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Physicians and Medicare Fraud

I have represented too many physicians charged with Federal felonies for allegedly committing Medicare fraud. Almost all of them have been respected professionals who had attended good schools and were considered competent in their fields. They all enjoyed good income from their practices.

So, why would someone with so much going for them commit such crimes?

Often, it is because they live beyond their means, and they reach a point where they feel they need “easy money”. Often, physicians become involved with unscrupulous clinic owners and home health care providers. In many of these cases, a large number of patients are presented to them for examinations, evaluations, treatment and to receive prescriptions. Sometimes, the patients are paid to be patients; sometimes, the patients see many doctors for the same claimed problems; sometimes, the patients suffer from various stages of dementia. And, in almost all the cases, the physicians are expected to see a large volume of patients.

The Federal government has become very suspicious of such practices, particularly in South Florida. Experienced prosecutors, often from the Department of Justice in Washington, D.C., and from the local Federal districts, are assigned to prosecute these cases after an investigation by Federal law enforcement agents.

Careers, reputations, medical licenses, families and freedom are always “on the line” in these cases.

Physicians often make the fatal mistake of voluntarily talking with investigating agents before being arrested and charged. Everything said by the physician will be potentially used against him/her, even minor discrepancies, or a perfectly human failure to recall certain facts about patients. Often, the physician is hostile; usually defensive and he/she typicality manages to incriminate him/her self, virtually insuring an indictment. They think the agents are there to help them sort out the facts. Of course, that is not the case; they agents are there to get evidence to use against the physician.

After forty years of representing physicians, my advice is clear: at the first sign of an investigation (a letter so stating, a visit from Federal agents, or after learning of inquiries being made of employees or patients), immediately call an experienced, Board Certified criminal defense lawyer who is knowledgeable in handling such cases. The sooner I get involved on behalf of a physician under investigation, the better things usually work out for my client.

Don’t be embarrassed to call an experienced criminal defense lawyer; it doesn’t mean that you are guilty – it means you are smart.

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