consulting related to the recent acquisition of a Medicare Advantage organization, including responses to a series of DOJ civil investigative demands focused on Medicare Advantage risk adjustment practices.
- Defended a financial institution in a False Claims Act qui tam lawsuit concerning its participation in the US Treasury Department’s Home Affordable Modification Program.
- Obtained dismissal of juvenile proceedings against a client charged with racketeering and murder in federal court.
- Obtained parole-eligibility for a client serving a life sentence under California’s prior felony-murder laws.
Admissions
Bar Admissions
- California
- District of Columbia
Court Admissions
- US District Court, Central District of California, Eastern District of Michigan
- US Court of Appeals, Fifth and Sixth Circuits
Education
- Stanford University, J.D.
- Stanford University, B.A., International Relations
Professional Activities
Clerkship
- The Honorable Gershwin Drain, US District Court for the Eastern District of Michigan