Amanda S. Marshall
Former U.S. Attorney
(Local Counsel)
Lynette Byrd
Former Assistant
U.S. Attorney
Roger Bach
Former Special
Agent
(OIG & DEA)
Joe Brown
Former U.S. Attorney
Dr. Nick Oberheiden
Attorney & Founder
Department of Justice Renews Crack Down Fraudulent Billing and Unlawful Kickbacks
Healthcare professionals must ensure total compliance with Medicare, Medicaid, and other federally-funded government programs to avoid liability. Federal prosecutors are again focusing their efforts on preventing healthcare fraud. However, as prosecutors hone in on reducing fraud, law-abiding healthcare professionals may get caught in the government's wide net. Two of the...
Read more
President Trump Issues Executive Order in Final Days of Presidency, “Protecting Americans From Overcriminalization”
In his second-to-last day as President of the United State, Donald Trump signed an executive order intended to limit the government's ability to criminally prosecute those in violation of certain regulations. The thrust of the Executive Order is to clarify when a violation of a regulation may result in criminal...
Read more
Compliance Issues Related to Cardiopulmonary Exercise Testing
While Cardiopulmonary Exercise Testing is considered the gold standard of exercise testing, it is not appropriate for all patients. Over recent decades, advancements in medicine and technology have extended the expected lifespan. However, while newly available medical testing can help to diagnose serious health conditions, practitioners must be careful when...
Read more
Physician’s Group Settles Medicaid False Billing Claim Related to Sleep Studies
A whistleblower complaint triggered the investigation, resulting in a $1.2 million settlement. Last year, Millennium Physicians Association, PLLC, paid the United States government $1,248,964 to settle a false billing claim related to allegations that the company billed Medicare for studies that were conducted without certified specialists. The case highlights how...
Read more
After Major Takedown, DOJ Continues to Target Cardiovascular Genetic Testing Fraud
As cardiovascular genetic testing continues to garner widespread use, the DOJ is targeting health care providers that fraudulently bill for predictive testing and preventative services. In September 2019, the U.S. Department of Justice (DOJ) announced a major takedown involving doctors, testing laboratories, and telemarketing companies accused of fraudulently billing Medicare...
Read more
Cardiovascular Genetic Testing Compliance: What Do Doctors Need to Know?
Cardiovascular genetic testing is a rapidly-growing, and extremely valuable, area of modern medicine. Providers seeking to offer these services to their patients must prioritize billing compliance in order to avoid recoupments, pre-payment review, and other penalties for health care fraud. For health care providers that offer cardiovascular genetic testing (hereditary...
Read more
What Doctors Need to Know Before Billing for Cardiovascular Genetic Testing
When billing Medicare and other payors for cardiovascular genetic testing, a key issue is whether the testing is "medically necessary" under the applicable billing guidelines. Cardiovascular genetic testing is a breakthrough form of diagnostic screening that allows doctors to help patients plan for – if not prevent – potentially-serious health...
Read more
What are the FBAR Penalties if You Don’t File with FinCEN?
If you are required to file an annual FBAR form with the U.S. Treasury Department's Financial Crimes Enforcement Network (FinCEN), failing to file can lead to steep penalties. Filing an inaccurate FBAR can have severe consequences as well. This is true even if your failure to file or the inaccuracy...
Read more
3 Fundamental Pieces of an FBI Compliance Program
The U.S. Department of Justice Criminal Division published its updated "Evaluation of Corporate Compliance Programs" memo in June 2020. It provides detailed information on what factors prosecutors should consider when (1) conducting their investigations of a corporation, (2) determining whether to bring charges, and (3) negotiating pleas or other agreements....
Read more
Healthcare Fraud Involving Mobile Clinics Defense
Experienced Defense Team If you need advice regarding charges of healthcare fraud involving mobile clinics, do not hesitate to contact one of our healthcare defense attorneys as soon as possible. As the coronavirus pandemic continues to take its toll on society, healthcare fraud has grown increasingly rampant. The DOJ is...
Read more