CEO, Staff Provider, or Individual Doctor-Owned Business, Each With No Mitigation Policies and Procedures: This DOJ TaskForce is Nothing to Fool With.

5/1/2024: The Palmetto Health Care Fraud Task Force (PHCF Task Force), the Department of Labor, and the South Carolina Attorney General’s Medicaid Fraud Control Unit have joined to combat health care fraud and recover taxpayer funds.??

They investigate false billings, COVID-19 fraud, and violations of the Anti-Kickback Statute in the District of South Carolina that victimize patients, healthcare providers, private insurers, and government insurers, such as Medicare, TRICARE, and Medicaid.

No matter how intentional or unintentional, once you become aware that their Task Force is making inquiries, you need legal representation as their case is mostly complete.

This includes finding representation with experience in Federal Criminal Defense, specifically defending cases like yours in Federal Court.

Nationwide, from May 1st - 9th, 2024, the fraud totaled approximately $2B.

From Security Clearances to stealing pain medications.

• Hospital Grant Funding Charges: $7M
• Medicare Fraud: $42M, $24.3M, $6.3M, $4.2M
• Opioid-Related: $1.563B,
• Medicaid Fraud: $1M, $1.6M
• COVID Related Fraud: $2.7M
• Anti-Kickback: $20K (smaller didn't matter)
• Healthcare Fraud: $174M

ENFORCEMENT EXAMPLES: U.S. DOJ, HHS, and OIG

• Government Contractor Settles Claims That It Billed for Personnel Who Lacked Required Security Clearances
• Nurse Sentenced to Federal Prison for Stealing Pain Medication from Patients and Fined $20,000
• Cleveland Clinic to Pay Over $7 Million to Settle Allegations of Undisclosed Foreign Sources of Funding on NIH Grant Applications and Reports
• Hospice Owner Sentenced To 240 Months Imprisonment And Ordered To Repay $42,000,000 For Defrauding Medicare.
• Cape Cod Hospital To Pay $24.3 Million To Resolve False Claims Act Allegations Concerning Its Failure To Comply With Medicare Rules For Cardiac Procedures
• Pennsylvania Man Sentenced To Probation And $20,000 Fine For Attempting To Obstruct Investigation Into Purdue Pharma’s And Practice Fusion’s Violations Of Anti-Kickback Statute
• U.S. Attorney Announces $2.5 Million False Claims Act Settlement With Diagnostic Testing Facility For Paying Kickbacks To Physicians For Patient Referrals
• Shelby Township Doctor Sentenced To 12 Years In Prison For Illegally Distributing More Than 270,000 Opioid Pills Worth More Than $6.3 Million
• Florida Hospital System Agrees to Pay $1.5 Million to Resolve Liability Relating to Self-Disclosure of Improper Discounts.
• Opioid Manufacturer Endo Health Solutions Inc. Ordered to Pay $1.536B In Criminal Fines and Forfeiture for Distributing Misbranded Opioid Medication.
• Justice Department Recovers Fraudulent Transfer Of Proceeds Arising From Kickback Scheme

No matter how intentional or unintentional, once you become aware that their Task Force is making inquiries, you need legal representation as their case is mostly complete. They have a 98% conviction rate.

This includes finding representation with experience in Federal Criminal Defense, specifically defending cases like yours in Federal Court.

Asking Questions Is Part of the Process of,

CHOOSING THE RIGHT ATTORNEY,?and one who,

1) Practices federal criminal defense in a federal court and

2) Has experience in cases like yours. It sounds like common sense, right?

• … at this moment, you may not be making the best decisions for yourself, so consider bringing along someone you trust to get their feedback as you meet and interview different attorneys.

3) A case in point is a client I had who, unfortunately, didn’t ask any questions, only to learn his

• attorney years later, didn’t specialize in Federal Criminal defense, and had a
• disciplinary problem with his state bar.

INTERVIEWING ATTORNEYS is your opportunity to find someone with a proven track record of,

4) Handling cases like yours is important. They should be willing to provide

5) Several current or past clients for you to speak with to ease some of your concerns and provide several

6) Sentencing memorandums (it should be about You – not just quoting legal stuff that the Judge already knows, like Booker) for cases like yours for you to read.

• If they mention HIPPA, agree, but Adobe allows for redacting all personal information and works better than a black marker – If you notice that the memorandums appear similar, keep interviewing other lawyers.
• Feeling comfortable with your chosen attorney is just one more step in the right direction as you develop a successful defense team.
• During the interview, try and

7) Ask why they wanted to practice law and what was their best federal case sentence result, as these are both good conversation ‘ice breaker’ questions and

8) Ask them when they recommend preparing for the Presentence Interview and Sentencing Hearing. According to Federal Judge Robert N. Scola:

• Judge Scola suggested that lawyers take a page out of the book from our death penalty colleagues and advised,
• “Don’t wait to think about sentencing advocacy,” since 99 percent of federal criminal clients will be facing sentencing, start preparing the case for sentencing early on.

CONTINUING,

9) Ask whether they charge hourly or flat fees and if they have a payment schedule option.

• If you want to go to trial (just feeling your right is insufficient), I give you FTX Sam Bankman-Fried and Elizabeth Holmes. Remember that the?DOJ has a 90+% conviction rate.

• Don't let counsel write your Personal Narrative and insert it into their sentencing memorandum. You, the defendant, are best served by providing a well-written Narrative that was proofread for content and spelling.

• Therefore, additional strategic questions would be:

10) How many trials and appeals (or what “%”) have they won, out of how many cases, over the past 3-7 years?

11) Don’t anger the court – before they ever meet you. That’s playing Russian Roulette with your life. SBF was remanded to an FDC, which is not a great place to be.

12) What is their current caseload, or how busy are they – too busy?

• Consider that a single attorney with a small staff could support two or three criminal trials per year while working full-time.
• A Federal Defender may be as good if not better than private counsel.

13) While not yet law, is your attorney familiar with the?Fairness in Restitution (FIR) Act? While not yet law, if you anticipate owing Restitution, consider requesting that the Government:

a) Show actual loss sustained by a victim as a direct and proximate result of the defendant’s actions,

b) Eliminate joint liability and ensure that defendants are only responsible for financial losses they caused,

c) Provide a right to an evidentiary hearing for proving or disproving the amounts included in a restitution order,

d) Change the statutory period of liability from 20 years to 10 years and prevent extensions;

h) Exempt any reduction in restitution amount owed from being counted as income for tax purposes.

i) Verify that the No Interest box is checked

14) What is their opinion of providing your Sentencing memo, which includes your Sentencing Length Explained under USSC Guidelines and your Placement Request, to your Probation Officer – before the interview and final version of the PSR? Federal Judge Patrick J. Schiltz?expresses exasperation;

• “It’s surprising how many otherwise competent attorneys ‘punt’ at the sentencing hearing.”

15) Last, if you have time, watch them in court.

If you find this helpful, please subscribe and share it with your colleagues. With more to follow, should you have any questions, are interested in engaging my services, or have any suggestions for future topics, I am easy to reach ??, and thank you for your time.

Watch for my new daily video series: WHITE COLLAR – INDICTED AND FACING PRISON

Marc, Dr. Blatstein

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