Health Care Fraud Defense and Compliance Counseling

  • Represented a medical doctor charged by the U.S. Attorney’s Office with violating the anti-kickback statute for receiving payments to refer patients for x-rays and CT scans.
  • Represented an individual in an investigation of an adult daycare facility by the Office of the Inspector General, Department of Health & Human Services, concerning civil claims of improper billing and receipt of payments from Medicaid, resulting in a civil settlement.
  • Representing a senior individual with a large health care company in a DOJ and HHS-OIG investigation of improper billing.
  • Successfully prosecuted largest healthcare fraud case in the District of Columbia, U.S. v. Florence and Michael Bikundi (while serving at DOJ; convictions affirmed by the DC Circuit on June 11, 2019).
  • Successfully prosecuted health care fraud case involving Medicaid with defendant being found guilty on one count of Health Care Fraud and 16 counts of false statements in health care matters (while serving at DOJ).

Looking Forward

We believe that health care fraud will continue to be one of the most active sectors of the U.S. Department of Justice’s overall fraud enforcement programs. Federal and state regulators will continue to aggressively pursue fraud and abuse in False Claims Act matters, anti-kickback violations and patient privacy issues. We saw in September 2020 that the DOJ had one of the largest takedowns in history that targeted, among others, fraud and abuse in the telemedicine and prescription drug industries. We anticipate that as a result of the COVID-19 pandemic, under the Biden Administration, the DOJ and HHS will increase their focus on fraud and abuse in telehealth services that had expanded greatly in response to the coronavirus crisis. Providers and other individuals and entities who provide telehealth supplies and/or services are encouraged to consult their legal counsel to ensure that their policies and procedures will not trigger regulatory or law enforcement scrutiny.