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Criminal Defense for Physicians and Pain Clinics

June 18, 2019

The health care industry is the most heavily regulated one in the United States. Aside from defense, the federal government spends more money on health care than it does any other industry. The high dollar amounts coupled with nearly endless state and federal regulations leave many physicians vulnerable to criminal accusations.

Most doctors are good people who only want to help their patients. However, there are those who choose to take advantage of the system by defrauding others. Some may also make honest mistakes in billing that leaves them open to suspicion and subject to criminal prosecution.

Some patients will try to entrap their providers by asking them to provide a bill for services they have not rendered. It’s tempting for many physicians to become entangled in such a scheme and eventually face criminal allegations.

Because it spends so much money on health care, the government has an incentive to cut down on fraud. Accordingly, this has led to a spur in physician arrests over the past few years. In addition, so-called whistleblowers have caused agents to open investigations based upon their own false allegations of misconduct. Entire fields within the health care industry are sometimes scrutinized as well.

If you are a physician who is facing criminal allegations, you need an attorney who is familiar with health care crimes. Ideally, that lawyer will have someone on staff who has also worked in a clinic or hospital, and can spot inconsistencies in a case very quickly. Remember that health care fraud cases are not like any other fraud case, and require a unique perspective if you are to prevail in court.

There are often warning signs that indicate you may be the target of a health care fraud investigation. For example, a patient or employee may be contacted by an investigator. You may personally receive a call from a government agent who is asking you questions. Some doctors receive a demand letter from Medicare or a target letter from a U.S. Attorney letting them know that they are the subject of an investigation.

When investigations become heated, it could result in your bank accounts being frozen or the arrest of other professionals you have partnered with. You may also receive a search warrant for records or be approached personally by a government investigator.

Don’t wait until these things happen to seek legal counsel. Be aware of the signs that you are a target of an investigation so that you can take action accordingly. Contact us if you believe you are the subject of a health care fraud investigation, even if you have not been arrested. The sooner you contact us, the greater the odds are that we can preserve your innocence.

It is imperative to contact and retain the services of an experienced attorney if a physician or other medical professional is a victim of a criminal accusation. Your livelihood and freedom are both in jeopardy, which is why you should contact us right away to schedule a consultation.

It’s no secret that in recent years the opioid prescription drug epidemic has increased. With an increased number of opioid-related overdoses from prescriptions and illicit street drugs, the government is cracking down on everyone. This intervention is cracking down especially on pain management doctors and pain clinics. Due to the very nature of the profession, many doctors are finding themselves on the receiving end of prescription fraud lawsuits and civil lawsuits for injured parties. This article will review some of the triggers that prompt government cases and the effects they have on pain clinics and prescribers of pain medicine.

The Department of Justice’s Crackdown on Opioid Abuse

Under the direction of Attorney General Jeffrey Sessions, “the largest health care fraud takedown in American history” was announced. The takedown included many arrests, exclusion from governmental insurance programs like Medicaid and Medicare, fraud and pharmacy fraud-related charges. It has been estimated that the takedown has saved taxpayers approximately $1.3 billion. Sessions also indicated that he intends on continuing with increased measures to fight the epidemic.

Increased Governmental Monitoring of Prescribing Practices and Pharmacy Fraud

To continue his campaign against opioid and pharmacy fraud, Attorney General Sessions also started the Opioid Fraud and Abuse Detection Unit. The unit operates under the DOJ and monitors data that alerts the unit to potential dangers of pharmacy fraud. Among these dangers include:

  • Opioid related drug diversion
  • Physician shopping
  • Kickbacks and incentives monitoring
  • Illegal drug dispensing practices

In addition to monitoring, the enforcement agency has assigned special federal prosecutors to 12 areas identified as having disproportionately high rates of opioid abuse. The unit will combine forces with the dea, FBI, HHS, and local and state law enforcement agencies. Those monitoring prescriber practices are also ordered to look for clues indicating the following:

  • Higher than average opioid scripts written
  • Opioid related deaths within 60-days
  • Patient demographics including ages of patients receiving opioid scripts
  • Other prescribing practices that are indicative of pharmacy fraud and abuse

The Penalties for Prescription Drug Fraud

As previously mentioned, stiff sentencing guidelines and civil penalties are at stake from prescription drug fraud. Depending on the severity of the circumstances, many prescribers could face from 10 to 20 years in prison with a maximum penalty of a life sentence. Hefty civil lawsuits are also common when a prescriber’s negligence is the result of serious injury or death. The loss of credentials, licensing, and income is also likely even if a prison sentence isn’t imposed. The loss of credibility and credentials in the medical field can also affect one’s future when attempting to obtain other employment. Family and relationship strains are almost a certainty as well.

When to Act

If you’ve been notified by the Opioid Fraud and Abuse Detection Unit or any other agency of law enforcement, you need immediate representation. If you have a strong suspicion that an investigation may be underway, it’s also time to contact a competent attorney that has federal case experience. Many clients can walk away unscathed with a solid legal defense and our expertise. It’s strongly inadvisable to speak with law enforcement until represented in these matters. Representing yourself in court is never a good idea. With such a complex area of the law involving many components, you’ll need an experienced attorney on your side. Get in touch with our law office for a case review. We’ll give you some insight and will get to work on your case by building a defense strategy and fighting for your rights.

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