Case Result: Michigan Physician, Urgent Care Owner Receives No Jail Time for Allegations of $2 Million in Healthcare Fraud

Professionals:
Physician
Urgent Care Clinic

Primary Issue:
Our client owned a busy urgent care clinic in Southeast Michigan. The Michigan Attorney General sent undercover patients into our client’s clinic and determined that our client was billing for services that were not rendered. As a result, our client was charged with racketeering and conducting a corrupt enterprise (more commonly known as RICO) and was facing a significant term of jail, significant fines, and loss of his medical license as well as his business.

How We Helped:
In cases such as this, our role is to minimize the damage to our client as much as possible and to protect our client’s assets, medical license, and freedom. While we did not dispute that some services were billed in error, we did dispute that the entire practice was corrupt. Many times, Blue Cross Blue Shield and other commercial insurance carriers who are involved in investigating health care fraud will use health care fraud allegations as a means to profit from criminal action against physicians by requesting large amounts of forfeiture through exaggerated fraud calculations. We could not let this happen and fought aggressively to show Blue Cross Blue Shield and the prosecutors that the charges were exaggerated. We combed through the files and examined the patient care to determine that the amount billed in error was exaggerated by the prosecution. We met with the Attorney General’s health care fraud task force several times to negotiate a successful resolution, and we were ultimately able to obtain a resolution that was satisfactory to our client.

Result:
As a result of our efforts, we were able to obtain a settlement for our client that resulted in no jail time and he was only required to repay the amount billed in error.

Areas of law:
Healthcare Fraud
Health Care Audits 
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.