Biola E. Macaulay

Associate

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Biola Macaulay is a litigation associate in O’Melveny’s Newport Beach office. Biola primarily represents health care organizations in internal investigations and related litigation. Her experience includes disputes involving the False Claims Act, Medicare Risk Adjustment (MRA), and medical coding practices. In addition, Biola has a robust pro bono practice representing indigent clients in criminal matters. She is currently applying for post-conviction relief for an inmate serving a life sentence and representing a defendant charged with racketeering in federal court. She is also involved in the local legal community and serves on the Board of Directors of the Thurgood Marshall Association.

Admissions

Bar Admissions

  • California

Court Admissions

  • US District Court, Central District of California
  • US Court of Appeals, Fifth Circuit

Education

  • Stanford University, J.D.
  • Stanford University, B.A., International Relations
  • Representing 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.
  • Conducting an internal investigation of the coding practices of the subsidiary of a leading managed care organization.
  • Representing 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.
  • Defending J.P. Morgan Chase & Co. in a False Claims Act qui tam lawsuit concerning Chase’s participation in the US Treasury Department’s Home Affordable Modification Program.
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