Healthcare Government Investigations and Criminal Defense Lawyers

| by Max Soni

Last Updated on: 3rd June 2023, 09:09 pm

Healthcare Fraud Investigations: What Healthcare Providers Need to Know

As a healthcare provider, you are subject to numerous and stringent regulations to ensure that you follow proper healthcare practices. Violations of these regulations, such as human resource violations, controlled substance issues, health insurance fraud, and general malpractice, can trigger investigations by state or federal law enforcement officials. The Spodek Law Group, headed by renowned attorney Todd Spodek, represents clients in federal healthcare issues nationwide, including investigations by the CMS, DEA, OIG, and DOJ.

Triggers for Healthcare Fraud Investigations

Healthcare fraud is difficult to conceal for long. Random and scheduled audits can reveal any shady activities. Complaints, whether from a patient or competitor, may also trigger an investigation. The government can also use informants and undercover operatives to conduct comprehensive investigations. Obtaining search warrants, subpoenas, and using surveillance equipment are also common investigation methods.

Provider Response

Healthcare providers must be vigilant when facing investigations. It is crucial to learn as much as possible about the investigating agency’s operations and to protect your rights with the help of a dedicated law firm, such as Spodek Law Group. Healthcare providers have rights and should not attempt to deal with investigations on their own, even if they believe in their own innocence.

One of the first pieces of advice a healthcare criminal defense lawyer will give a healthcare provider under investigation is to be prepared for evidence-sharing between government agencies. It is highly recommended that healthcare providers only speak with an investigating agency while their lawyer is present to prevent accidentally incriminating statements.

Document Retention

A criminal defense attorney representing a healthcare provider during a government investigation will provide valuable advice on evidence requests by the government. The government may demand financial or institutional records, testimony from staff members, or other sources they think are viable. However, a provider should not blindly hand over every piece of information in the hopes of showing transparency, as it may lead to additional allegations being made against them. Only an experienced criminal defense lawyer can advise on what evidence should be produced in specific scenarios.

After the Investigation

criminal charges will only be filed after an investigation has concluded, but the consequences of an investigation can be severe. This may include heavy fines, exclusion from programs, and loss of license. Healthcare providers who face a healthcare fraud investigation should hire a healthcare defense lawyer to assert their rights and build an effective defense.

Examples of Cases Handled by Spodek Law Group

Spodek Law Group represents businesses and individuals facing healthcare fraud investigations, including cases involving overbilling, medication diversion and dispensing, phantom billing, billing for unnecessary services, offering kickbacks, and coding violations. They can assist at all stages of an investigation, including fee for service contractor audits like MAC, RAC, and ZIP.

Potential Consequences

Consequences of a healthcare fraud investigation can be severe, including repayment of overbilled amounts, exclusion from programs, loss of license, and civil or criminal fines or imprisonment. The Spodek Law Group can help healthcare providers avoid or minimize these consequences.

Remember that a healthcare fraud investigation is a serious issue that can have severe consequences. If you are facing an investigation by state or federal law enforcement officials, it is crucial to seek the help of a dedicated law firm with experience in healthcare fraud cases. The Spodek Law Group has the knowledge and expertise to help healthcare providers navigate the complex regulations and defend against allegations of healthcare fraud. Don’t wait until it’s too late, contact us today.