Alec Alexander

Alec Alexander is a Partner who serves on the firm’s Management Committee and leads the Fraud and Abuse Practice Group. An experienced attorney, corporate executive, healthcare enforcement consultant and presidential appointee, Mr. Alexander has handled state and federal fraud, waste, abuse and enforcement issues in the administrative, civil and criminal context for twenty years. Through his extensive public service background, Mr. Alexander also assists health care and life sciences companies understand the nature and scope of the enforcement realities they face and navigate an increasingly complex and challenging regulatory, market and political environment.

Before joining Sullivan Stolier Schulze, Mr. Alexander was a Managing Director in the Healthcare Industry Group at Alvarez & Marsal. Prior to this role, he served for three years as Deputy Administrator of the Centers for Medicare & Medicaid Services (CMS) and Director of the Center for Program Integrity, overseeing a $1.2 billion budget and providing administrative, operational and policy leadership for 500 career staff. As Director, he was responsible for protecting the integrity of $1.2 trillion in annual spending using an array of innovative advanced data analytics systems and tools, including AI and machine learning advancements, across Medicare, Medicaid and the Affordable Care Act (ACA) marketplace. He was charged with overseeing and directing program integrity contractors who conduct ZPIC/UPIC audits, the Targeted Probe and Educate (TPE) program, and other provider audits in Medicare Fee-for-Service, Medicare Advantage, Medicare Part D, Medicaid, and the ACA marketplace. At CMS, Mr. Alexander was the principal liaison of the Department of Health and Human Services (HHS)/CMS to all federal and state law enforcement entities working to identify, investigate, and refer matters for enforcement action. He has been publicly recognized for creating and implementing an innovative, cross-agency case collaboration and coordination regimen between HHS-OIG, HHS-OCIG, FBI, CMS, and DOJ (Civil and Criminal Sections). This regimen ensures that national fraud matters are handled timely and efficiently, while also providing prompt de-escalation and education for good-faith, error-prone providers and plans. For this work, Mr. Alexander was awarded the 2021 Inspector General Honor Award for Excellence in Fighting Fraud, Waste and Abuse.

In 2018, Mr. Alexander testified before the House Ways and Means Subcommittee on Oversight and addressed the full range of HHS/CMS efforts to address, identify and prevent fraud and abuse in federal healthcare programs. At HHS/CMS, Mr. Alexander co-chaired the Healthcare Fraud Working Group of the Presidential Task Force on Market Integrity and Consumer Fraud. In that capacity he led the development and recommendation of a set of innovative and comprehensive national healthcare anti-fraud initiatives. On behalf of the Task Force, he presented these recommendations before the full Working Group chaired by the Deputy Attorney General of the United States and the Director of the Federal Bureau of Investigation. Mr. Alexander also served as the HHS/CMS government liaison attorney to the American Bar Association’s Health Law Section and to the Board of the National Healthcare Anti-Fraud Association.

In 2020, Mr. Alexander led the design and execution of the HHS/CMS program integrity response to the COVID 19 pandemic and Public Health Emergency (PHE). He coordinated special response teams to quickly identify, assess and refer fraud matters to law enforcement authorities and enhanced data analytics and systems coordination between CMS, DOJ, OIG and states. Mr. Alexander also established a systematic process for identifying potential fraud within the hundreds of waivers, flexibilities, rule changes, and program instructions provided by HHS/CMS to address the PHE, as well potential misuse of statutory initiatives under the CARES Act.

Before his appointment as Deputy Administrator and Director, Mr. Alexander was a partner with Breazeale Sachse & Wilson, where he led the Healthcare Section’s Fraud and Abuse Practice Group. In that capacity he represented a wide variety of healthcare companies and C-Suite leaders in administrative, civil and white collar criminal enforcement actions, performed internal investigations for healthcare organizations facing related issues, and conducted compliance / enforcement exposure assessments for healthcare providers, suppliers and systems.
Earlier in his career, Mr. Alexander served as a senior executive in a large hospital system where, among other roles, he was Chief Compliance Officer. Prior to his hospital system service, Mr. Alexander spent eight years investigating and prosecuting regional and national healthcare fraud cases as an Assistant United States Attorney. For his work during this time, he was twice awarded the HHS Inspector General’s Integrity Award. He also received similar awards from both the Department of the Interior and the Department of Defense.

Mr. Alexander earned his bachelor’s degree from the University of Dallas and his Juris Doctor from South Texas College of Law. He is a member of the Louisiana State Bar and the State Bar of Texas.

Overview of Current Healthcare Enforcement Trends, Priorities, and Structures, 2022 Rural Hospital Coalition Conference, Baton Rouge, LA., May 17, 2022

Building A Culture of Compliance, Dead Reckoning: Navigating the Perilous Waters of Federal Healthcare Enforcement in 2022, i3 Healthcare Solutions Summit, Nashville, TN., September 8, 2022.

Building A Culture of Compliance Part I: Expert Insights and Strategies For Successfully Managing Current Federal Healthcare Enforcement Risks, APDA 41^st Annual Conference and Expo, Las Vegas, NV., November 2, 2022.

Building A Culture of Compliance Part II: Expert Insights and Strategies For Successfully Managing Current Federal Healthcare Enforcement Risks, APDA 41^st Annual Conference and Expo, Las Vegas, NV., November 3, 2022.

Hot Topics In Federal Healthcare Enforcement: Building a Culture of Compliance, Expert Insights and Strategies for Successfully Managing Current Federal Healthcare Enforcement Risks, Medtrade Expo + Conference, Dallas, TX., March 30, 2023.