Jeremy A. Avila

/My focus

My practice reflects the complex overlapping issues and risk areas healthcare and life sciences entities face: regulatory advice and counsel, complex litigation and dispute resolution, and government investigations and enforcement actions. I have served as a prosecutor, government lawyer, and state-level general counsel advising key regulators and helping shape legislation and policy. Because of this experience, I offer clients unique insight into the full spectrum of challenges they face and how to navigate them successfully.

REGULATORY AND COMPLIANCE

Drawing on twelve years of experience in California government, including my appointment by Governor Newsom as chief counsel for the California Department of Aging, I bring a 360-degree awareness of how a single challenge or legal issue can carry simultaneous regulatory, enforcement, and policy implications. Responding to these challenges routinely requires a strategic and insider perspective, as well as dynamic, outside-the-box thinking. As someone who advised state-level regulators and helped shape legislation and policy, I use that experience to counsel clients on Medicaid/Medi-Cal certification and licensing issues, managed care operations, the corporate practice of medicine, corporate governance, data privacy, and healthcare regulatory questions, so that clients are able to move forward confidently rather than merely react to the latest developments in Sacramento or DC.

LITIGATION AND DISPUTES

Disputes arise every day. Some can be resolved, whereas others require long-term advocacy and litigation before judges, juries, or other neutral parties. I have litigated and tried civil and criminal matters in federal and state courts and administrative forums, ranging from novel payer-provider disputes to HIPAA, data breach, and privacy litigation, commercial disputes, and white-collar defense. I have also represented national medical associations and individual clients in federal APA challenges to changes in national vaccine policy and have secured favorable outcomes for clients ranging from large Medicaid managed care organizations and Medicare Advantage plans to a global leader in digital health, e-commerce, and telehealth. Using my knowledge of how to build or defend a case, I advocate for clients and look for arguments and authority to help deliver meaningful results.

GOVERNMENT INVESTIGATIONS AND ENFORCEMENT

I counsel and represent clients facing investigations, audits, and enforcement actions, whether brought by the federal or state government. Across my career, I have worked with or across the table from government agencies that investigate or regulate healthcare entities, including the California Department of Justice, the California Department of Managed Health Care, the California Department of Health Care Services, the US Department of Justice, and the Centers for Medicare and Medicaid Services. Regardless of the audience, my approach remains the same and is informed by over a decade of combined experience as a prosecutor and government attorney, where I led or participated in a wide range of complex investigations involving civil and criminal conduct, including the False Claims Act. I know how investigations and cases are built, and I use that knowledge to guide and advocate for clients at all stages of an investigation or enforcement action.

/Looking ahead

Government is closely scrutinizing payers, providers, and integrated systems for competition and affordability. This is not happening in a vacuum, and how clients respond could create new risks that we will see play out in the months and years ahead.