Healthcare Fraud/White Collar Criminal Defense: Investigations and Audits

A doctor reading the list of the 7 elements of health care compliance on a laptop.

In recent years, the federal government has teamed up with state and local government to aggressively identify and stop health care fraud. The investigators are often ruthless and use confidential informants, previous employees and others with potential inside information to assist in the investigation and prosecution. As a result, incidental errors or negligence are often identified as potential fraud.

The Medicare/Medicaid billing manuals/procedures are not easy to understand, and often coding errors and simple misunderstandings lead to adverse consequences. With significant increases in funding from the federal government for health care fraud audits, health professionals are often faced with intrusive investigations.

These investigations and audits do not resolve themselves. The assistance of a national health care fraud defense lawyer who understands Centers for Medicare Services (CMS) regulations and state and federal fraud and abuse laws should be retained at the earliest possible time to limit exposure and help ensure a positive outcome.

What Governmental Authorities Conduct Health Care Fraud Investigations?

The Department of Justice (DOJ) is aided by the Drug Enforcement Administration (DEA), the Office of Inspector General (OIG), the HEAT Task Force, state Medicare fraud control units, and Zone Program Integrity Contractors (ZPIC) in its efforts to counteract fraud.

These entities often work together during parallel investigations of health care entities in order to enforce a broad range of civil, administrative, and criminal regulations. Civil fines, recoupments, and forfeitures can be in the millions of dollars, and Federal Sentencing Guidelines are not friendly to those convicted of committing fraud.

Why Contact a Healthcare-Based Criminal Law Law Defense Attorney for Health Care Fraud Investigations and Audits?

Health care fraud defense is an extremely complicated area of law. In contrast to other health law matters, they progress very quickly and carry significant penalties and fines. Often the key to a strong defense is one that is prepared as early as possible. Even the mention of health care fraud can trigger licensing investigations and Medicare and Medicaid audits. 

If you have been arrested for health care fraud, contacted by federal or state/local law enforcement, or contacted by a medical insurer raising questions of potential fraud, contact a defense attorney as soon as possible.

The allegations are very serious, and prosecutors will often try obtaining information from you before you have retained an attorney. You should not give authorities or the prosecutor information without first seeking counsel.

Turn to the National Healthcare Fraud and Criminal Law Attorneys at Chapman Law Group When You Are Faced with Government Investigations and Audits

The health care fraud defense lawyers at Chapman Law Group have a 35-plus-year reputation for aggressively defending physicianspain management specialistspharmacists, chiropractors, and other licensed medical professionals across the U.S. on criminal matters. Our team are there to advise on state, multistate, and federal criminal matters and investigations commenced by the FBI, HH, FDA, DEA, and DOJ.

We have four national health care fraud and healthcare-based criminal law offices:

Contact us today to learn more about what an experienced, reputable health care fraud attorney can do for you.

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