In a hard-fought victory for healthcare providers, Chapman Law Group mounted an aggressive challenge to overbroad bond conditions, and the Government ultimately conceded in open court to a significant modification. Following extensive briefing and oral argument, the U.S. Attorney’s Office agreed to stipulate to modify an onerous bond restriction that had prohibited two physician clients, in separate cases but facing similar allegations, whose patient populations were comprised almost entirely of Medicare beneficiaries, from billing Medicare or Medicaid while awaiting trial.
The original condition was sweeping. It barred our clients from submitting or causing the submission of any claims to government healthcare programs, even for entirely legitimate, medically necessary services provided to their existing patients. After two tense hearings, we secured a stipulation limiting the restriction to its proper scope. Under the new agreement, our clients are prohibited only from causing the submission of any home healthcare-related claims, which is the narrow focus of the allegations. Importantly, they can now bill for all other Medicare and Medicaid services, prescribe medications, and continue caring for their patients without disruption.
This outcome highlights why retaining specialized healthcare fraud defense counsel matters. Many non-healthcare criminal defense attorneys rarely, if ever, challenge these conditions, assuming they are “standard” in fraud prosecutions. But in reality, courts require that bond conditions be narrowly tailored under the Bail Reform Act’s “least restrictive means” standard. Where allegations of fraud are limited to discrete services, there is no basis for blanket restrictions that threaten both patient care and providers’ livelihoods.
Still, this victory represents only one phase of the fight. Even after successfully narrowing bond conditions, providers often face a separate and equally serious challenge: Medicare payment suspensions imposed by the Centers for Medicare & Medicaid Services (CMS). Under 42 C.F.R. § 405.371(a)(2), CMS can suspend payments entirely based on a “credible allegation of fraud” after consulting with the Office of Inspector General and, in some cases, the Department of Justice. These suspensions can be imposed without prior notice and can remain in effect indefinitely while an investigation continues. See 42 C.F.R. § 405.372(a)(3)-(4), (d)(3). However, CMS is required, with or without prior notice, to give the provider an opportunity to submit a rebuttal statement explaining why the suspension should be removed. See 42 C.F.R. § 405.372(b).
For providers, the harsh reality is that the punishment often begins long before any finding of guilt. But our firm’s focused strategies address both fronts. By first challenging overbroad bond restrictions, we protect providers’ ability to maintain their practices and care for their patients. At the same time, we develop targeted approaches to contest or mitigate CMS payment suspensions and safeguard long-term practice stability.
At Chapman Law Group, we fight relentlessly to defend healthcare providers against aggressive government enforcement. If you or your organization faces allegations of healthcare fraud, retaining counsel with deep Medicare and Medicaid expertise is critical. As this result demonstrates, the difference between folding and fighting often determines whether a provider can keep their doors open during the pendency of a case.
Individuals depicted or heard in the foregoing media appearance or images may no longer be current attorneys, employees, members or affiliates with Chapman & Associates, PC or The Chapman Law Group (the “Firm”), including Ronald W. Chapman, II who is no longer affiliated with the Firm. For a current listing of the attorneys and services available with the Chapman Law Group, please see https://chapmanlawgroup.com/team.
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Laith Quasem
Associate Attorney
Professional Licensing & Regulatory Affairs, Healthcare Compliance, Federal Criminal Defense
Seattle Office (Satellite)
Washington
Phone: (877) 234-5911
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