For dental practices that bill federal programs like Medicaid or Tricare—or those considering accepting such insurance—regulatory compliance must be your foremost concern. The dental-specific billing rules under these programs create significant risk exposure, with even minor documentation errors potentially triggering costly audits or investigations.
Call Lowther | Walker for dental defense lawyers with decades of experience handling federal matters for the dental care field.
Request your free consultation with a dental fraud defense attorney to explore your next steps.
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 […]
Federal government audits and investigations have an immediate and damaging impact on your practice, your team, and your patients. Building a comprehensive strategy in response to legal action against your dental business is the best method for minimizing long-term repercussions. Lowther | Walker works with dentists and dental practice owners across the U.S. to provide:
When regulatory challenges interrupt your practice you require federal lawyers who can step in and handle communications with the federal law enforcement.. Our team implements decisive, thoughtful responses to protect your practice’s reputation and financial stability.
Cookie-cutter approaches to compliance fail in healthcare as regulations evolve and new federal targets arise. We develop tailored legal frameworks addressing your specific practice model, patient demographics, and billing patterns.
In federal investigations, documentation quality and quantity often determines outcomes. Our methodical approach ensures your practice maintains robust policy documentation and compliance verification. Our healthcare fraud attorneys are veterans of thousands of cases and know the documents and procedures investigators will pursue.
Our legal team brings visionary insights into compliant dental business structure. We help dental business operators comply with Stark Law and the Anti-Kickback Statute.
Generic legal counsel rarely understands dental-specific regulatory nuances. Our team’s focused expertise in dental law provides targeted solutions for specific federal enquiries related to areas such as dental billing, dental product procurement, and dental drug diversion investigations.
Today’s dental professionals face unprecedented legal scrutiny. Even practice owners with robust reputations and a strong compliance background can encounter severe criminal penalties, including prison terms and millions of dollars in fines.
Areas of legal exposure include:
Medicaid, Tricare, and Department of Labor program participation brings rigorous documentation and coding requirements. Seemingly minor errors can trigger major healthcare investigations, with penalties reaching tens of thousands of dollars for even unintentional mistakes.
License challenges can instantly halt your ability to practice. Our preventative approach identifies and addresses potential licensing issues before they escalate to board actions.
Complex practice relationships, referral arrangements, and compensation structures require careful structuring. We navigate these regulatory concerns to protect legitimate business operations while preventing costly violations.
We recommend proactively calling our legal team for dentists in contact with federal law enforcement.
Lowther | Walker’s offers unparalleled experience and comprehensive insight into dental industry criminal fraud cases. Our senior defense lawyers are available on short–notice to respond to your inquiries and confirm your free case consultation.
Call Lowther | Walker via (404) 496-4052 and book a free, no-obligation consultation with a dental defense lawyer.
No-obligation. Fully confidential.
Call Us Today: (404) 496-4052
Federal investigations often take 1-3 years from initiation to resolution, though complex cases may extend longer. Initial document requests and audits might take 3-6 months, followed by potentially lengthy periods of government analysis. If the case proceeds to litigation or criminal charges, expect additional years before final resolution. This timeline underscores the importance of early, specialized legal representation to potentially expedite resolution through negotiation or demonstrate compliance issues that might narrow the investigation’s scope.
Remain calm and professional. Immediately contact your attorney and request they come to the site. Do not obstruct the search, but do not volunteer information or engage in substantive discussions about the case. Ask for a copy of the warrant and inventory of items seized. Instruct staff not to discuss the practice or investigation with investigators without counsel present. Document everything that occurs during the search, including which areas were searched and what was taken.
Yes, you must respond, but do so strategically. These requests often precede formal investigations. Have counsel review the request and your response before submission. Maintain copies of everything provided, organize documents methodically, and ensure compliance with deadlines. Never alter records or create backdated documentation, as this can transform a billing dispute into potential obstruction charges.
Penalties can be severe and multi-layered. Civil penalties under the False Claims Act can include treble damages (three times the amount of fraudulent claims) plus penalties of $12,537 to $25,076 per false claim as of 2025. Criminal penalties may include imprisonment, exclusion from federal healthcare programs, and license revocation. Even unintentional errors, if part of a pattern, can result in substantial recoupment demands and civil monetary penalties.
Few law firms across the U.S. hold the experience and background of Lowther | Walker. Our team’s experience in federal healthcare fraud cases includes successfully defending our client in the largest healthcare fraud case ever brought by the DOJ. Through each phase of a healthcare fraud case, from the initial audit to trial and appeal, Lowther | Walker is ready to step and protect your dental clinic.
If your clinic is under investigation by the DEA for violations of the Controlled Substances Act or an audit flags substance-related questions, Lowther | Walker’s attorneys can protect your practice and respond to investigators and auditors. We respond to enquiries related to over-prescribing, unusual prescribing patterns, and questions regarding your clinic’s evaluation process.
For new practice owners and those with questions about the latest changes to federal compliance laws, Lowther | Walker can help build comprehensive compliance programs. Our focus is on mitigating business and personal liability exposure and helping your practice meet its compliance obligations during each phase of development.