Recent Blog Posts
When Marketing Companies And Call Centers Become Part Of A Substance Abuse Fraud Investigation
Substance abuse treatment providers often rely on outside companies to advertise their services, answer calls from prospective patients, verify insurance information, or connect people with treatment programs. In South Florida’s large treatment and recovery industry, those relationships may involve marketing companies and call centers operating far from the facility itself. A business arrangement intended… Read More »
Physician Compensation Based On Productivity: Navigating Federal Enforcement Risks
A physician may receive a productivity bonus after performing more procedures, expanding clinic hours, or taking on a heavier patient load. Years later, federal investigators may place those payments beside referral data and argue that the compensation rewarded business sent elsewhere in the health system rather than the physician’s own work. The formula becomes… Read More »
When HIPAA Violations Become Criminal Charges
Healthcare professionals and employees routinely handle sensitive patient information as part of their work. Federal criminal exposure may arise when investigators believe a person knowingly accessed medical records without authorization, disclosed patient information to an unauthorized recipient, or used that information for personal or financial gain. A HIPAA investigation can begin with a single… Read More »
Embezzlement Accusations In The Healthcare Industry: Unique Risks For Medical Professionals
A healthcare practice can be busy, complicated, and financially messy even when everyone is acting in good faith. Money moves through insurance reimbursements, patient payments, vendor accounts, payroll, provider compensation, refunds, management fees, and billing adjustments. Doctors, administrators, and practice managers often rely on internal staff, outside billers, accountants, and electronic records to keep… Read More »
The Criminalization Of Medical Judgment: When Disagreements Become Federal Charges
A physician may believe a treatment is medically necessary while an insurer, expert reviewer, or federal investigator reaches a different conclusion. That disagreement can begin with dosage, treatment frequency, testing, therapy duration, or the use of a particular procedure. In a criminal investigation, however, prosecutors may try to turn the disagreement itself into evidence… Read More »
Telehealth Marketing Arrangements: When Lead Generation Becomes A Criminal Scheme
A telehealth company may begin with a marketing contract designed to bring patients into a virtual care network. Leads arrive through online advertising, outbound calls, health questionnaires, or outside vendors. Physicians are then asked to evaluate patients remotely and decide whether treatment, testing, equipment, or another service is appropriate. That structure can become dangerous… Read More »
How Federal Drug Charges Differ From Florida State Charges And Why It Matters
A drug arrest in Miami can lead to very different consequences depending on who prosecutes the case. Conduct investigated by local police may remain in Florida state court, while an investigation involving federal agents, an alleged distribution network, interstate activity, or a larger trafficking operation may move into federal court. The facts may overlap,… Read More »
Home Health Certification Fraud: Risks For Physicians Signing Off On Care Plans
A physician may receive a home health certification after a hospital discharge, office visit, or referral from an agency already involved with the patient. The paperwork may include diagnoses, nursing assessments, therapy recommendations, and a proposed plan of care assembled by people outside the physician’s practice. Signing that certification may seem administrative. During a… Read More »
Does Double Jeopardy Apply In Civil And Criminal Cases Arising From The Same Incident?
A single incident can expose someone to more than one legal proceeding. An arrest may be followed by criminal charges while a separate civil lawsuit seeks damages. Police may seize cash, a vehicle, or other property and begin a forfeiture action while prosecutors pursue the underlying offense. Professional or administrative consequences can also develop… Read More »
Clinical Trial Billing Fraud: When Research And Reimbursement Overlap
A hospital may treat a patient while also enrolling that person in a clinical trial. Physicians order scans, laboratory work, medications, and follow-up visits as care continues. Research sponsors may pay some expenses, while Medicare or a private insurer remains responsible for others. A classification made at that intersection can later become the basis… Read More »
