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Lowther | Walker’s healthcare compliance lawyers respond to healthcare audit requests, DEA enquiries, medical billing concerns, and OIG subpoenas.
Our broad scope of healthcare compliance knowledge covers all administrative and criminal actions by the federal authorities. Contact our healthcare compliance attorneys for guidance on complying with evolving federal healthcare laws and safeguard your practice.
No-obligation. Fully confidential.
Call Us Today: (404) 496-4052
Investigation terminated; no prosecution. DOJ notified our client, the CEO of a major hospital network, that he was the target of a multi-million-dollar healthcare fraud investigation related to “Medicare upcoding” that the FBI and HHS-OIG […]
The FBI and the HHS-OIG investigated our client for Health Care Fraud based on the client’s submitting over $7 million in alleged false claims to Medicare. The Government indicted our client on Conspiracy to commit […]
HHS-OIG investigated our client for Healthcare Fraud and Aggravated Identity Theft based on the client’s allegedly participating in a “telemedicine” kickback scheme that defrauded Medicare of approximately $30 million in reimbursements for not-medically-necessary durable medical […]
A private insurance company discovered that our client, a dentist, fraudulently billed it, various other insurance companies, and federal health care benefit programs for approximately $400,000 of services that our client did not provide. We […]
The Department of Justice’s Criminal Division, Fraud Section charged our client and nine other individuals in a $1.4 Billion health care fraud, wire fraud, and money laundering conspiracy (the largest health care fraud case that […]
Investigation terminated; no prosecution. DOJ notified our client, the CEO of a major hospital network, that he was the target of a multi-million-dollar healthcare fraud investigation related to “Medicare upcoding” that the FBI and HHS-OIG […]
The FBI and the HHS-OIG investigated our client for Health Care Fraud based on the client’s submitting over $7 million in alleged false claims to Medicare. The Government indicted our client on Conspiracy to commit […]
HHS-OIG investigated our client for Healthcare Fraud and Aggravated Identity Theft based on the client’s allegedly participating in a “telemedicine” kickback scheme that defrauded Medicare of approximately $30 million in reimbursements for not-medically-necessary durable medical […]
A private insurance company discovered that our client, a dentist, fraudulently billed it, various other insurance companies, and federal health care benefit programs for approximately $400,000 of services that our client did not provide. We […]
The Department of Justice’s Criminal Division, Fraud Section charged our client and nine other individuals in a $1.4 Billion health care fraud, wire fraud, and money laundering conspiracy (the largest health care fraud case that […]
If you’re deciding between several firms to represent you, consider the following reasons for selecting Lowther | Walker:
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 practitioners simply cannot match. We understand the nuances of medical documentation and can effectively challenge government interpretations of clinical decision-making.
If your healthcare facility is under a Medicare audit or receives patient file requests from OIG investigators, Lowther Walker’s legal team can respond urgently and provide clear legal guidance for an effective response. Our proactive feedback to government regulators can help prevent audits and investigations from turning into fraud charges and criminal penalties.
Beyond the team’s experience communicating with federal investigators and auditors on their clients’ behalf, Lowther | Walker attorney Murdoch Walker also has years of experience as a DEA task force officer. This background in pursuing charges empowers the team with clear insight into investigative strategies and how investigators review compliance matters and initiate prosecutorial steps.
Our healthcare compliance work across the U.S. means Lowther | Walker is often one of the first calls healthcare teams make when they have questions relating to billing practices, documentation, and the latest DEA and HHS regulations. We serve a broad range of healthcare clients, including:
Lowther | Walker helps healthcare providers across the country meet federal compliance requirements and respond to legal concerns surrounding their data, billing, and business structures. Request a confidential call with our healthcare lawyers to discuss your compliance concerns with our nationally recognized attorneys.
No-obligation. Fully confidential.
Call Us Today: (404) 496-4052
Medical professionals often unknowingly commit violations related to improper documentation, billing errors, kickback arrangements, inadequate privacy protections, and insufficient informed consent. The most frequently prosecuted issues include Medicare/Medicaid billing fraud, HIPAA privacy breaches, Anti-Kickback Statute violations, Stark Law self-referral issues, and documentation deficiencies that suggest services weren’t actually provided as claimed.
When facing an investigation, immediately secure legal representation before responding to inquiries. Do not alter records, destroy documents, or backdate any information. Designate a single point of contact for investigators, preserve all relevant documents, and maintain attorney-client privilege by involving counsel in compliance discussions. A coordinated response with legal guidance can often resolve issues before they escalate to formal charges.
Implement a robust compliance program that includes regular internal audits, staff training, clear documentation policies, and designated compliance officers.
Document reasonable efforts to detect and prevent fraud. Conduct regular risk assessments, stay updated on changing regulations, and promptly self-disclose any discovered violations. Courts and regulators view proactive compliance efforts favorably when determining penalties or deciding whether to pursue charges.
The distinction between error and fraud largely hinges on intent. Innocent billing mistakes become potential fraud when there’s a pattern suggesting deliberate upcoding, unbundling of services, billing for services not rendered, or consistently disregarding compliance warnings. Courts look for evidence of knowledge and intent, such as continued improper billing after being notified of errors, attempts to conceal mistakes, or creating false documentation to support improper claims.
Consequences range from civil monetary penalties and repayment obligations to exclusion from federal healthcare programs, loss of licensure, and even criminal prosecution. Financial penalties can include treble damages under the False Claims Act plus additional penalties per violation. Beyond financial consequences, providers face reputational damage, practice restrictions, and mandatory compliance monitoring. Criminal healthcare fraud convictions can result in imprisonment, especially in cases involving patient harm or substantial financial loss.
Lowther | Walker is a first-class resource for healthcare providers upgrading their billing processes, as well as those in the industry building their initial compliance structures. Our attorneys can help set clear guidelines and policies for your internal compliance structures, organizing systems relating to areas such as licensing, business relationships, and federal healthcare program enrollment.
During investigations where the medical necessity of a procedure is in doubt, our healthcare lawyers can help demonstrate that organizations followed accepted industry standards and analyzed the proper medical necessity considerations before proceeding. We can also collect evidence and present findings to the investigators. We prove teams did not intend to violate ethical or legal considerations governing necessity.
Regulations such as the Eliminating Kickbacks in Recovery Act and the Physician Payment Sunshine Act govern financial transactions between related healthcare entities, such as physicians’ offices and teaching hospitals. Providers participating in federal healthcare programs must adhere to strict regulations governing payments and items of value to eliminate potential compromises on treatment decisions. Lowther | Walker can help build speciality compliance structures in strict adherence to the latest federal healthcare regulations.
Our healthcare compliance lawyers can guide medical industry professionals on risk mitigation and analyze existing structural issues within compliance programs. Lowther | Walker’s team has broad experience responding to whistleblower claims, and non-compliance allegations, and helps stakeholders navigate complex coding, billing, and reimbursement matters.
Our healthcare compliance lawyers can guide medical industry professionals on risk mitigation and analyze existing structural issues within compliance programs. Lowther | Walker’s team has broad experience responding to whistleblower claims, and non-compliance allegations, and helps stakeholders navigate complex coding, billing, and reimbursement matters.
