Justo Mendez is a partner and government investigations attorney with more than 20 years of experience in the healthcare industry. His practice focuses on representing and advising healthcare providers in regulatory compliance, criminal and civil enforcement defense, transactional, recoupment, reimbursement, and disciplinary matters. Mr. Mendez dedicates a considerable part of his practice representing physicians in disciplinary actions brought by the Texas Medical Board.
In addition, Mr. Mendez has experience with COVID Relief Fraud Investigations, Paycheck Protection Program (PPP) Fraud Investigations, and Health Resources and Services Administration (HRSA) Fraud Investigations. His experience in government investigations also includes serving as assistant attorney general in the Texas Medicaid Fraud Control Unit; as a federal agent for the Office of the Inspector General in the U.S. Department of Health and Human Services (HHS); and as a federal prosecutor for the U.S. attorney’s office in Houston. As a federal prosecutor in the white-collar crimes section, Mr. Mendez successfully investigated and prosecuted dozens of healthcare fraud cases, amounting to millions of dollars in recoveries. The cases involved allegations of false claims, violations of the federal Anti-Kickback Statute (AKS) and Health Insurance Portability and Accountability Act (HIPAA), and other cases related to healthcare qui tam actions and Stark Law violations. Further, Mr. Mendez investigated and prosecuted bank and bankruptcy fraud cases, as well as cases related to the Foreign Corrupt Practices Act (FCPA).
Previously, Mr. Mendez served as senior regulatory counsel for a Fortune 500 healthcare company, where he focused on regulatory compliance of ongoing and future ventures, provided legal advice regarding compliance and led internal investigations related to healthcare regulatory matters. In addition, Mr. Mendez served as chief legal, compliance and human resources officer for a private healthcare organization. In that role, he managed more than 900 employees across five states and oversaw healthcare regulatory compliance, health information privacy, employee relations, provider disciplinary issues, use of outside counsel and negotiations with providers of employee benefits.
Mr. Mendez began his career with private firms, where he represented healthcare providers and businesses in diverse matters as well as in administrative hearings before Medicare’s administrative law judges.
Court Admissions
- U.S. District Court for the Southern District of Texas
Bar Admissions
- Puerto Rico
- Texas
Education
- LL.M., University of Houston Law Center, 2006
- M.H.A., Tulane University, 2005
- J.D., University of Puerto Rico School of Law, 2000
- B.A., University of Michigan, 1997
Languages
- Spanish
Representative Experience
- Defended providers in recoupment actions by Medicare, Medicaid and fiscal intermediaries
- Structured transactions and drafted contracts in compliance with healthcare regulations
- Defended providers in regulatory actions by federal and state authorities
- Represented providers in labor-related matters
- Defended providers in recoupment actions by private insurance carriers
- Represented providers in proceedings before Texas Department of State Health Services
- Defended providers in disciplinary actions by licensing entities
- Assured providers on continued compliance with relevant healthcare regulations
Professional and Community Involvement
- American Health Lawyers Association, Member
- American College of Healthcare Executives. Member
- American Cancer Society – Houston Chapter, Board Member
- Hope Clinic – Asian American Health Coalition, Board Member
Speaking Engagement
- Navigating Healthcare Compliance: Current Trends in Health Care Enforcement, The Harris Center for Mental Health & IDD Board Training, October 27, 2021
- PPP Loan Fraud Enforcement: Where It Stands and Where It’s Headed, Lexology, June 23, 2021
- Kickbacks and Commercial Payors Legal Roundtable, Texas Ambulatory Surgery Center Society Annual Conference, March 2019
- Out-of-Network Billing Developments, Hospital Outpatient Department (HOPD) Arrangements Legal Roundtable, Texas Ambulatory Surgery Center Society Annual Conference, March 2018
- Out-of-Network Billing, Forest Park Indictment, Aetna vs. Humble Surgical Hospital Legal Roundtable, Texas Ambulatory Surgery Center Society Annual Conference, March 2017
- Common Discharge Planning Pitfalls for Case Management Professionals, 11th Annual American Case Management Association (ACMA) Conference, December 2014
- Healthcare Entity Reporting Obligations, 9th Annual ACMA Conference, November 2012
- Healthcare Fraud and Abuse Awareness and Update, Memorial Hermann Case Manager Retreat, October 2012
- Healthcare Fraud and Abuse Awareness, 8th Annual ACMA Conference, November 2011
- Healthcare Fraud Investigation and Prosecution, University of Houston Law Center, December 2010
- Healthcare Fraud, Detection, Prosecution, Litigation and Sentencing Guidelines, Houston Bar Association Continuing Legal Education (CLE) Session, January 2010
Recognitions
- Houstonia, “Top Lawyers– Healthcare,” 2016, 2021-2022
- Houston Medicare Fraud Strike Force, Inspector General’s Exceptional Achievement Award, 2012
- S. Department of Homeland Security, Sharpshooter Certification, 2010
Publications
- “Everyone Wants Electronic Medical Records, But Who Can Really Afford Them?,” University of Houston Law Center’s Health Law Perspectives, March 2006
- “Good News for Physicians: E-Prescribing Will Not Be Another Unfunded Mandate,” University of Houston Law Center’s Health Law Perspectives, February 2006
