Leading healthcare law firm adds Brian O'Loughlin, a former state prosecutor, auditor and fraud investigator for Qlarant, to its Audits and Investigations practice group in response to escalating Medicare and Medicaid enforcement and recoupment demands.

SHORT HILLS, N.J., Aug. 11, 2026 /PRNewswire/ -- Health Law Alliance, a national healthcare defense firm, announces the strategic expansion of its Audits and Investigations attorney team to better serve providers facing unprecedented federal and state suspensions, revocations, audits and investigations by CMS, Unified Program Integrity Contractors (UPICs), private payors, and state agencies.

Brian M. O'Loughlin, JD, RN, a former state Deputy Attorney General, Qlarant auditor and fraud investigator, and registered nurse, further strengthens the firm's established capabilities in connection with Medicare audits, healthcare fraud investigations, and related regulatory enforcement matters. O'Loughlin brings distinctive perspective and experience in Medicare audit standards and guidelines, fraud, waste and abuse (FWA) data mining and analytics, Special Investigative Unit (SIU) protocols and processes, clinical documentation, statistical extrapolation methodologies, billing and coding, and white-collar prosecution.

As a healthcare fraud investigator for Qlarant, O'Loughlin analyzed Medicare and Medicaid claims, medical records, clinical documentation and provider operations, identified potential FWA, and helped develop program integrity investigations involving complex healthcare billing patterns. Qlarant is the largest Medicare UPIC and has nationwide authority over FWA analytics for all Medicare Part C (Medicare Advantage) and Part D (Prescription Drug) plans through its oversight of the National Benefit Integrity Medicare Drug Integrity Contract (NBI MEDIC) and the Investigations Medicare Integrity Contract (I-MEDIC).

As a prosecutor for the New Jersey Attorney General's Office, O'Loughlin was responsible for investigating and prosecuting complex criminal cases involving corruption and white-collar frauds. Before entering the legal profession, O'Loughlin built a career spanning clinical nursing, healthcare operations, quality assurance and improvement, accreditation, insurance claims auditing, provider education, and EMR implementation.

"Brian resembles a first-round draft pick for healthcare providers facing audits and investigations," said Anthony Mahajan, founding partner of Health Law Alliance. "He understands clinical documentation, claims review, fraud referrals, FWA investigations, and the government enforcement perspective. That rare combination of skillsets in an attorney will provide exceptional insight and value to our firm's clients."

O'Loughlin's hire comes amidst a rapid increase in federal and state enforcement targeting healthcare providers, including hospice and home health agencies, wound care clinicians, DME suppliers, laboratories, DEA registrants, and Medicaid ancillary services.

About Health Law Alliance

Health Law Alliance is a national healthcare defense firm that specializes in defending business executives and healthcare providers in audits, investigations, administrative proceedings, and civil and criminal enforcement actions. The firm's attorneys include several former prosecutors, payor executives, and healthcare providers who draw on their experience in government enforcement, payor oversight, and healthcare operations, to help clients respond strategically when reimbursement, licensure, or reputation is at risk.

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SOURCE Health Law Alliance