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How CMS Finds Medicare Fraud

The Centers for Medicare & Medicaid Services (CMS) triggers an immediate fraud action when an allegation possesses indicia of reliability, under 42 C.F.R. § 405.370, The Centers for Medicare & Medicaid Services (CMS) detects fraud using advanced data analytics to monitor traditional Medicare claims. CMS algorithms identify anomalous billing patterns—such as sudden billing spikes—signaling potential [...]

What is an OIG Healthcare Fraud Investigation?

OIG (Office of Inspector General) investigations are independent inquiries conducted by oversight offices within government agencies to detect and prevent fraud, waste, abuse, and mismanagement. This guide is to help professionals facing an OIG investigation understand the next steps and the defense options. [...]

A Guide to DOJ Civil Investigative Demands

Key Statistics on Federal Enforcement Department of Justice 2024 data shows a record-high 1,504 civil investigative demands (CIDs) were issued under the False Claims Act. This represents a significant increase in federal scrutiny, marking CIDs as the primary evidence-gathering tool for federal authorities today. What is a Civil Investigative Demand? A Civil Investigative Demand (CID) [...]

Understanding the Types of DEA Warrants

The Controlled Substances Act gives the DEA broad authority to request access to a healthcare business’s data. Because refusing to comply with a legal request to disclose information to the DOJ can lead to additional penalties beyond those related to the initial inquiry, healthcare business operators should carefully review their legal obligations and rights under [...]

Have You Received a Target Letter? Take These Steps

Have you recently received a target letter informing you that you're the suspect in a federal investigation?

Federal defense attorneys, Lowther | Walker have helped clients across the United States respond to target letters and resolve complex federal cases while mitigating penalties.

Put decades of federal defense experience behind you and learn the [...]

How Is Mail Fraud Proven?

Learn how mail fraud is proven in 2026 and the steps prosecutors take to bring mail fraud to federal court. Federal mail fraud attorneys Lowther | Walker explain mail fraud evidence. [...]