Billing disputes, recast as federal crimes.
Medicare, Medicaid, and private-payer investigations - OIG subpoenas, audits, and indictments against providers. We defended an NBA veteran’s $4M healthcare case to time served.
Netflix told the story. The defense was ours.
When Shonda Rhimes built Inventing Anna, the defense at its center was Todd Spodek’s - argued for the so-called fake heiress in a Manhattan courtroom long before Arian Moayed of Succession played him on screen. What 320 million hours of viewers watched is the method every client of this firm gets, in every federal district.
The record, dated and sourced.
How your case unfolds.
THE FULL PROCESS →Risk-free, in person or by phone. Ask anything, for as long as it takes. Strategy starts the same day.
A records request that went quiet - we engage the referral before it hardens into §1347 counts.
Attack billed-versus-lost, defend medical judgment, manage exclusion in parallel - negotiating from strength, trying necessity to a jury of patients.
Healthcare fraud enforcement turns coding disagreements into criminal theories: upcoding, medical necessity, kickbacks. Providers face exclusion and prison for what is often a documentation fight. We bring auditors and billing experts, engage OIG and DOJ early, and separate clinical judgment from criminal intent - as in the $4M NBA healthcare fraud case resolved at time served.
The data flagged you before anyone read a chart.
CMS algorithms and qui tam relators start most healthcare cases - billing outliers, impossible days, codes that cluster wrong. Then agents visit staff at home and the civil inquiry hardens into §1347. The moment you learn of a records request is the moment the defense should start.
Billed is not lost.
The government opens with billings; the guideline runs on loss; and the gap between them is where sentences move. Medically necessary services, actual reimbursement rates, and the federal-program ladder in §2B1.1(b)(7) all get litigated. Exclusion and licensure fallout get managed in parallel - the sentence is not the only exposure.
Medicine is not fraud.
Coding disputes, medical-necessity judgments, and documentation lapses are civil problems dressed as crimes. The government must prove intent to defraud - not an audit disagreement. Physician judgment, industry practice, and the payer’s own guidance are the defense, and juries of patients understand them.
§1347 and its satellites.
Healthcare fraud carries ten years - twenty with serious injury, life if death results - and travels with the Anti-Kickback Statute (ten years per referral arrangement), Stark’s civil overlay, EKRA for labs and treatment facilities, and §1035 false statements. EKRA reaches private-pay referrals the AKS never did, and prosecutors have noticed. Exclusion by HHS-OIG - the practice-ending penalty - follows program-related convictions automatically; plea structure decides it.
When the audit goes quiet.
A UPIC audit that stops responding usually means referral. Freeze document-destruction schedules, image the EHR audit trail, and map who actually touched billing - certifications get charged to physicians who never saw the claims. Do not self-disclose or refund in bulk without counsel: repayments admit falsity if framed wrong, and protect you if framed right.
Todd A. Spodek is a second-generation trial lawyer whose defense of Anna Delvey became Netflix's Inventing Anna. He appears on Fox News and CNN as a legal analyst, authored "My Advice to Diddy" in The Spectator, and is quoted by the Associated Press when the biggest federal cases break. The record behind the profile: a complete acquittal in a $26M money-laundering trial, RICO charges carrying a 10-year minimum dismissed, and 6 months on a $12M Ponzi case.
See who fights for you before you ever call.
Who we are, how we work, and why clients nationwide trust us with their future - in under a minute.
Why this firm.
Five decades of federal courtrooms. Whatever the government has charged, this firm has defended it before.
No allegiance to U.S. Attorneys, agents, or agencies. The client is the only constituency.
Every district in the country, one client portal - documents, invoices, counsel, in real time.
We decline more federal matters than we accept - and every accepted case gets the whole bench.
Know who is on the other side.
The first 72 hours decide the next 72 weeks.
No interviews, no consents, no explaining, no deleting. The words said in hour zero are the exhibits at trial. Write down what was asked and by whom - then stop.
Privilege attaches, facts get mapped while memory is fresh, documents get preserved the right way, and nobody in your orbit talks to agents unrepresented again.
We contact the government as your counsel: target, subject, or witness gets confirmed, deadlines get calendared, and the defense - not the investigation - sets the tempo.
On the record, on the wire.
Get ahead of the case.
Answered within 24 hours, guaranteed. Some stories are better told out loud -
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