Healthcare Fraud Investigations and Defense

If you are under investigation or have been charged with a crime, then you are facing prosecutors and investigators who have tremendous resources on their side.  You should not try to handle this on your own.  Get an experienced healthcare fraud defense lawyer on your side immediately, before you speak with anyone from the government.

​By the time Medicare or Medicaid fraud investigators contact you, most of their investigation has been completed.  They have already analyzed your claims for reimbursement.  They may have already interviewed current or former patients, employees, and other witnesses.  They already believe that you did something wrong.

The next step is critical.  Will they charge you with serious crimes?  Will they demand that you pay back money?  Will your lawyer be able to 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 investigation.  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.
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The stakes are too high for you to take a do-it-yourself approach.  You need an experienced healthcare defense lawyer on your side. 

Every case is different.  In some cases, you must prepare an aggressive defense and fight the charges to protect your rights.  In other cases, cooperation and a negotiated settlement or plea agreement can avoid more serious consequences.  You need an experienced Medicare and Medicaid fraud attorney to help you make these very important decisions.

Get an Experienced Healthcare Lawyer on Your Side Today

Call (212) 601-2728

Get the Skills and Experience You Need to Protect Your Rights

Medicare and Medicaid fraud is a highly specialized area of law.  Before hiring a lawyer, you should ask two very specific questions.

• Does the lawyer have a thorough understanding of the complex laws, rules, and regulations that govern Medicare and Medicaid?
• Does the lawyer have the criminal defense experience necessary to protect your rights, negotiate with prosecutors to avoid criminal charges and, if necessary, defend you before a judge and jury?

You need a lawyer who can honestly answer yes to both questions.  An inadequate defense can be catastrophic.  There is too much at stake to settle for anything less that a healthcare fraud defense lawyer who has all the skills and experience you need.
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Over the past 30 years, our lawyers have defended pharmaceutical companies, physician practice groups, durable medical equipment companies, healthcare professionals and employees in hundreds of Medicare and Medicaid fraud investigations.  Our lawyers are also experienced trial lawyers.  They have tried cases before judges and juries in state and federal courts throughout the country.  Let us put all that experience to work for you.

Call Our Healthcare Fraud Defense Lawyers Today

Call (212) 601-2728

​Preparation is the Best Defense

“The best defense is a good offense,” especially when it comes to defending yourself against allegations of Medicare and Medicaid fraud. 

Medicare and Medicaid fraud investigations are not always black and white.  There are often gray areas where the government is willing to negotiate.  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 response to the investigation.

Sometimes we discover that our clients did not intend to commit fraud, but they made mistakes.  Sometimes the government makes mistakes too.  In many cases, we find that the government is relying on a misunderstanding of the facts, an incorrect analysis of documents, or witnesses who are confused or lack credibility.  In other cases, we discover documents or witnesses that contradict the evidence that the government thinks it has.  Analyzing all the evidence is critical before deciding whether and how to respond to the investigators’ questions.
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The bottom line is:  Do not rush into responding to a Medicare or Medicaid fraud investigation.  Get an experienced Medicare and Medicaid fraud defense lawyer on your side first.  Take the time to develop a thoughtful strategy based on the law and the evidence.  Take advantage of our experience to help you get the best possible outcome.

What to Do When Investigators Contact You

​The first sign that you are under investigation for Medicare or Medicaid fraud is usually very low key.  You might receive a letter requesting documents or asking you to come in for an "interview."  Or an investigator might stop by your home or office unannounced.  How you respond is critical.

You must understand that this is not the beginning of the investigation.  By the time investigators contact you, they have already gathered evidence against you.  They have already reviewed any documents that you have submitted to Medicare or Medicaid.  They have already investigated your background and spoken with potential witnesses.  The investigators already believe that you have done something wrong. 

The investigators are not trying to help you.  They are trying to gather evidence that will help them prove a case against you.  Anything you say and anything you give them can and will be used against you.

You have a number of very important rights during the investigation.  Among these are the right to remain silent, the right to consult with a lawyer before you voluntarily turn over any records or documents, and the right to have your lawyer present if you agree to be interviewed.  In addition, while the government may request certain records, there are many types of records that you do not have to turn over.

​Giving up your rights can have catastrophic results.  You need to contact a lawyer before you start turning over documents or answering any questions.

Do Not Ignore the Investigators

Never ignore Medicare or Medicaid fraud investigators.  Burying your head in the sand will not make the investigators go away.  They will simply finish their investigation without your input.

That said, you should never answer the investigators’ questions or turn over any documents before consulting with an experienced lawyer.
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So, what should you do when contacted by Medicare or Medicaid fraud investigators?  Be polite and professional.  Let the investigators know that you want to cooperate, but 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 call us at (212) 601-2728 for advice on how to respond.

Having your lawyer respond to the investigators is the first step to preventing a catastrophe.  When you get us involved as your lawyers, it tells investigators that you are taking this seriously.  It tells them that you are acting professionally.  It also tells them that you have experienced lawyers who will aggressively protect your rights.  That is exactly the message that you want to send.

​You Need More Than a Criminal Defense Lawyer

When it comes to Medicare and Medicaid fraud, you definitely need an experienced criminal defense lawyer on your side.  But you need much more.  You need a lawyer who understands healthcare.  You need a lawyer who can protect your professional license, your livelihood, and your career.

A major issue for healthcare professionals is the potential for exclusion from government healthcare programs.  Even if you avoid criminal charges, you may still face exclusion from Medicare, Medicaid, and other healthcare programs with devastating consequences.  Exclusion results in your inability to submit claims to federal healthcare programs.  It means that you cannot work for any healthcare providers that accept payment from such programs.  In addition, many private insurance companies will not do business with an excluded professional.

You also need to protect your professional license.  Even if you avoid criminal charges, you may face disciplinary action that could result in a suspension or revocation of your professional license.

Unfortunately, too many criminal defense lawyers try to do everything from negotiating drunk driving plea agreements to defending healthcare professionals in complex healthcare fraud investigations.  When faced with a Medicare or Medicaid billing dispute or fraud investigation, these lawyers focus exclusively on avoiding criminal charges or reducing the financial exposure.  They do not think about the career-destroying potential of a negotiated settlement or plea agreement until it is too late.  Too often that results in them winning the battle and you losing the war.
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At The Howley Law Firm, we focus on all aspects of healthcare defense to protect your legal rights, your professional license, your livelihood, and your career.  Call us today to get an experienced healthcare lawyer on your side.

Call (212) 601-2728

​Read The Reviews

"John is an incredible attorney, possessing compassion towards his clients and depth in his understanding and application of the law. He is a walking encyclopedia and ​​a very successful, results-driven attorney."
Maggi Maksoud​

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​"Since forming his own law firm, John has been doing ​the same brilliant work for individuals that he used to do for Fortune 500 companies.  Whenever anyone asks me to recommend a lawyer, the first name I think of is John Howley.""
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"The Howley Law Firm is what my family and I would consider the best there is in New York.  They helped my father reach a settlement of his case in a timely and professional manner.  We highly recommend them."
Justin Yulo

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We Are Here to Help

You are not alone.  At The Howley Law Firm, we care about you.  We are ready to listen to your needs and help you understand your legal rights and options.

We can protect your rights during the investigation, take action to limit the scope of an investigation, and help prepare answers to any questions investigators may have.  At every stage, we are prepared to protect your rights during an investigation and, if necessary, at trial.

Call (212) 601-2728