Tricare is one of the three primary federal government medical benefit programs. Federal law enforcement agencies have long focused on combating Medicare fraud and Department of Labor (DOL) fraud; but, until relatively recently, they paid little attention to Tricare.
Lately, however, federal agencies have significantly expanded their investigative efforts with respect to healthcare providers that bill Tricare. In particular, they have been focusing on compound pharmacies, toxicology laboratories, and other high-dollar ancillary branches.
Trusted Defense Attorneys for Allegations of Tricare Fraud
The attorneys at the The Criminal Defense Firm regularly represent healthcare providers and their executives who have been accused of Tricare fraud in all parts of the country. The primary goal of our defense strategy is to keep the government’s investigation civil so that our clients can avoid facing criminal charges. This is a critical distinction, and many providers are surprised to learn that not all healthcare fraud investigations result in criminal prosecutions.
In many cases, it is unclear at the outset of a case what exactly the government’s objectives are with its investigation. As a result, one of the first questions that we seek to answer in Tricare fraud cases is whether the government is demanding reimbursements (in which case the investigation is civil) or threatening prison time (which would mean a possible criminal prosecution). Some of the factors that we look at to determine the nature of the case are:
- The way our client was made aware of their alleged Tricare violation
- The government agency (or agencies) involved
- The prosecutors who have been assigned to the case (the mere fact that a prosecutor from the U.S. Attorney’s Office is involved does not necessarily mean that it is a criminal investigation)
- The demands being made by the government
- The way that our client describes the events leading up to their decision to hire an attorney
All of these are important elements for properly assessing a case and understanding our client’s potential exposure.
Recent Case Results in Healthcare Fraud Investigations
The following is just a small sampling of our recent results in Tricare and other healthcare fraud investigations:
- Defense of laboratory against investigations by the Department of Defense and the U.S. Attorney’s Office for alleged Tricare Fraud
Result: No civil or criminal liability, case dismissed.
- Defense of nationally operating healthcare company against an investigation by the Department of Defense for alleged Tricare fraud.
Result: No civil or criminal liability, case dismissed.
- Defense of a healthcare services company against an investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for alleged False Claims Act and Stark Law violations
Result: No civil or criminal liability, case dismissed.
- Defense of nationally operating healthcare provider against investigations by the Department of Health and Human Services and the Office of Inspector General for alleged healthcare fraud.
Result: No civil or criminal liability, case dismissed.
- Defense of healthcare marketing company against an investigation by the Office of Inspector General for alleged False Claims Act and Medicare violations.
Result: No civil or criminal liability, case dismissed.
- Defense of a surgical implant company against an investigation by various branches of the federal government for alleged fraud.
Result: No civil or criminal liability, case dismissed.
- Defense of a physician owned entity against an investigation by the Department of Health and Human Services for alleged Stark Law violations.
Result: No civil or criminal liability, case dismissed.
- Defense of a physician owned entity against an investigation by the Office of Inspector General for alleged fraud.
Result: No civil or criminal liability, case dismissed.
Contact The Criminal Defense Firm for a Free Case Evaluation
If you are facing a Tricare fraud investigation, you should speak with a healthcare fraud defense attorney immediately. The experienced defense attorneys and former federal healthcare prosecutors at the The Criminal Defense Firm are here to help. To schedule a free, confidential case evaluation with a member of our defense team, call 866-603-4540 or contact us online now.
Brian Kuester offers his extensive experience to counsel companies and individuals under civil or criminal government investigation. When resolution requires litigation, clients choose Mr. Kuester’s proven court and litigation experience.