Recent Blog Posts
PIP Fraud And False Billing Claims Involving Exaggerated Or Fabricated Treatment
A PIP fraud accusation often starts with the ordinary mechanics of a crash-treatment file. A patient is treated after an auto accident. A visit is documented. A bill is sent to the insurer. Months later, the same file may be read by fraud investigators as evidence that treatment was exaggerated, unsupported, or never performed…. Read More »
Rebuilding After A White-Collar Criminal Case
A federal white-collar case can take over a person’s life before a jury hears evidence or a judge imposes a sentence. An investigation can threaten a career, freeze business opportunities, strain professional relationships, and put family finances under pressure. The public nature of many white-collar cases adds another layer. Court filings, media attention, employer… Read More »
Digital Forensics In Cybercrime Cases: Challenging The Government’s Technical Evidence
Digital evidence can look powerful in a courtroom. A login time. An IP address. A file path. A device image. A message pulled from an account. Prosecutors often present these details as if they speak for themselves, but digital evidence rarely tells the whole story without interpretation. In cybercrime cases, the real fight often… Read More »
Pharmacy Compounding And Prescribing Patterns In Prescription Scheme Cases
Compounded medication can be prescribed for reasons that begin and end with patient care. A patient may need a medication without an ingredient that caused a reaction. Another may need a topical preparation after oral medication led to side effects. In a medical practice, those decisions can reflect ordinary clinical judgment rather than any… Read More »
Federal Investigations Triggered By Artificial Intelligence And Automated Monitoring Systems
A federal investigation can begin quietly. A transaction alert appears inside a bank’s compliance system. A billing pattern falls outside an expected range. A surveillance tool isolates trading activity around a market event. No agent has to knock on the door for the first step to occur. The data is already moving through reviewers,… Read More »
Cosmetic Medicine And Cash-Based Practices Can Create Unexpected Federal Fraud Risks
Cosmetic medicine often runs on a private-pay rhythm. Patients choose aesthetic care expecting to pay directly, finance the procedure, or use a package purchased through the practice. Because many of these services are elective, a physician-owned med spa or cosmetic surgery office may not expect the same fraud scrutiny that follows Medicare, Medicaid, or… Read More »
The Signature You Can’t Take Back
Telehealth Orders, Signed Certifications, and Federal Fraud Exposure A note for physician clients on the criminal risk in signing telemedicine orders and prescriptions For a physician, signing a doctor’s order can feel like the smallest act of the day. The patient information is already filled in, the equipment is already selected, and all that… Read More »
When “Medically Unnecessary” Becomes a Federal Crime
What Physicians Should Understand About Medical Necessity as a Theory of Criminal Liability A note for physician clients on how medical-necessity-based prosecutions work and where the real exposure lies Every physician makes judgment calls about what a patient needs. A brace, a cardiac workup, a wound graft, a genetic test: these decisions turn on… Read More »
You’re a Data Point Now – How CMS Analytics Identifies Physicians Before an Investigation Begins
A note for physician clients on the shift to data-driven healthcare fraud enforcement In May 2026, a federal jury in Los Angeles convicted a Glendale physician of a $45 million Medicare fraud scheme built around Botox injections. What should arrest the attention of every practicing physician is not the size of the loss. It… Read More »
Controlled Substance Prescribing And Fraud Overlap: When Opioid Cases Become Financial Crimes
A controlled substance investigation can move quickly from a review of prescribing decisions into a full financial crime prosecution. For physicians, clinic owners, pharmacists, executives, and licensed providers, the danger is not limited to whether a prescription was appropriate. Federal agents may begin with opioid prescribing patterns, then expand into billing records, Medicare and… Read More »