Why Doctors and Pharmacists Should Be More Watchful Than Ever
The words “health care crackdown” are enough to elicit a hush in just about any doctor’s office or medical supply company, and for good reason.
There are only so many clinics in this country, and every time the government gets more money to hire additional investigators, the likelihood of any given medical practice falling within federal crosshairs increases.
Unfortunately, with crackdowns come breakdowns in a justice system that should ensure that only nefarious care providers are being subjected to unwanted governmental intervention.
No one wants to see abuse or theft in a taxpayer-funded system like Medicaid or Medicare, and no one can deny that there are true cases of white-collar medical fraud in the United States. But it is also true that no one wants innocent care providers to lose their businesses or their medical licenses (or to fret over possible criminal charges) because of an investigation that goes too far.
Sure enough, investigations can and do go too far in the midst of a health care crackdown. And these crackdowns are happening more often, thanks to the establishment of several Strike Force offices around the country that is, federal investigative units that exist solely to hunt down and penalize people suspected of submitting inaccurate bills to Medicare or other programs as well as newfound political fervor for reducing the cost of federal benefits within the current administration.
A health care crackdown can take many forms. In today’s article, we explain what you should watch out for if you’re currently working in the medical field (and especially if you provide services to patients covered by Medicare or Medicaid). We’ll also look at a few recent crackdown initiatives to illustrate how they play out in reality.
What Happens in a Health Care Crackdown
A “crackdown” usually refers to an intensive, multi-departmental effort by the federal government to prosecute numerous defendants within the same industry all at once.
Crackdowns lead to headlines like “412 People Arrested, Including 10 Doctors, for $1.3 Billion in Health Care Fraud.” (See The New York Times.) The government devotes countless hours over the course of many months to investigating anyone and everyone with a potential connection to suspected fraudulent activity. Agents are eager to gain media attention for their “massive takedowns,” so they purposely coordinate their investigations to charge or arrest as many people as possible at the same time.
Accordingly, a crackdown involving your practice could be underway right now, and you might not even know it.
Federal agents tend to work closely with state and local law enforcement, as well as civil or private government contractors (such as ZPICs or RACs) that might have data on your medical practice, which the government can then use against you.
In reality, it has become just about meaningless to even talk about health care crackdowns as isolated events. The truth is that these crackdowns are now happening on a constant, continual basis. One investigation leads to another, and so on. The work of federal investigators is full-time and nonstop.
They can involve a whole range of criminal charges or civil enforcement measures, including:
- DEA controlled substances investigations
- Medicare fraud
- Health care kickbacks
- Mail fraud / wire fraud
- Money laundering
- Public corruption
- Tax fraud
Because of the coordinated nature of these investigations, federal crackdowns almost always produce conspiracy to commit health care fraud charges a real concern because conspiracy law gives the government power to extend charges to people who had little to nothing to do with the underlying criminal behavior. Once a conspiracy charge begins, the charges continue to ripple outward.
What Do Medical Providers Need to Worry About in a Health Care Crackdown
The very word itself, “crackdown,” suggests a sense of urgency. That’s part of the problem. These investigations tend to be hasty, excessively aggressive, and they very often make unfounded assumptions about a defendant’s behavior that rely on an unfair and unreasonable reading of the facts.
We’ve seen it all including truly innocent medical professionals who can’t begin to understand why they’re being targeted. The situation is understandably terrifying. It threatens to ruin livelihoods and reputations that took a lifetime to build. And the sentences for a conviction can include many, many years in prison, not to mention fines that are impossible to pay.
If you’ve been named in a recent health care crackdown, please don’t waste any time in getting an aggressive white-collar criminal law defense attorney on your side. A vigorous and proactive legal defense can make all the difference, just as it has for so many of our clients.
Free Case Review for Health Care Law Professionals at The Criminal Defense Firm
If health care crackdowns are part of the daily conversations around the water cooler in your clinic or office, you aren’t alone. As the takedowns continue, they are impacting a greater number of health care companies all across the country, and providers are naturally afraid even if they haven’t done anything wrong.
The best thing you can do is take steps sooner rather than later to protect yourself. That is true whether you are currently facing charges or merely want to avoid ever facing them in the future.
The Criminal Defense Firm is a federal law criminal defense law firm that focuses on legal matters in the health care field. From Medicare fraud and qui tam lawsuits to pill mill investigations and controlled substances charges, we are here to:
- Get charges dropped
- End investigations in the early stages
- Protect your reputation
- Preserve your medical licenses and DEA registration
- Spare you from crippling fines or penalties (like pre-payment review)
- Keep you out of prison
Those are the goals we fight for in each and every case, always vigorously pursuing the absolute best possible outcome for all our clients. Don’t face a health care crackdown on your own. Contact The Criminal Defense Firm for a free consultation right away. Call 866-603-4540.
Compliance Litigation – Defense
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.