Healthcare Fraud Defense
Federal and state investigations, False Claims Act defense, and criminal healthcare fraud cases.
Clinical Judgment as a Defense in False Claims Act Cases
The Eleventh and Third Circuits disagree on whether a physician's disagreement alone can make another's clinical judgment false un…
New York OPMC Investigations of Physicians
How a New York OPMC complaint becomes an investigation, an investigation committee referral, and a hearing before the medical cond…
Medical Board of California Investigations: Interviews and Accusations
How a Medical Board of California complaint moves from intake through the investigator interview, medical review, an Accusation, a…
Conspiracy Charges in Healthcare Fraud Cases
Conspiracy charges under 18 U.S.C. 1349 and 371 reach the agreement itself, not a completed fraud, and can expose employees along…
Licensed Therapist Board Complaints: LCSW, LMFT and LPC Investigations
Boundary, confidentiality, dual-relationship and billing complaints against LCSW, LMFT and LPC counselors, and how board investiga…
Informal Settlement Conferences With Licensing Boards
What happens at an informal settlement conference, who attends, how to prepare, and when to settle rather than go to a board heari…
When Employees Need Their Own Lawyer in a Healthcare Investigation
Explains when a healthcare employee needs independent counsel in an investigation, who typically pays, and where company counsel's…
Waiving Copays and Deductibles: Beneficiary Inducement and Kickback Risk
Routine Medicare and Medicaid copay or deductible waivers can trigger Anti-Kickback Statute and beneficiary inducement penalties.
The Personal Services and Management Contracts Safe Harbor
Six standards govern personal services and management contracts under the Anti-Kickback Statute, and missing one voids protection…