Healthcare Fraud Defense
Federal and state investigations, False Claims Act defense, and criminal healthcare fraud cases.
False Claims Act Exposure for DME Suppliers
Missing orders, absent delivery proof, thin necessity records and kickback-tainted referrals each create civil False Claims Act ex…
Willfulness Under the Anti-Kickback Statute After the ACA Amendment
The 2010 ACA amendment removed the need to prove specific intent to violate the Anti-Kickback Statute, but courts still require kn…
Relying on a Billing Company as a Defense to Criminal Fraud Charges
A billing company's errors do not excuse a provider once personal Medicare certifications establish what the provider knew and sig…
False Claims Act Exposure for Clinical Laboratories
Clinical laboratories face civil False Claims Act exposure from unnecessary testing, panel billing, and marketer kickbacks tied to…
False Claims Act Exposure for Behavioral Health Providers
Psychotherapy time codes, supervision billing, and group therapy notes each create civil False Claims Act exposure when the record…
Partial Hospitalization Program Fraud Prosecutions
Partial hospitalization and intensive outpatient fraud cases turn on eligibility, group therapy content, and attendance records, n…
Genetic Testing Fraud Schemes: How Prosecutors Build Them
How prosecutors build genetic testing fraud cases around telemarketing, physician orders, and lab billing, and what it means for r…
Filter Teams and Privileged Material in a Healthcare Search Warrant
A DOJ filter team screens privileged material seized in a healthcare search warrant before investigators see it, but circuits spli…
But-For Causation in Kickback-Based FCA Claims
Federal circuits are split on whether a kickback must cause a claim, or merely touch one, before it becomes False Claims Act liabi…