NYC Healthcare Fraud Attorneys

It seems that the more changes are made to the United States health care, the more complex become the regulations, which makes more difficult to control their observance and ultimately gives way to more criminal investigations, prosecutions and convictions. We at Joseph Potashnik and Associates routinely defend patients and physicians, nurses, dentists, therapists, chiropractors, pharmacists as well as corporate clients – hospitals, pharmacies, private practices, home health agencies, medical equipment providers, medical laboratories, nursing homes and insurers, in audits, criminal investigations and court proceedings.

Federal Healthcare Fraud Investigations

Investigations into alleged healthcare fraud are conducted both on federal and state levels. Federal agencies authorized with this task are the following:

  • Office of Inspector General (OIG) and Centers for Medicare and Medicaid Services (CMS) of the Dept. of Health and Human Services;
  • Defense Criminal Investigative Service of the Dept. of Defense;
  • Dept. of Justice through the FBI and U.S. Attorney General’s Office.

NYS authorities that conduct such investigations:

Healthcare fraud lawyers at our law firm have dealt with all of these governmental bodies in multiple situations. Any health care provider should realize that one day their practice may be audited or investigated. Considering the confusing nature of the existing regulations, you may be in trouble even though you did not intend to violate the rules. This could be extremely disruptive to business operations and staff morale. In order to minimize the exposure and business disruption, you must think ahead and prepare a plan that will address this situation. Speaking with our experienced attorneys before agents appear at your door can resolve many issues before they arise. If your practice or some of your employees is under audit or investigation, get in touch with us immediately to discuss your matter.

There are multiple things that can spark off investigations into alleged fraud by providers and beneficiaries. Follow the link below to learn them.

READ MORE: What Triggers Medicaid Fraud Investigations in New York

Consequences of Healthcare Fraud

If you are accused of such offenses, the consequences may be severe even if no conviction is obtained. Criminal proceedings may tarnish your reputation as a medical professional and consequently make you lose your clients. If the prosecutors manage to secure a criminal conviction, you may be excluded from participating in federal health care programs for minimum 5 years or, at worst, permanently. The conviction will inevitably lead to disciplinary proceedings that may result in medical license loss. The person may also be denied hospital privileges. Besides that, the person will be obliged to pay restitution and may face prison time and steep fines. Health care corporations charged with fraud may be banned from doing business with the government, which will lead to bankruptcy.

What to Do If Investigated for Healthcare Fraud

As you may see, criminal investigations and charges are not something to be taken lightly, and the way you address the issue at the very beginning will most likely affect the outcome of the situation. Below is a roadmap describing what you should do if you learn that you are a subject of such investigation.

1 The first thing you should know is that by attempting to cope with the situation with your own forces is fruitless. Most likely it is the first time you end up with the issue, so you’d better seek help from someone who has handled it multiple times – a competent healthcare fraud lawyer.

2 Don’t allow any officials to inspect files in your office unless the have a search warrant. Don’t destroy or alter any files and records and don’t instruct your staff to do so or to lie. This will aggravate the situation and complicate your defense.

3 Don’t talk to the investigators and don’t let them interrogate your staff. Tell them politely that first you need to discuss the situation with a lawyer – and do so immediately. Contact our healthcare fraud attorneys for help!

Not every probe will necessarily result in arrest and conviction. Timely intervention of an experienced Medicare fraud defense lawyer can make an enormous difference and determine the outcome of the situation. We may be able to prevent the charges from being filed or to get them dismissed or minimized. Our Medicaid fraud attorneys also have experience representing New York clients in exclusion and licensing procedures and in most of these situations we were able to minimize or avoid debarment at all or set the stage for an early termination of suspension.

Contact Joseph Potashnik and Associates for Help

Defending healthcare fraud cases requires quite narrow expertise and thus shouldn’t be handed to general criminal lawyers – only to healthcare fraud attorneys. This is the kind of lawyers our New York firm has on board, and they routinely represent clients in interactions with all investigative agencies conducting healthcare fraud investigations. We also have defended multiple clients in trials and appeals. Check out just a few of our cases.

Our Recent Cases

We defended several providers in an NY MFCU investigation into allegations of $1M Medicaid fraud. We reached an administrative settlement with no criminal charges filed.

We defended a Medicaid provider in administrative proceedings by the OMIG. We were able to successfully appeal our client’s termination from federal health care.

We represented a New Jersey physician in a massive Medicare fraud case. We managed to reach a probation sentence.

Our client was a transportation company accused of overbilling Medicaid. A civil settlement was reached.

Our client was a pharmacy investigated for insurance fraud. We reached a civil settlement.

Our attorneys defended a nursing home investigated by the NY OIG. No criminal charges were filed.

We realize that the U.S. health care is a tangled system of ever-changing regulations that are hard to make out, which makes it easy for many to make an error, though unintentionally. If you or your business are a target of healthcare fraud investigation, don’t leave your livelihood and freedom to chance – contact Medicaid fraud attorneys at our NYC firm to set up an immediate review of your case. We will carefully go through the details to figure out the best line of defense and mitigate possible damages.