Healthcare Fraud Defense
Federal and state investigations, False Claims Act defense, and criminal healthcare fraud cases.
Board Interviews: Should You Attend Without Counsel
A medical board's informal interview is a recorded, formal investigative step, and how a physician handles it can decide the case.
Self-Disclosure Versus Waiting for the Qui Tam
OIG's Self-Disclosure Protocol and DOJ's FCA cooperation credit both reward disclosing first, before a qui tam relator files under…
Money Laundering Counts in Healthcare Fraud Indictments
Money laundering counts under 18 U.S.C. 1956 and 1957 can add 20 years of exposure and open forfeiture reaching beyond fraud proce…
Risk Adjustment Fraud and the FCA
DOJ's 2026 Medicare Advantage settlements show how unsupported HCC codes and one-sided chart reviews become False Claims Act liabi…
Medical Directorship Agreements Under Kickback Scrutiny
A medical directorship survives Anti-Kickback Statute scrutiny only when compensation reflects fair market value for services actu…
Living Under a Corporate Integrity Agreement
A Corporate Integrity Agreement's real work starts at settlement: IRO reviews, a 30-day Reportable Event clock, and stipulated pen…
Reverse False Claims Liability for Retaining an Overpayment
Retaining a known Medicare or Medicaid overpayment past the 60-day deadline can itself be a False Claims Act violation under the r…
Medically Unnecessary Services as an FCA Theory
Medical necessity splits the federal circuits on what counts as false under the FCA, turning a documented clinical judgment into t…
Materiality as a Defense: Government Knowledge
Escobar made FCA materiality a demanding standard. Continued government payment despite knowledge of a violation is very strong ev…