Lowther | Walker’s local Atlanta, GA healthcare fraud defense attorneys hold decades of experience defending medical providers in the Georgia federal courts. If you’re accused of Medicare billing fraud, anti-kickback violations or any other type of healthcare fraud, call Lowther | Walker to speak with an experienced healthcare fraud defense attorney.
No-obligation. Fully confidential.
Call Us Today: (404) 496-4052
Learning the phases of a healthcare fraud investigation can prepare your team for the road ahead. Follow the steps below to begin protecting your Georgia healthcare business.
Healthcare fraud investigations can continue for months or years. Throughout this challenging period, maintaining close collaboration with experienced healthcare fraud defense counsel is essential for protecting your practice, license, and professional future. Remember that investigators’ initial allegations don’t necessarily reflect the final outcome – with proper legal guidance, many investigations conclude without criminal charges or with significantly reduced penalties.
Lowther | Walker’s lawyers have decades of experience defending Georgia medical providers. We understand the complexities of these laws and provide aggressive defense strategies for healthcare providers facing fraud allegations. Our experienced legal team has successfully defended doctors, nurses, administrators, and healthcare businesses against investigations and charges brought by federal authorities.
If you are under investigation or charged with healthcare fraud, acting quickly is critical.
Do not speak with investigators without legal counsel. Gather relevant documentation, and consult with an experienced attorney immediately. Lowther Walker offers expert guidance to navigate these challenges and build a strong defense strategy tailored to your case.
With a track record of success in defending Georgia healthcare professionals, we are committed to protecting your career, reputation, and future.
Contact Lowther Walker’s Atlanta, GA offices today for a confidential consultation.
Many physicians facing allegations believe their billing practices were compliant. The realization that years of standard office procedures are being scrutinized as potentially fraudulent can be devastating. Our billing fraud lawyers provide perspective on similar cases we’ve successfully defended and establish a robust defense for billing charges such as upcoding and double billing.
Healthcare providers facing fraud investigations by the FBI, MFCU (Medicaid Fraud Control Unit), US DEA (Drug Enforcement Administration), or US Department of Health can immediately call our lawyers for urgent answers to their legal questions. Our landmark healthcare fraud defense results include defending a client in the largest fraud case ever prosecuted by the DOJ.
For Medicare audit responses, Medicaid documentation requests from the government or any form of official communication regarding potential action against your healthcare business, call Lowther for an urgent response. Our attorneys can conduct an investigation and mitigate the potential for criminal charges.
Lowther | Walker protects Georgia medical providers facing Medicare fraud investigations. Our team has over 20 years of experience responding to investigators, representing healthcare providers, and defending complex cases involved Medicare billing and associated health services.
If you’re deciding between several firms to represent you, consider the following reasons for selecting Lowther | Walker:
1
Lowther Walker brings decades of focused experience defending medical professionals against healthcare fraud allegations.
Our attorneys possess deep knowledge of complex healthcare regulations, billing requirements, and compliance standards that general law firms cannot match. We understand the nuances of medical documentation and can effectively challenge government interpretations of clinical decision making.
2
Our firm has successfully defended healthcare providers against investigations by HHS-OIG, DOJ, and FBI throughout Georgia.
We’ve achieved case dismissals, reduced charges, and favorable settlements for physicians, practice owners, and healthcare executives facing severe penalties. Our attorneys have successfully navigated complex Medicare fraud, Anti-Kickback, and False Claims Act cases, achieving outcomes that protected our clients’ licenses and livelihoods.
3
Years of handling federal investigations empowers our lawyers with valuable insight into how federal agencies build healthcare fraud cases.
Healthcare professionals call us because we understand the internal processes that drive investigations. This institutional knowledge allows us to anticipate prosecution strategies and position your defense advantageously from the start.
4
We recognize that facing healthcare fraud allegations creates immense personal and professional stress. Our attorneys provide 24/7 accessibility, clear communication about case developments, and honest assessments of your situation. We explain complex legal concepts in understandable terms and involve you in strategic decisions that affect your future.
Throughout the process, we remain focused on achieving outcomes that allow you to move forward with your medical career intact.
Discover why medical care providers in Georgia call upon Lowther | Walker for their healthcare law defense. For help with Medicare or Medicaid Fraud defense in Georgia, request a confidential consultation with Lowther | Walker at (404) 496-4052.
No-obligation. Fully confidential.
Call Us Today: (404) 496-4052
Federal healthcare fraud involves knowingly submitting false or fraudulent claims to government healthcare programs like Medicare, Medicaid, TRICARE, or other federal health benefit programs.
This can include billing for services not rendered, upcoding (billing for more expensive services than provided), unbundling (separately billing for services that should be billed together), accepting or paying kickbacks, and providing medically unnecessary services.
A billing error is an unintentional mistake made in good faith, while fraud requires intent to deceive or knowledge that claims are false.
The key distinction is whether you knowingly submitted false claims or acted with reckless disregard for the truth. However, a pattern of “errors” that consistently benefit your practice financially may be investigated as potential fraud, even if you claim they were unintentional.
Multiple federal agencies may investigate healthcare fraud, including the Department of Health and Human Services Office of Inspector General (HHS-OIG), the Federal Bureau of Investigation (FBI), the Department of Justice (DOJ), the Drug Enforcement Administration (DEA) for prescription-related fraud, and the Centers for Medicare & Medicaid Services (CMS).
These agencies often work together in task forces dedicated to healthcare fraud prosecution.
Federal healthcare fraud can result in significant criminal penalties, including imprisonment for up to 10 years per violation (or up to 20 years if the fraud results in serious bodily injury, or life imprisonment if it results in death).
You may also face substantial criminal fines up to $250,000 per count for individuals, plus restitution to the defrauded programs. Additionally, you could face asset forfeiture of property obtained through fraudulent activities.
Civil penalties under the False Claims Act can include treble damages (three times the government’s losses) plus penalties of $13,946 to $27,894 per false claim (adjusted annually for inflation). You may also face exclusion from participating in all federal healthcare programs, which effectively ends your ability to treat Medicare and Medicaid patients. State Medicaid programs typically follow federal exclusions, further limiting your practice.
Your medical license may also be suspended or revoked by your state medical board.
The False Claims Act allows private individuals (whistleblowers or “relators”) to file lawsuits on behalf of the government and receive 15-30% of any recovery. Current or former employees, billing staff, partners, or even competitors who have knowledge of fraudulent billing practices can file these “qui tam” actions.
The lawsuit is initially filed under seal, meaning you won’t know about it while the government investigates and decides whether to intervene. Many healthcare fraud cases originate from whistleblower complaints.
Immediately contact an experienced healthcare fraud defense attorney before responding to any government inquiry.
Do not destroy any documents, alter records, or discuss the matter with staff or colleagues, as this could lead to additional charges of obstruction of justice. Do not speak with investigators without your attorney present, even if you believe you’ve done nothing wrong.
Anything you say can be used against you, and investigators are trained to elicit incriminating statements. Cooperate with document production as directed by your attorney, but assert your constitutional rights.
In some cases, particularly civil False Claims Act cases or matters handled administratively by the OIG, settlement may be possible.
This might include repayment of overpayments, civil monetary penalties, and a Corporate Integrity Agreement (CIA) that imposes compliance requirements and monitoring for a period of time (typically 3-5 years). However, if the case involves egregious conduct, significant financial losses, or the government believes criminal prosecution is warranted, settlement options may be limited.
Your attorney can assess whether negotiation is viable in your situation.
A Corporate Integrity Agreement is a compliance program imposed by the OIG as part of a settlement in healthcare fraud cases, typically lasting 3-5 years.
It requires you to implement specific compliance measures, including hiring a compliance officer, conducting employee training, engaging an independent review organization to audit your claims, establishing a confidential disclosure program, and submitting regular reports to the OIG.
Violations of a CIA can result in exclusion from federal healthcare programs. While burdensome and expensive, a CIA allows you to continue practicing and participating in federal programs.
The statute of limitations for criminal healthcare fraud is generally 10 years from the date of the offense under some provisions, though it can be as short as 5 years under others.
For civil False Claims Act cases, the limitations period is 6 years from the violation or 3 years from when the government knew or should have known about the violation, whichever is later, but not more than 10 years after the violation.
However, each false claim can be a separate violation, so charges may extend back many years if fraudulent billing was ongoing. Additionally, if you’re under investigation, that clock may be tolled (paused) in certain circumstances.
