Healthcare Fraud Defense
Federal and state investigations, False Claims Act defense, and criminal healthcare fraud cases.
Inside an FCA Investigation: The Defense Timeline
How a False Claims Act investigation moves from civil investigative demand to DOJ decision, damages workup, and settlement for phy…
License Cases That Run Beside Criminal Investigations
A medical board complaint and a criminal referral can arise from the same conduct, and a board statement can become evidence again…
Monitoring and Impaired-Practitioner Programs: Entry, Terms, and Exit
Voluntary and board-ordered PHP monitoring differ sharply in confidentiality. Here is what happens when compliance or completion i…
Statistical Sampling in FCA Cases: Where Courts Draw Limits
Courts let sampling size FCA damages routinely, but proving liability by extrapolation turns on representativeness and sample meth…
The 60-Day Overpayment Rule: Identification, Quantification, and Repayment
CMS's 2025 rule replaced reasonable diligence with the False Claims Act's knowing standard for when a Medicare overpayment is iden…
Consent Orders in License Cases: What You Give Up and What You Keep
A consent order can end a licensing board case without a hearing, but it carries reporting and payor consequences that outlast the…
How a Licensing Board Complaint Becomes an Investigation
How a state board of pharmacy or medical board complaint moves from intake through an investigator interview to dismissal, informa…
The Materiality Defense After Escobar
The Supreme Court's Escobar decision made materiality a rigorous, fact-intensive defense in False Claims Act cases against healthc…
How a Qui Tam Lawsuit Unfolds: From Sealed Complaint to Intervention
A qui tam lawsuit under the False Claims Act moves through a sealed investigation before a physician or practice ever learns a cas…