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Lowther | Walker is a national leader for the defense of physicians in healthcare fraud cases. Our healthcare fraud attorneys have won landmark victories intervening at all stages of healthcare fraud investigations and prosecutions.
If your license and practice are under threat due to HHS-OIG and DOJ fraud and billing enquiries, call Lowther | Walker for urgent legal guidance.
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 […]
When the Department of Justice (DOJ), the FBI, or the Office of Inspector General (HHS-OIG) targets a medical practice, the dynamic is fundamentally different from any other legal challenge. You are not just fighting for your liberty; you are fighting for your medical license, your NPI number, your reputation, and the business you spent decades building.
At Lowther | Walker, we bring unmatched experience in nationwide healthcare defense for doctors. We understand that in federal healthcare prosecutions, the government often tries to criminalize complex medical decisions and administrative errors. You need a defense team that understands the intersection of medicine, billing regulations, and federal criminal law.
Here is why doctors across the country trust Lowther | Walker to protect their futures:
Our firm offers a unique tactical advantage: we combine elite trial advocacy with insider knowledge of federal investigations.
Joshua Sabert Lowther, Esq. is a nationally recognized trial and appellate attorney. He is known for his fearless courtroom advocacy and his ability to dismantle complex government theories in front of a jury.
Murdoch Walker, II, Esq. brings the perspective of the “other side.” As a former investigator and Task Force Officer, he understands exactly how federal agents build their cases, how they use informants, and where they make mistakes. We use this insider knowledge to attack the government’s investigation before it even reaches the courtroom.
Many firms claim experience; we claim victory. We have successfully defended clients in some of the largest healthcare fraud prosecutions in United States history.
The $1.4 Billion Acquittal: We represented a client in United States v. J.P., et al., a $1.4 billion conspiracy case. While other defendants faced decades in prison, we secured a full acquittal – Not Guilty on all counts, proving that we can win against the full weight of the DOJ.
Pre-Indictment Success: Our greatest victories often never make the news. We have successfully intervened in investigations involving millions of dollars in alleged fraud, convincing prosecutors to decline charges and close the case without a single day of jail time for our clients.
General criminal defense lawyers often struggle to understand the nuances of CPT coding, “incident-to” billing, or the medical necessity of opioid prescriptions. If your lawyer has to learn the basics of the Stark Law or the Anti-Kickback Statute on your dime, you are already at a disadvantage.
We understand the difference between a Level 4 and Level 5 office visit.
We know how to distinguish between honest billing errors and fraudulent schemes.
We work with independent medical experts and forensic coders to validate your clinical judgment and prove that your actions were within the standard of care.
Most firms tell you to “wait and see” if you are indicted. We believe that is a recipe for disaster. From the moment you hire us, we launch a parallel investigation. We interview witnesses, preserve evidence, and engage with prosecutors immediately. Our goal is to kill the case at the investigative stage, saving you the expense, stress, and public humiliation of a federal trial.
Federal healthcare law is consistent across the country, and so is our reach. Whether your practice is in Miami, Atlanta, New York, or Los Angeles, we are equipped to defend you in any federal district court in the United States.
Federal healthcare fraud is not a single crime but a broad category of offenses used to prosecute medical providers. The most common charges we defend include:
This is the “catch-all” statute used by the Department of Justice (DOJ). It involves allegations of knowingly executing a scheme to defraud a healthcare benefit program (like Medicare, Medicaid, or Tricare). Common theories of prosecution include:
Billing for Services Not Rendered: Claims for appointments or procedures that never happened.
Upcoding: Billing for a more expensive service or procedure than was actually performed (e.g., billing a Level 5 office visit for a routine check-up).
Unbundling: Separating procedures that should be billed together into distinct codes to increase reimbursement.
Federal law strictly prohibits offering, paying, soliciting, or receiving any remuneration to induce referrals for services covered by federal healthcare programs. Prosecutors often target legitimate business arrangements—such as medical directorships, consulting fees, or speaker programs, alleging they are disguised bribes. Unlike civil statutes, violations of the Anti-Kickback Statute are felonies punishable by up to five years in prison per count.
While similar to Anti-Kickback, the Stark Law is a strict liability civil statute. It prohibits physicians from referring Medicare patients for designated health services (DHS) to an entity with which the physician (or an immediate family member) has a financial relationship. Violations can result in massive civil penalties and exclusion from federal healthcare programs.
The DEA and DOJ aggressively target pain management clinics and individual prescribers. Doctors are often charged with Drug Diversion (21 U.S.C. § 841) for prescribing opioids “outside the usual course of professional practice” and “without a legitimate medical purpose.” These cases often rely on the testimony of non-medical experts to second-guess your clinical judgment.
Many federal investigations begin as Qui Tam (whistleblower) lawsuits under the False Claims Act. If the government intervenes, you may face treble damages (three times the actual loss) and civil penalties of over $20,000 per false claim. In egregious cases, these civil allegations morph into criminal indictments.
At Lowther | Walker, we do not wait for an indictment to begin your defense. Led by attorneys Joshua Sabert Lowther, Esq. and Murdoch Walker, II, Esq., our team frequently conducts its own independent investigations, utilizing former special agents to uncover exculpatory evidence before the government finalizes its case.
We have successfully convinced the DOJ to terminate investigations and decline prosecution in multi-million dollar fraud cases. If you have received a target letter, a subpoena for records, or a visit from federal agents, time is your most valuable asset.
Contact Lowther | Walker today to protect your practice, your license, and your future.
When federal investigators initiate a case against you, your professional reputation and decades of hard work are at stake. Lowther | Walker is dedicated to protecting your healthcare business and your good name, harnessing our deep background in medical provider defense.
Do not wait until you are indicted to build your defense.
Call us immediately at (404) 806-7997 to speak with an experienced healthcare defense lawyer.
No-obligation. Fully confidential.
Call Us Today: (404) 496-4052
The defining factor is intent, though the line is often blurred by prosecutors. A simple billing error is a mistake; healthcare fraud (18 U.S.C. § 1347) requires “knowingly and willfully” executing a scheme to defraud
A Subject is someone whose conduct is within the scope of the Grand Jury’s investigation, but prosecutors haven’t yet decided if they are a main culprit. A Target is someone against whom the government has substantial evidence and intends to indict. We often intervene to keep a “Subject” from becoming a “Target,” or to persuade prosecutors to downgrade a “Target” to a witness.
Do not answer their questions. You are not required to speak to them without an attorney present, even if they claim they “just want to clear a few things up.” Ask for their business cards, politely state that your attorney will contact them, and ask them to leave. Then, call Lowther | Walker immediately. Anything you say during that initial surprise visit can be used to build the indictment against you.
An investigation alone does not automatically revoke your license, but an indictment or conviction can trigger immediate suspension or revocation by your state medical board. Furthermore, a conviction (or even certain civil settlements) can lead to mandatory exclusion from Medicare/Medicaid (OIG Exclusion), which effectively ends most medical careers. Our goal is to resolve the case in a way that preserves your ability to practice medicine.
Yes. In healthcare fraud cases, the government often uses civil or criminal forfeiture to freeze personal and business assets they believe are “proceeds of fraud” before you are convicted. This is designed to cripple your ability to hire defense counsel. We have extensive experience contesting these seizures to release funds for your defense and business operations.
Likely, yes. Lowther | Walker has defended clients in some of the largest healthcare fraud prosecutions in U.S. history. Notably, we represented a client in United States v. J.P., et al., a $1.4 billion healthcare fraud conspiracy—the largest ever prosecuted by the DOJ at that time. We secured a mistrial after a six-week trial and, upon retrial, a full acquittal (Not Guilty on all counts) for our client.
Yes, this is our primary goal. We frequently intervene during the “pre-indictment” phase. For example, we represented a chiropractor investigated for $3.5 million in billing fraud. By conducting our own independent investigation and presenting our findings to prosecutors, we convinced the government to terminate the criminal investigation entirely and resolve the matter with a civil settlement, keeping our client out of prison and off the criminal docket.
Healthcare defense requires specific knowledge of medical coding, billing regulations, and federal administrative law that general criminal lawyers lack. Joshua Sabert Lowther, Esq. is a nationally recognized trial and appellate advocate who has secured acquittals and dismissals in federal courts across the country. Murdoch Walker, II, Esq. brings a unique perspective as a former investigator and Task Force Officer. He understands exactly how federal agents build their cases, allowing us to dismantle them from the inside out.
Yes. You cannot outsource criminal liability. Federal prosecutors often use the theory of “deliberate ignorance” or “willful blindness” to charge physicians. This means that if you signed the claims, or if the government believes you should have known that the billing was improper (for example, if the revenue was suspiciously high), they can charge you as if you personally manipulated the codes. We defend against this by demonstrating that you relied in good faith on hired professionals and that there was no criminal intent to defraud.
These are known as Qui Tam lawsuits under the False Claims Act. A whistleblower (often a former employee) files a lawsuit under seal, meaning it remains secret while the Department of Justice investigates you—often for months or years—to decide if they will join the case. If the government intervenes, the case can easily shift from a civil lawsuit to a criminal indictment. If you suspect an employee has filed a complaint, or if one is threatening to, you must engage counsel immediately to conduct an internal audit and prepare a defense before the government strikes.
