Criminal Defense Lawyers

Phoenix Healthcare Fraud Defense Lawyer

The Brutal Truth About Healthcare Fraud Charges

There’s one reason you’re on this website: you’re looking for an elite criminal defense law firm, because you or someone you care about is facing devastating healthcare fraud charges.1 Most law firms implement a cookie cutter strategy in order to fight your case, and save their own time – they don’t look carefully at your situation, they simply want to move on to the next case.1 At Spodek Law Group, we leave no stone unturned.1 We do everything possible to win. Everything we do is focused on getting you results.1We understand the difficult challenges of going through a case like this.1 If you’re accused of healthcare fraud, schedule a consultation with our criminal attorneys today.

What Exactly Is Healthcare Fraud?

Healthcare fraud is a violation of federal law, it can have civil or criminal consequences.4 It happens when claims are filed with federal healthcare programs like Medicare, Medicaid, Tricare, or workers’ comp by providers who want to get reimbursed for services, equipment or supplies they didn’t actually provide or weren’t medically necessary.4

Common examples include:

• Billing for services that weren’t performed (phantom billing)
• Double billing for the same service or equipment
• Certifying patients for unnecessary medical services like hospice
• Accepting kickbacks for referrals
• Providing medically unnecessary services or supplies

The federal government takes this extremely seriously, because tens of billions are lost to healthcare fraud annually.3 You’re going up against a team of bloodthirsty prosecutors who want to make an example out of you.1

The Stakes Couldn’t Be Higher

So, what do you do, if you get hit – with one of these things?1 Well, take a deep breath, because the consequences are dire:

• Potential prison time, we’re talking years or even decades behind bars1
• Millions in fines and penalties1
• Loss of your medical license and ability to practice
• A permanent criminal record that follows you forever

And that’s just the criminal penalties. You’ll also face devastating collateral consequences like:

• Exclusion from federal healthcare programs, killing your career
• Disciplinary action from your state licensing board
• Lawsuits and having to pay back all of the claims

Allegations of fraud can destroy your reputation and change your life forever. You must fight back and work to defend yourself as best you can. The only way to truly know if you can beat the charges is to hire a private criminal defense attorney.1

Christine Twomey

2024-03-21

Just had my Divorce case settled 2 months ago after having a horrible experience with another firm. I couldn’t be happier with Claire Banks and Elizabeth Garvey with their outstanding professionalism in doing so with Spodek Law Group. Any time I needed questions answered they were always prompt in doing so with all my uncertainties after 30 yrs of marriage.I feel from the bottom of my heart you will NOT be disappointed with either one. Thanks a million.

Brendan huisman

2024-03-18

Alex Zhik contacted me almost immediately when I reached out to Spodek for a consultation and was able to effectively communicate the path forward/consequences of my legal issue. I immediately agreed to hire Alex for his services and did not regret my choice. He was able to cover my case in court (with 1 day notice) and not only was he able to push my case down, he carefully negotiated a dismissal of the charge altogether. I highly recommend Spodek, and more specifically, Alex Zhik for all of your legal issues. Thanks guys!

Guerline Menard

2024-03-18

Thanks again Spodek law firm, particularly Esq Claire Banks who stood right there with us up to the finish line. Attached photos taken right outside of the court building and the smile on our faces represented victory, a breath of fresh air and satisfaction. We are very happy that this is over and we can move on with our lives. Thanks Spodek law 🙏🏼🙏🏼🙏🏼🙏🏼🙌🏼❤️

Keisha Parris

2024-03-15

Believe every single review here about Alex Z!! From our initial consultation, it was evident that Alex possessed a profound understanding of criminal law and a fierce dedication to his clients rights. Throughout the entirety of my case, Alex exhibited unparalleled professionalism and unwavering commitment. What sets Alex apart is not only his legal expertise but also his genuine compassion for his clients. He took the time to thoroughly explain my case, alleviating any concerns I had along the way. His exact words were “I’m not worried about it”. His unwavering support and guidance were invaluable throughout the entire process. I am immensely grateful for Alex's exceptional legal representation and wholeheartedly recommend his services to anyone in need of a skilled criminal defense attorney. Alex Z is not just a lawyer; he is a beacon of hope for those navigating the complexities of the legal system. If you find yourself in need of a dedicated and competent legal advocate, look no further than Alex Z.

Taïko Beauty

2024-03-15

I don’t know where to start, I can write a novel about this firm, but one thing I will say is that having my best interest was their main priority since the beginning of my case which was back in Winter 2019. Miss Claire Banks, one of the best Attorneys in the firm represented me very well and was very professional, respectful, and truthful. Not once did she leave me in the dark, in fact she presented all options and routes that could possibly be considered for my case and she reinsured me that no matter what I decided to do, her and the team will have my back and that’s exactly what happened. Not only will I be liberated from this case, also, I will enjoy my freedom and continue to be a mother to my first born son and will have no restrictions with accomplishing my goals in life. Now that’s what I call victory!! I thank the Lord, My mother, Claire, and the Spodek team for standing by me and fighting with me. Words can’t describe how grateful I am to have the opportunity to work with this team. I’m very satisfied, very pleased with their performance, their hard work, and their diligence. Thank you team!

Anthony Williams

2024-03-12

Hey, how you guys doing? Good afternoon my name is Anthony Williams I just want to give a great shout out to the team of. Spodek law group. It is such a honor to use them and to use their assistance through this whole case from start to finish. They did everything that they said they was gonna do and if it ever comes down to it, if I ever have to use them again, hands-down they will be the first law office at the top of my list, thank you guys so much. It was a pleasure having you guys by my side so if you guys ever need them, do not hesitate to pick up the phone and give them a call.

Loveth Okpedo

2024-03-12

Very professional, very transparent, over all a great experience

Bee L

2024-02-28

Amazing experience with Spodek! Very professional lawyers who take your case seriously. They treated me with respect, were always available, and answered any and all questions. They were able to help me very successfully and removed a huge stress. Highly recommend.

divesh patel

2024-02-24

I can't recommend Alex Zhik and Spodek Law Firm highly enough for their exceptional legal representation and personal mentorship. From the moment I engaged their services in October 2022, Alex took the time to understand my case thoroughly and provided guidance every step of the way. Alex's dedication to my case went above and beyond my expectations. His expertise, attention to detail, and commitment to achieving the best possible outcome were evident throughout the entire process. He took the time to mentor me, ensuring I understood the legal complexities involved to make informed decisions. Alex is the kind of guy you would want to have a beer with and has made a meaningful impact on me. I also want to acknowledge Todd Spodek, the leader of the firm, who played a crucial role in my case. His leadership and support bolstered the efforts of Alex, and his involvement highlighted the firm's commitment to excellence. Thanks to Alex Zhik and Todd Spodek, I achieved the outcome I desired, and I am incredibly grateful for their professionalism, expertise, and genuine care. If you're in need of legal representation, look no further than this outstanding team.

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Google rating score: 4.9 of 5, based on 736 reviews

At Spodek Law Group, we pride ourselves on taking a hands-on approach.1 It means researching the exact situation surrounding your case, and putting in the leg work to be familiar with every single intimate detail.1 Our firm has excellent work ethics, and we constantly hold firm meetings in order to discuss and address all of our cases.1 In the event of an emergency, we have a full team of lawyers available to help you.1

Our Unique Expertise Gives You the Edge

When it comes to healthcare fraud cases, you need a team with expertise that runs deeper than just “legal knowledge.”1 You need lawyers who understand the intricacies of the medical industry itself.1 That’s what sets Spodek Law Group apart – we’re not just criminal defense attorneys, we’re medical coding experts, Medicare policy mavens, and masters of healthcare regulation.1 

This inside knowledge allows us to:

• Spot billing errors and documentation issues a mile away
• Understand the nuances of physician compensation models
• Navigate the tangled web of safe harbors and Stark Law exceptions

In other words, we speak the language of the healthcare world.1 We know all the loopholes, gray areas, and potential pitfalls your average lawyer would miss.1 And when you combine that industry fluency with our legal prowess? You get a defense strategy that’s truly unbeatable.1

Our Scorched Earth Litigation Tactics

Sometimes prosecutors will only be fair if you respond with force to them.1 Without an attorney advising you, you might accidentally plead guilty when you could’ve won the case.1

At Spodek Law Group, we take a two-pronged attack:

1. Tear their case to shreds
2. Build an ironclad defense for you

It’s that simple.1 But pulling it off? That’s where our elite team comes in. We start by mercilessly dissecting the prosecution’s evidence, exposing every flaw and hole in their theory.1 Things like:

• Improper documentation or procedural violations that taint the evidence
• Witnesses with motivation to lie or inconsistent statements
• Lack of proof you acted “knowingly and willfully”

Basically, we turn their “evidence” into a stack of useless paper.1 At the same time, we’re constructing an airtight defense strategy tailored to your situation.1 We have a million ways to approach this, like:

• Showing your billing practices were legitimate under a reasonable interpretation of the rules
• Using expert testimony to show you made reasonable medical decisions
• Arguing you were actually the victim of employee fraud or government overreach

The amount of manpower and brainpower we dedicate to this process is staggering.1 But that’s what it takes to win at the highest levels of criminal defense.1

When the Government Overreaches

Sometimes the government oversteps their authority in their zeal to get a “win.”1 Maybe they:

• Conducted an illegal search and seizure, violating your 4th amendment rights
• Entrapped you into committing a crime you wouldn’t have otherwise
• Selectively prosecuted you based on your race, gender or other protected status

When that happens, we flip the script and go on the offensive.1 We file motions to get charges dismissed and evidence excluded based on prosecutorial misconduct.1 We turn their dirty tricks back on them.1

When Employees Go Rogue

Not every healthcare fraud case is about greedy providers lining their pockets.1 Sometimes, it’s a simple case of a rogue employee going off the rails and falsifying records or billing for their own gain.1 In those situations, we argue our client was an innocent victim who had no knowledge of the fraudulent scheme.1 We prove the employee was acting alone, outside the course and scope of their duties.1 That way, we can get the charges against the business owners dismissed, while still allowing for prosecution of the misbehaving employee.1

When Mistakes Happen

Look, nobody’s perfect – even the most diligent healthcare providers make unintentional mistakes sometimes.1 Maybe there was a misunderstanding about what services were covered, or a coding error that led to an improper bill.1 In those cases, we argue that any errors were simply negligent mistakes, not intentional fraud.1 We show that our client had robust compliance programs in place and acted in good faith at all times.1 That lack of criminal intent should result in a complete dismissal, or at most minor civil penalties.1

The Spodek Law Group Advantage

Regardless of how tough your situation is, we are here to help you.1 Our criminal defense lawyers work hard to have a solution for you, irrespective of the situation you find yourself in.1 Many clients are often embarrassed by their situation, and don’t speak openly about their alleged issue.1 We encourage open dialogue, and recommend full transparency, so we can give you the best possible legal advice.1But enough about us, let’s talk about you.1 

About what you can expect as a Spodek Law Group client:

• 24/7 access to your attorneys via phone, text and email
• A dedicated support staff to answer questions and address concerns
• Frequent updates on case strategy and developments
• A team approach with attorneys, investigators and experts all working together
• Discreet representation protecting your privacy
• Honest assessments about your odds, not just telling you what you want to hear

From the moment you sign on with us, you become our top priority.1 We’ll hunt down every shred of evidence, interview every witness, and explore every possible legal avenue.1 No matter how complex your situation, we have the skills and resources to handle it.1The Spodek Law Group handles cases nationwide.1 We have offices in NYC and Los Angeles.1 But no matter where you’re located, we’ll be by your side every step of the way.1 Call us today or schedule a free consultation online to get started.1

Defending Against Healthcare Fraud Charges: A Comprehensive Guide

Healthcare fraud charges can completely upend your life and career. You’re facing potential prison time, massive fines, and the loss of your professional licenses. Not to mention the personal toll of having your reputation dragged through the mud. So if you or your medical business is under investigation, or you’ve already been indicted, you need to take this deadly seriously. You can’t just wing it and hope for the best – you need elite legal representation from a firm with deep healthcare fraud expertise. Here’s a comprehensive look at what that entails.

The Government’s Tactics

To understand how to defend against healthcare fraud charges, you first need to know what you’re up against. The federal government has made prosecuting provider fraud a top priority, devoting massive resources to it. You’ll be squaring off against an entire team of specialized prosecutors and investigators, including:

• Assistant U.S. Attorneys from the Department of Justice
• Agents from the FBI, DEA, IRS, and other federal agencies
• Auditors, investigators and lawyers from the HHS Office of Inspector General
• Members of elite Medicare Fraud Strike Force teams in high-risk areas like Phoenix

These people do nothing but eat, sleep and breathe healthcare fraud cases. They have virtually unlimited funds, the ability to get subpoenas and warrants, and a huge head start in building their case against you. Their goal is to hit you with an overwhelming pile of evidence that leaves you no choice but to plead guilty. 

Some of their favorite tactics include:

• Executing surprise raids to seize documents and data from your office
• Interviewing former employees or disgruntled patients to get insider info
• Pouring over your billing records and medical documentation looking for discrepancies
• Having undercover agents attempt to catch you in a sting operation
• Threatening you with absurdly severe charges to force a plea bargain

As you can see, they’re not messing around. You need a defense team that can match their resources, skills and aggression.

Building an Ironclad Defense Strategy

The key to defending healthcare fraud charges is taking a multifaceted approach that both pokes holes in the prosecution’s case and provides airtight justifications for your actions.1 

Some potential defense strategies include:

Lack of Criminal Intent

For a healthcare fraud conviction, the government must prove you acted “knowingly and willfully” with intent to defraud.1 If there’s any ambiguity in the laws or regulations, or you made a reasonable mistake in interpreting them, you can’t be found guilty.1 We’ll argue you acted in good faith based on your understanding of the rules.

Billing Errors vs. FraudNot every billing mistake or coding error constitutes criminal fraud.1 We may be able to get charges reduced by showing any errors were simply negligent oversights, not intentional attempts to defraud.1 Things like having a robust compliance program in place can help demonstrate lack of intent.

Lack of Evidence

The prosecution has to prove their case beyond a reasonable doubt.1 We’ll pour over their evidence looking for deficiencies like:

• Lack of documentation or incomplete medical records
• Testimony from unreliable witnesses like disgruntled ex-employees
• Violations of your constitutional rights during searches or interrogations
• General lack of proof connecting you to any scheme

Prosecutorial Misconduct

If prosecutors engaged in any misconduct like entrapment, illegal searches, or hiding exculpatory evidence, we can get charges dismissed on those grounds.1

Advice of Counsel Defense

If you were acting based on advice from a qualified healthcare lawyer or compliance expert who analyzed the situation, you can’t be convicted of intentional fraud.1

Mere AssociationJust because you associated with someone involved in fraud doesn’t make you guilty.1 We’ll argue you had no knowledge or participation in any criminal scheme.

Employee Fraud

In some cases, lower-level employees commit fraud for their own benefit, without the knowledge of ownership or management.1 We can get charges dismissed against the business itself using this defense. As you can see, there are many potential avenues to attack healthcare fraud charges.1 Having a skilled defense lawyer who understands all the nuances is crucial.

Negotiating a Favorable Resolution

Of course, taking a case to trial and fighting for full acquittal isn’t always the right move. In some situations, the best strategy is to negotiate with prosecutors for a favorable pre-trial resolution. An experienced healthcare fraud defense attorney will be able to:

• Get charges reduced or dismissed through skilled motions practice
• Advocate for a sentence of probation rather than incarceration
• Negotiate affordable criminal fines and penalties
• Prevent you from being excluded from federal healthcare programs
• Maintain your professional licenses and hospital privileges

They’ll be able to leverage things like:

• Lack of criminal history and otherwise clean record
• Cooperation, acceptance of responsibility, and remedial compliance efforts
• Ability to make a compelling case for avoiding a harsh sentence at trial

The goal is to resolve the case with the best possible terms, while avoiding a trial you may not win. It’s all about mitigating the potential damage as much as possible.

Why You Need the Best Defense From Day 1

As you can see, defending against healthcare fraud charges requires a comprehensive, multidisciplinary approach.1 From analyzing complex billing data and medical records, to understanding evolving statutory and regulatory requirements, to constructing airtight legal defense strategies – it’s not something just any lawyer can handle.1That’s why from the very first moment you learn about an investigation, you need to have elite defense counsel in your corner. An experienced healthcare fraud attorney can get involved early to:

• Intervene in civil audits before they turn criminal
• Represent you during OIG interviews or in response to subpoenas
• Ensure you don’t make incriminating statements or destroy key evidence
• Negotiate with prosecutors to avoid charges or get favorable terms
• Collect exculpatory evidence while memories are fresh and trails are hot

The bottom line? Trying to handle a healthcare fraud investigation on your own is like performing surgery on yourself.1 You need a skilled professional who knows exactly what they’re doing.1 Otherwise, you’re risking catastrophic consequences that could destroy your life’s work and future.1

The Spodek Law Group Difference

So if you’re under the microscope for suspected healthcare fraud, what should you do? Simple – call the Spodek Law Group immediately.1 We’re former federal prosecutors ourselves, so we know all the dirty tricks the government likes to play.1 More importantly, we know how to fight back against them using all available legal and ethical weapons.Our healthcare fraud defense team includes:

• A former Chief Healthcare Fraud Coordinator from the U.S. Attorney’s Office
• Former federal prosecutors who used to take these cases to trial
• Healthcare lawyers with expertise in medical coding, billing, and regulations
• A dedicated staff of investigators, forensic accountants, and other professionals

We’ve handled cases at every level, from responding to UPIC audits, to negotiating with the OIG and DOJ, to taking major healthcare fraud cases to jury trials.1 We quite literally wrote the book on defending providers like you.1When you hire us, you get a multidisciplinary strike force committed to your cause.1 We’ll spare no expense, exploring every possible avenue for attacking the government’s case while shielding you from excessive penalties.1 We’re not afraid of the big courtroom battles – in fact, we relish them.1 But we also know that litigation isn’t always the best solution.1 If the facts and circumstances warrant it, we can negotiate a favorable pre-trial resolution that keeps you out of prison and able to continue your career.1 We’ll leverage our credibility and good working relationships with federal prosecutors to get you the best possible deal.1

No matter what though, you can count on one thing – we’ll fight like hell for you every single step of the way.1 We’ll always keep you informed, never judge, and most importantly, never sugar coat or mislead you about your situation.1 You’ll get our honest, expert counsel about what’s truly in your best interests.1

If you’re under investigation or have been charged with healthcare fraud anywhere in the Phoenix area, your next move is clear – get the Spodek Law Group on your side today.1 Your future depends on it.