California Defense Attorney for Cardiologists Being Investigated for Medicare Fraud Allegations
Following one of the largest Medicare fraud takedowns in history, which included charges against 22 medical providers in California for their alleged involvement in a $162 million fraud scheme, cardiologists and clinicians in the state are increasingly finding themselves the targets of federal Medicare fraud investigations.
Medicare fraud has long been one of the federal government’s top law enforcement priorities. Each year, cardiologists and other healthcare providers use Medicare fraud schemes to defraud the government out of hundreds of billions of dollars, and this has led to an increased risk for all providers who bill Medicare to find themselves in the crosshairs of federal investigators.
Oftentimes, these investigators are part of the Medicare Fraud Strike Force, a coordinated federal law enforcement organization that is devoted to identifying and combating Medicare fraud. The Medicare Fraud Strike Force has teams placed in key cities around the country. Along with the Medicare Strike Force, the Centers for Medicare and Medicaid Services (CMS), the Federal Bureau of Investigation (FBI), the Office of Inspector General (OIG), and numerous other federal agencies all investigate suspected Medicare fraud cases as well.
What to Do if Your Cardiology Practice is Being Targeted in a Medicare Fraud Investigation
If your cardiology practice is being targeted in a Medicare fraud investigation, you should not be surprised, and you do not even necessarily need to be alarmed. But, you do need to take your situation extremely seriously. The Medicare Fraud Strike Force is increasingly relying upon data analysis to identify potential targets for its investigations, and this, unfortunately, means that many innocent medical providers are facing invasive investigations. The fact that you are under investigation does not mean that you are guilty, but it does mean that you will need the help of an experienced legal team to make sure that you avoid unjustified civil or criminal charges.
When you find out that you or your cardiology practice is under investigation, here are three things that you can do to help minimize the consequences:
1. Know Your Rights.
You have rights during the government’s investigation. While you will be asked lots of questions and the investigating agents will want you to give them lots of documents, you have the right not to voluntarily disclose information that the government might eventually be able to use against you. Your healthcare fraud defense attorney will be able to explain your obligations when it comes to cooperating with investigators and will be able to communicate with the investigators on your behalf.
2. Avoid Potentially Costly Mistakes.
While you do not have to voluntarily disclose incriminating information, you cannot intentionally conceal or destroy information in order to prevent it from becoming evidence in your case. Destroying records does not make you innocent (and can itself lead to criminal charges), even if it turns out that the records you destroyed would not have helped prove the government’s case.
3. Seek Experienced Legal Representation.
You can protect your rights and avoid potentially costly mistakes by seeking legal representation during your investigation. Too often, targets of Medicare fraud investigations either (i) assume that the investigation will go away, or (ii) believe that they do not need an attorney unless they get charged. But, in order to convince prosecutors not to bring charges, you will need to hire an experienced defense lawyer to intervene in the investigation and demonstrate that you have a strong and legitimate defense.
As the target of a federal Medicare fraud investigation, your top priority should be preventing the investigation from leading to civil or criminal charges. It can be much easier to make your case go away during the investigation phase. By avoiding charges, you can avoid the risk of having a jury return a guilty verdict at trial.
Consequences of Failing to Defend Yourself Against a Government Investigation
In Medicare fraud cases, prosecutors have the option to bring either civil or criminal charges. Both have the potential to lead to severe, life-changing penalties if you fail to mount a successful defense:
- Civil Penalties for Medicare Fraud: Fines of up to $11,000 per false claim, treble (triple) damages for the amount you obtained through fraudulent or false pretenses, other financial penalties, and loss of your right to participate in Medicare and other federal government benefit programs.
- Criminal Penalties for Medicare Fraud: Criminal fines (which can easily add up to hundreds of thousands of dollars) and a federal prison sentence of 10 to 20 years for each count of Medicare fraud.
If your investigation is going to lead to a prosecution, at the The Criminal Defense Firm, we will seek to keep your case civil in nature. By keeping your case civil, we can keep the possibility of prison time off of the table. To do this, we focus on raising serious questions about each element of the offense that the government needs to prove in order to obtain a conviction at trial. If we can convince prosecutors that they are not going to win your case, we can protect you without the need to go in front of a judge and jury in federal criminal court.
Making the Right Choice for Your Medicare Fraud Defense
So, you now know why you need an attorney, and you also now know that you need an attorney during your investigation. But, how do you choose the best legal team to defend you?
The short answer is that you need to put experience on your side. The Medicare Fraud Strike Force is an elite team that, “harness[es] data analytics and the combined resources of Federal, State, and local law enforcement entities to prevent and combat healthcare fraud.” The agents on the Medicare Fraud Strike Force know what they are doing, and many of them have several years of experience building cases against cardiologists and other physicians suspected of Medicare fraud. The same holds true for the CMS, FBI, OIG, and other federal investigators who handle Medicare fraud cases as well.
Then, there is the fact that, by the time you find out that you are being investigated, the government has most likely already begun building its case against you. This means that you are starting from a disadvantage. So, to turn the tables in your favor, you need to match the investigators? experience and you need to take control of the investigation.
At The Criminal Defense Firm, the attorneys in our Healthcare Fraud Defense Group bring decades of experience to defending cardiologists suspected of Medicare fraud in California.
Learn More About Defending Your Dental Practice Against Allegations of Medicare Fraud
When facing a federal Medicare fraud investigation, you need to make informed decisions. This starts (but does not end) with choosing an experienced legal team to represent you during the investigation.
To learn more about protecting your rights, review the following resources prepared by the healthcare fraud defense attorneys at The Criminal Defense Firm:
Schedule a Free California Medicare Fraud Defense Evaluation Today
If your California cardiology practice is being targeted in a Medicare fraud investigation, The Criminal Defense Firm’s Healthcare Fraud Defense Group is here to help. To speak with our senior attorneys in a free and confidential consultation, call (714) 602-4316 or submit our online defense evaluation now.
Dr. Nick Oberheiden is a national litigation and trial criminal defense attorney who practices exclusively in the area of federal law.