Case Result: Pain Physician Facing 32 Counts of Drug Trafficking, Healthcare Fraud Has Charges Dismissed, Receives Non-Prosecution Agreement

Professional:
Pain Management/Addition Medicine Specialist

Primary issue:
The client was investigated by the DEA, FBI, HHS, and a local insurance network for alleged healthcare fraud, drug trafficking, and wire fraud. The client was subjected to a multiyear investigation alleging that he improperly billed codes 99214-99215 for services rendered to patients in his pain management practice.

Background:
The local counsel on the case reached out to Chapman Law Group for the assistance of a dedicated healthcare law firm, and we took over as lead counsel. We analyzed the case, medical records, and evidence and determined that the physician was actually in compliance with Medicare and Medicaid rules because of a provision called “incident to.” This provision allows a physician to bill a higher reimbursement code even for services rendered by ancillary staff. Moreover, we reviewed the prescriptions that the government alleged were unlawful and were able to secure expert testimony confirming that the prescriptions were legitimate.

The case was set for trial. We proceeded to file pre-trial motions related to the discovery production of the government and were able to determine that the government failed to disclose a significant amount of files, which the government is required to disclose under Brady v. Maryland, 373 U.S. 83 (1963). We filed a motion to dismiss the 32-count indictment because of the government’s failure to provide discovery and its violation of federal rules.

Areas of Law:
Healthcare Fraud 
Federal Criminal Defense

Disclaimer:
This information is a sample of our past results. Prospective clients may not obtain the same or similar results. Every case is different and each case must be evaluated and handled on its own merits. The circumstances of your case may differ from the results provided. The information provided has not been reviewed or approved by the State Bar.