Healthcare Fraud Defense
Federal and state investigations, False Claims Act defense, and criminal healthcare fraud cases.
False Claims Act Cases Against Hospices
The Eleventh Circuit's AseraCare decision limits hospice False Claims Act cases to proof of objective falsehood, not a second doct…
The False Claims Act: What the Government Must Prove Against a Provider
The five elements the government or a relator must prove under the False Claims Act, and where a provider's defense lives in each…
Services Not Rendered Allegations: How They Are Built and Answered
How investigators detect billing for services never performed, the documentation gaps that mimic it, and how providers build the d…
Accused of Drug Diversion at Work: Nurses and Anesthesia Providers
A nurse or anesthesia provider named in a facility diversion investigation faces a licensing board case, a DEA report, and sometim…
Who Files Qui Tam Suits Against Healthcare Providers
Qui tam suits against healthcare providers come from billers, compliance officers, departing staff, competitors, and data-mining f…
Texas Medical Board Complaints: Process and Response
A Texas Medical Board complaint moves through jurisdictional screening, investigation, an informal conference, and a contested cas…
Med Spa Medical Directors and Board Complaints
A board complaint against a med spa medical director turns on supervision and ownership, not whether the physician treated a patie…
The Stark Law: What the Physician Self-Referral Ban Prohibits
What the Stark Law's physician self-referral ban prohibits: the referral, the financial relationship, and the bar on the Medicare…
Common False Claims Act Violations in Healthcare, With Examples
A plain catalogue of the fact patterns that create civil False Claims Act exposure in healthcare billing, each with a short illust…