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Major Federal Investigation into Medicaid and Medicare Fraud

Posted by: Nicole DeBorde
July 02, 2009
Topic: Medicaid and Medicare Fraud

There are news reports circulating that both federal and state agencies are actively investigating Medicare and Medicaid Fraud. These rumors are true and we can expect many arrests in the coming months. Law enforcement, including agents from the FBI and local police, is actively investigating doctors, clinics, healthcare practitioners and anyone who might be responsible for dealing with Medicaid benefits. Doctors who are prescribing medication and medical supplies or equipment may very well find themselves answering questions about their practices and the treatment they and their clinics provide. Any employee working in these settings, like a doctors office or clinic or therapy provider, may also find themselves answering questions – or at least being asked. Nurses, nurse practitioners and, really, anyone working in these settings could be confronted with questions about billing practices as well as how treatment is provided and by whom. Law enforcement may get a search warrant to collect records to scrutinize to determine whether or not proper procedures were followed.

If law enforcement does not have a warrant to enter an office or to collect documents, they may simply ask if they can come in and talk to people or collect paperwork. It is important to remember that everyone has the right to ask to speak to a lawyer if they choose before answering questions or providing access to materials if there is no search warrant for the materials. Even if there is a search warrant, a person can ask to speak to a lawyer before talking with law enforcement. Our office handles these matters and can guide you through this process if you find yourself or your business in this circumstance. Some of the cases from these investigations will land in state court and others in federal court. The consequences for persons convicted of these crimes are severe and include prison time. It is always smart to consider getting a lawyer involved early. Think about it: law enforcement has their lawyers involved from the start. Why shouldn’t you?