Lowther | Walker’s Atlanta, GA healthcare fraud defense attorneys bring over 30 years of experience protecting physicians, practice groups, hospital executives, and healthcare providers throughout Atlanta against aggressive federal Medicare and Medicaid fraud investigations.
Call Lowther | Walker today at (877) 208-7146 or contact us online to schedule a free consultation with a healthcare defense attorney.
24/7 Office Phone Service
Atlanta Location:
Centennial Tower, 101 Marietta St NW, Suite 3650, Atlanta, GA 30303, United States
Speak with an Experienced Healthcare Fraud Defense Lawyer Immediately.
Lowther | Walker’s successful defense experience covers all types of healthcare cases. Our broad knowledge of federal medical fraud regulations and their impact on Atlanta healthcare providers makes our firm the clear choice for those facing federal investigations and in contact with the HHS, DEA, FBI, and other government agencies.
Our Healthcare fraud defense experience includes:
Healthcare fraud investigations present significant risks to Atlanta physicians. The right legal representation can make a crucial difference in protecting your practice, license, and reputation. Here’s how healthcare fraud attorneys can assist Atlanta doctors:
Healthcare fraud attorneys can step in at the earliest signs of an investigation, often before the DOJ files formal charges. For Atlanta physicians, this might begin with:
Early legal intervention often prevents investigations from escalating and gives attorneys time to identify defense strategies.
Atlanta doctors face a multi-layered enforcement environment. Experienced healthcare fraud attorneys understand:
This regional knowledge helps our firm’s attorneys to anticipate enforcement actions and develop appropriate responses.
Many healthcare fraud cases challenge a physician’s medical judgment. Attorneys with healthcare expertise can:
Atlanta physicians may face various fraud allegations that require specialized defense approaches:
Beyond criminal penalties, healthcare fraud charges threaten a doctor’s ability to practice. Skilled attorneys work to:
When appropriate, healthcare fraud attorneys can negotiate favorable resolutions, which may include:
Lowther | Walker provides aggressive defense and representation for Atlanta physicians, dentists, mental health experts, and other medical professionals. Clients choose our attorneys for their:
When Atlanta healthcare providers face federal scrutiny, experience matters. Our defense team has successfully represented physicians, practice groups, pharmacies, and healthcare companies across Georgia’s medical landscape. With multiple dismissed indictments, favorable plea agreements, and trial victories against the Department of Justice’s healthcare fraud prosecutors, our results in Georgia’s federal courtrooms demonstrate our capacity to deliver when the stakes couldn’t be higher.
Healthcare investigations follow predictable patterns, each requiring distinct defensive approaches. From responding to Medicare audits before they escalate to navigating grand jury subpoenas and search warrants to presenting compelling defenses at trial, our Georgia healthcare defense attorneys meticulously calibrate strategies appropriate to each phase. This comprehensive approach allows us to resolve many matters before formal charges, preserving both your reputation and practice
Atlanta’s position as the Southeast’s medical hub creates unique enforcement dynamics. Our attorneys maintain close professional relationships with Georgia’s federal prosecutors, understand the investigative methodologies of Atlanta-based federal agents, and regularly appear before the federal judiciary in the Northern, Middle, and Southern Districts of Georgia. This institutional knowledge proves invaluable when navigating Georgia’s complex federal healthcare enforcement landscape.
The Northern District of Georgia’s U.S. Attorney’s Office has significantly increased healthcare fraud prosecutions, particularly targeting Atlanta’s large healthcare systems, physician practices, and behavioral health providers. The district has established a dedicated Healthcare Fraud Unit that coordinates with the Atlanta Medicare Fraud Strike Force. This specialized team focuses on data analytics to identify statistical outliers in billing patterns among Atlanta providers, with particular emphasis on opioid prescribing, home health services, DME suppliers, and laboratory testing schemes. Atlanta physicians should be aware that this district has pursued more aggressive charges and penalties compared to surrounding jurisdictions.
Atlanta’s healthcare landscape features extensive hospital-physician integration, creating specific Stark Law and Anti-Kickback risks. Physicians joining these networks face compliance issues with compensation arrangements that may include productivity bonuses tied to referral volumes, especially with Emory Healthcare, Piedmont, Northside, and WellStar systems. Atlanta physicians should exercise particular caution with medical directorships, office space leases within hospital-owned buildings, and EHR subsidies. The Northern District prosecutors scrutinize whether compensation exceeds fair market value for the Atlanta market, specifically, not just national averages
Atlanta has become a regional hub for telemedicine fraud enforcement, with federal prosecutors focusing on arrangements between local physicians and nationwide DME suppliers, laboratories, and pharmacies. Atlanta-area physicians who provide remote consultations should be particularly careful about compensation structures that appear to incentivize prescriptions or orders. The Georgia Composite Medical Board has also increased scrutiny of physician telemedicine practices, focusing on documentation standards and patient relationship requirements specific to Georgia’s telemedicine regulations, which differ from neighboring states.
Atlanta physical therapy practices face heightened scrutiny for specific documentation issues including inadequate documentation of one-on-one time versus group therapy, lack of measurable progress goals, missing physician certification/recertification, and inappropriate use of therapy assistants without proper supervision documentation. ZPICs and UPICs operating in Georgia have increasingly targeted “therapy factories” with high patient volumes, particularly in Atlanta’s northern suburbs. These contractors are reviewing therapist-to-patient ratios and billing patterns that suggest services could not reasonably be delivered as documented.
The DEA’s Atlanta Field Division has established specific monitoring parameters that trigger investigations, including: prescribing to patients traveling from outside Atlanta’s metropolitan area (particularly from Tennessee and Alabama), patients filling prescriptions at multiple pharmacies across different counties, high-volume prescribing of specific combinations (especially opioid/benzodiazepine/muscle relaxant combinations), and patterns of patients paying cash despite having insurance. Atlanta prescribers should be aware that the DEA has advanced data analytics to identify prescribers with patterns that deviate from those of doctors within the same Atlanta zip code or specialty.
With Atlanta’s high Medicare Advantage penetration rate, providers face increased scrutiny around risk adjustment practices and hierarchical condition category (HCC) coding. Federal investigators are focusing on Atlanta medical groups with risk-sharing arrangements that may incentivize upcoding or incorrect diagnosis codes. The Northern District has pursued cases against several Atlanta physician groups for allegedly manipulating risk scores through tactics like unnecessary home visits, inappropriate annual wellness visits, or documentation that doesn’t support submitted diagnostic codes. Providers should implement specific compliance protocols for Medicare Advantage.
Serving healthcare providers in Atlanta, across northwestern Georgia and throughout the state, federal defense attorneys Lowther | Walker will help protect your business, your reputation, and your freedom.
Call Lowther | Walker’s Atlanta office via 1-404-806-7997 and book a free, no-obligation consultation with a healthcare fraud attorney.
Our landmark results in federal cases highlight our experience defending healthcare professionals across Atlanta and throughout the U.S.
US v. M.M.
Investigation terminated; no prosecution.
IRS–CI investigated our client, the owner of a software–engineering company, for the willful failure to pay a substantial amount of employment taxes. After our having conducted our own investigation into the matter, we convinced the Government not to prosecute our client.
$100 Million Healthcare Fraud Case: US v. A.C.
HHS-OIG and FBI investigated our client, the former director of a national laboratory, for Healthcare Fraud and Money Laundering based on their alleged participation in a scheme to defraud Medicare of approximately $100 million in reimbursements for not-medically-necessary molecular testing and violating the federal anti-kickback statute. After conducting our own investigation into the matter and presenting the evidence to the investigating agents and prosecutors, we convinced the Government not to prosecute.
$1 Million Bank Fraud Case: US v. J.C.
The USDA-OIG investigated our client, a public official, for Bank Fraud, Wire Fraud, Mail Fraud, and Money Laundering, alleging that the client allegedly conspired to obtain over $1 million in pandemic subsidies and loans. Despite the overwhelming evidence against our client, we convinced the Government to agree to our client’s plea of guilty to one count of Wire Fraud, and, over the Government’s objection, we convinced the Court to sentence our client to three years of probation.
US v. R.C.
Investigation terminated; no prosecution; civil settlement.
OPM-OIG and a private insurance company’s SIU investigated our client, a chiropractor, for submitting over $3.5 million in Medical billing claims for services not rendered, all of which the insurers paid. We conducted our own investigation of the matter, and within five months, convinced the Government to terminate the criminal investigation, not prosecute our client, and accept a $500,000 payment as full settlement for any and all alleged losses to the insurers and the Government.
Medicare Upcoding Case: US v. A.M.
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 were conducting. We conducted our own investigation of the case and convinced the DOJ not to prosecute him, terminating both the criminal and civil investigations against him.
US v. T.B.
Investigation terminated; no prosecution.
DOJ notified our client that she was the target of a multi-million-dollar public corruption, money-laundering, and tax-fraud investigation that FBI and IRS-CI were conducting. The client’s former atto rney had arranged for her to plead guilty to money-laundering and tax offenses before indictment, but she contacted our law firm for a “second opinion” before she agreed to plead guilty, and retained our firm three days later. Less than three weeks after she retained us, we conducted our own investigation of the case and convinced DOJ not to prosecute her, terminating both the criminal and civil investigations against her.
