Author Archives: Jay Butchko
Unbundling And The Anti-Kickback Statute: Are You At Risk Of Violations?
Understanding Unbundling in Medical Billing Unbundling refers to the practice of separately billing for procedures that should be covered under a single comprehensive code. This practice increases reimbursement by breaking down services into individual components rather than charging a single, inclusive rate. While unbundling can sometimes be the result of legitimate coding errors, it… Read More »
The Standard Of Review In Criminal Appeals: How Courts Evaluate Errors
When a criminal conviction is appealed, the appellate court does not conduct a new trial or reweigh the evidence. Instead, it reviews the trial court’s proceedings for legal errors that may have affected the outcome. The framework for this review is known as the standard of review, which dictates how much deference the appellate… Read More »
Upcoding Vs. Billing Errors: When Does A Mistake Become A Crime?
Medical billing is a complex process that requires precision, compliance with federal and state regulations, and adherence to ethical standards. While billing mistakes can occur due to clerical errors or coding misunderstandings, upcoding—the act of billing for more expensive services or procedures than what was actually performed—can lead to criminal charges and severe penalties…. Read More »
The Role Of Due Process In Medical License Defense: What Physicians Need To Know
For physicians, maintaining a valid medical license is essential to practicing medicine. However, allegations of misconduct, malpractice, or regulatory violations can place a doctor’s career in jeopardy. When a physician’s license is at risk, due process plays a crucial role in ensuring a fair and just legal proceeding. Understanding the legal protections afforded to… Read More »
Can You Go To Jail For Not Filing Taxes? Exploring Criminal Non-Filing And Tax Evasion
Tax laws in the United States are among the most complex in the world, and compliance can be daunting. While many people may miss deadlines or struggle to gather the right documentation, outright failure to file taxes can have severe consequences. In some cases, this failure can escalate to criminal charges, including prison time…. Read More »
How Prescription Drug Fraud Leads To Illegal Distribution Of Controlled Substances
The illegal distribution of controlled substances is a significant issue in the U.S., driven in part by prescription drug fraud. Prescription drug fraud occurs when individuals or entities unlawfully obtain prescription medications through fraudulent means, often leading to the diversion and distribution of these drugs on the black market. Consult a Florida distribution of… Read More »
A Look At Recent Settlements In Healthcare Fraud Kickback Schemes
Healthcare fraud remains a significant concern in the U.S., as demonstrated by recent settlements involving seven individuals and entities accused of violating the Anti-Kickback Statute and the False Claims Act. The Justice Department announced that these parties, including laboratory marketers, physicians, and a medical practice owner, agreed to pay over $1.1 million to resolve… Read More »
Exceptions To Attorney-Client Privilege: Crime-Fraud Exception Explained
Attorney-client privilege is a fundamental legal concept that promotes open and honest communication between attorneys and their clients. It ensures that confidential information shared by a client with their attorney cannot be disclosed without the client’s consent. However, this privilege is not absolute. One of the most significant exceptions is the crime-fraud exception, which… Read More »
Defenses Against Wire Fraud Charges
Wire fraud is a serious federal offense involving electronic communication to further a fraudulent scheme. Convictions can lead to significant prison time, hefty fines, and damage to personal and professional reputations. Defending against wire fraud charges requires a thorough understanding of the law, strategic legal tactics, and strong representation. Consult an Orlando white collar… Read More »
Kickbacks And Fraud: The Case Of Medically Unnecessary Brain Scans
A legal development occurred in a healthcare fraud case involving a New York operations manager, Timothy Doyle, who pleaded guilty to conspiracy charges. The case highlights how kickbacks in healthcare, particularly those involving diagnostic testing, undermine the integrity of federally funded programs like Medicare. The Scheme: Fraudulent Brain Scan Orders From 2013 to 2020,… Read More »
