Medicare and Medicaid Fraud InvestigationsBy the time Medicare or Medicaid fraud investigators contact you, most of their investigation has been completed. You were not chosen at random. The investigators have already reviewed your claims to government healthcare programs. They have already concluded that you violated the law.
The next step is critical. Will they charge you with serious crimes? Will they demand that you pay back money? Can you convince them that you did nothing wrong or that any mistakes you made were unintentional?
The answers to these questions will depend on how you respond to the investigators.
Respond properly and you may be able to avoid serious consequences, even if you made mistakes. Fail to respond properly and you may face a life-changing disaster that includes heavy fines, a criminal record, the loss of professional licenses, exclusion from the Medicare and Medicaid programs, a long prison sentence and, if you are not a U.S. citizen, deportation.
You need to get an experienced health care fraud lawyer on your side immediately. Medicare and Medicaid fraud investigations are too complex, and the potential consequences are too severe, for anyone to take a do-it-yourself approach.
John Howley, Esq. has helped clients avoid serious consequences in government investigations for more than 30 years. Call him today to schedule a free and confidential consultation.
How Should I Respond to Healthcare Fraud Investigators?Never talk to health care fraud investigators without a lawyer.
Many clients ask, “But if I hire a lawyer, won’t the investigators think I’m guilty?”
Let’s get something straight right off the bat: If the investigators are investigating you, then they already believe that you are guilty. Talking to the investigators without a lawyer will not convince them that you are innocent.
The investigators are not trying to help you. They want to charge you with Medicare or Medicaid fraud. They want to use your own words to convict you. An innocent mistake or memory lapse about a minor detail can be deadly. For example, if you say something that is not 100% consistent with what they see in your records, the investigators will use that inconsistency to argue in court that you are a liar.
Medicare and Medicaid fraud investigators work in teams. If you agree to speak with them, they will interrogate you. While you are being asked questions, one of the investigators will take notes. They will use their words, not your words, to describe what you tell them. Those notes will be used against you.
You need to protect yourself. An experienced healthcare fraud lawyer will act as a buffer between you and the investigators. He can talk to the investigators, learn what they know, and discuss their concerns. Most importantly, your lawyer may learn where the gaps are in the investigators’ case. This is critical information that will help you develop a defense.
In some cases, your lawyer can negotiate a resolution without you ever having to speak with the investigators. In other cases, your lawyer may negotiate a “proffer” agreement. This type of agreement allows you to explain your side of the story to prosecutors without them using your statements against you as long as you tell the truth.
You cannot obtain these protections on your own. In fact, the investigators will not advise you of these protections and defenses. Their job is to interrogate you. They want to keep you afraid and off balance. They want to double-team you and build the case against you. Without a lawyer, you are at a serious disadvantage.
Having an experienced lawyer on your side tells the investigators that you are taking the investigation seriously, and that you are ready to challenge any charges against you.
Call John Howley, Esq. today to schedule a free and confidential consultation. Let him use more than 30 years of experience to help you understand and protect your rights.
The Best Defenses to a Healthcare Fraud InvestigationThe best defense is a good offense, especially when it comes to Medicare and Medicaid fraud investigations. Merely denying the investigator’s allegations will not convince them to go away. You must have a strategy for convincing them not to charge you with a crime. This strategy should include both legal challenges and challenges based on the evidence.
The starting point is getting an objective understanding of the facts, including any mistakes you may have made. Sometimes clients had no intent to commit Medicare or Medicaid fraud, but mistakes were made. You need an objective look at your records and an understanding of where things may have gone wrong. Once you understand where the problems are, you can begin to build your defense.
You also need to understand the evidence against you. Do the investigators have documents or witnesses that they intend to use against you? What are those documents and who are those witnesses? Are there other documents that will contradict the evidence that the government thinks it has against you? You need to think through all the evidence the government may have before you respond to the investigators’ questions.
You have a Constitutional right to remain silent and to require the government to prove its case beyond a reasonable doubt. If, after conducting a review of your records, it appears that you have serious problems, your lawyer may recommend that you exercise those rights.
On the other hand, if the review of your records reveals that the government is mistaken or that there are weaknesses in its case, then your lawyer may advise you to produce evidence to raise doubts about the strength of the government’s case against you.
For example, if you are accused of making false statements, you may be able to avoid criminal charges by giving the investigators evidence that the statements were true when they were made, or that you believed the statements to be true when they were made, or that any problems with the statements were the result of a mistake and not an intentional attempt to defraud the government.
Medicare and Medicaid fraud investigations are not always black and white. There are often gray areas where the government will be willing to negotiate a resolution without going to court. You need to have a complete understanding of your case – and a complete understanding of what the government may and may not do – in order to prepare your defense.
The bottom line is: Do not rush into responding to a Medicare or Medicaid fraud investigation. An effective defense requires a thoughtful strategy based on the law, the agency that is conducting the investigation, and the evidence.
Start preparing your defenses today. Call John Howley, Esq. to schedule a free and confidential consultation.
Do Not Delay or Ignore Healthcare Fraud InvestigatorsOnce you are contacted by Medicare or Medicaid fraud investigators, time is not on your side. You need to get an experienced healthcare fraud lawyer on your side immediately.
Burying your head in the sand will not make the investigators go away. They will simply finish their investigation without your input. They will tell the prosecutor and the court that you refused to cooperate. They will argue that your refusal to cooperate shows that you are guilty and deserving of the harshest punishment.
That said, you should never answer the investigators’ questions or turn over any documents before consulting with an experienced lawyer. Anything you say can and will be used against you.
So, what should you do when contacted by healthcare fraud investigators? Be polite and professional. Let the investigators know that you want to cooperate, but that you cannot talk right now. Then get professional help and advice right away.
If you are contacted by letter, bring the letter to an experienced healthcare fraud defense lawyer and get advice on how to respond. Make sure that you or your lawyer responds by the date in the letter, even if it is only to ask for more time.
If you are contacted by telephone or in person, politely tell the investigator that you cannot talk right now. Get their business card or ask for their name and telephone number. Tell them that you will get back to them. Then bring the investigator’s contact information to your lawyer for advice on how to respond.
Responding promptly to health care fraud investigators and letting them know that you are willing to cooperate with the advice of an attorney are the first steps to preventing a catastrophe.
When you tell an investigator that you want to speak with your lawyer first, it tells them that you are taking this seriously. That is exactly the message you want to send. It tells them that you are professional. It tells them that you are not a pushover.
Here is the most important point. Your request to speak to a lawyer first cannot be used as evidence against you. While an investigator may tell a judge or jury that you refused to cooperate, they may not argue that you are guilty because you exercised your Constitutional right to a lawyer.
Get an experienced healthcare fraud investigations lawyer on your side today. Call John Howley, Esq. to schedule a free and confidential consultation.
Hire the Best Healthcare Fraud Investigation LawyerYou wouldn’t seek out a dermatologist for heart surgery. Health care fraud is a highly specialized area of law. You need an experienced specialist on your side.
Medicare and Medicaid fraud investigations require an understanding of complex government insurance laws and regulations, plus privacy laws, plus criminal laws. Most of all, your lawyer must understand how all of these laws and regulations apply in the real world of medicine.
Criminal defense lawyers – even very good ones – do not always have the necessary expertise in Medicare and Medicaid laws, rules and regulations. Healthcare lawyers do not always have experience with criminal procedures, investigations and trials. You need a lawyer who has both healthcare and criminal defense expertise.
You also need a lawyer who is intimately familiar with the different agencies that investigate and prosecute Medicare and Medicaid fraud. Each agency is different. Some agencies are very quick to recommend criminal prosecution. Other agencies are more interested in civil settlements to recover money. Some agencies require investigators to get approval from supervisors for any decisions. Other agencies give investigators authority to resolve matters on their own. Understanding how each agency works is critical to avoiding bad results.
It is critical to have a lawyer who knows the investigative agencies, how they operate, what their authority is to settle or prosecute a case, and what criteria they use to decide whether or not to bring a criminal prosecution.
Make sure your lawyer has specialized expertise in Medicare and Medicaid fraud investigations and defense.
John Howley, Esq. is a trial lawyer with more than 30 years of experience in criminal investigations, trials, and appeals. He represents clients before the Bureau of Fraud Investigation, the Medicaid Fraud Control Unit (MFCU), the Office of Medicaid Inspector General (OMIG), and in criminal proceedings brought by federal, state and local prosecutors.
His experience includes defending major pharmaceutical companies, physician practice groups, individual physicians, pharmacists, nurses and physical therapists, durable medical equipment providers, and patients.
Mr. Howley has received the Gideon Champion of Justice Award from the New York State Association of Criminal Defense Lawyers, the Thurgood Marshall Award from the New York City Bar Association, and the Medal for Excellence in Advocacy from the American College of Trial Lawyers. He has argued in the U.S. Supreme Court, and he has been named one of New York’s SuperLawyers.
To schedule a free and confidential consultation, call us today at (212) 601-2728.
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John Howley, Esq.
(212) 601-2728 |