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At Lowther | Walker, our Medicaid fraud defense lawyers are trusted advocates for healthcare professionals under scrutiny. We protect doctors, nurses, clinic owners, and other providers facing audits, investigations, or fraud accusations tied to Medicaid billing.
Our Medicaid defense firm handles the following charges:
Proactively book your free, confidential consultation online or call (404) 496-4052 to discuss our Medicaid defense services.
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 […]
The 2025 data from the HHS-OIG shows the Medicaid Fraud Control Units recovers $3.46 for every $1 on investigations. Federal government investigators recovered $1.4 billion in settlements and judgements, and 1,151 individuals were convicted of Medicaid fraud.
When investigators suspect you of Medicaid fraud the consequences are serious. Financial penalties, loss of licensing, and criminal charges are all on the table. Many providers don’t realize how quickly an administrative inquiry can evolve into a criminal investigation.
Whether triggered by an automated claim analysis or a whistleblower report, once your name is flagged, investigators can access volumes of your patient data and billing history. Without skilled legal representation, you risk being overwhelmed by government scrutiny.
Lowther | Walker’s healthcare fraud attorneys have guided clients through every phase of the Medicaid investigation process. From solo practitioners to multi-site healthcare organizations, we offer tailored defense strategies backed by real courtroom experience.
Understanding the stages of a Medicaid fraud case can help your team prepare and respond decisively:
The process often starts with internal data analysis—CMS or MFCUs may flag providers whose billing patterns deviate from local or national norms. Sometimes, a single complaint can trigger a deep-dive investigation.
Once concerns are validated, the matter may be handed off to fraud control units, attorneys general, or the DOJ. At this point, the investigation becomes formal—records are collected, and interviews may begin.
Any communication or cooperation at this stage should be carefully guided by a Medicaid fraud defense attorney.
Investigators will likely demand extensive documentation: patient records, billing logs, staff communications, and contracts. These requests can be overwhelming, especially if they go back years.
Lowther | Walker can manage these requests, ensure your rights are protected, and guard against overreach or misinterpretation.
Government analysts—including medical experts—will conduct a thorough review of the materials you provide. This can take weeks or months and often determines whether the case is closed, escalated, or resolved through negotiation.
Outcomes may include a repayment demand, civil settlement, criminal referral, or referral to your licensing board. Early intervention by our defense team can shift the direction of the investigation and reduce your legal exposure.
Lowther | Walker provides aggressive defense and representation for physicians, dentists, psychiatrists, and other health professionals and companies facing Medicaid investigations. Turn to our healthcare lawyers for:
Our attorneys have an in-depth understanding of the healthcare system, from billing codes to regulatory compliance. We’ve successfully defended doctors, nurses, dentists, mental health professionals, and clinics across the U.S.
Medicaid fraud cases often begin without warning. That’s why our legal team is available around the clock to help you respond to subpoenas, navigate audits, and avoid critical missteps.
From negotiating settlements to winning at trial, our attorneys have achieved results in complex, high-profile fraud cases. We understand how prosecutors think—and we know how to counter their strategies effectively.
If you’re under investigation or want to protect your practice from becoming a target, reach out to the Medicaid defense attorneys at Lowther | Walker. Call (404) 496-4052 or schedule a consultation online. We’re ready to defend your career, your practice, and your future.
No-obligation. Fully confidential.
Call Us Today: (404) 496-4052
Investigations may begin due to unusual billing patterns, data mismatches, whistleblower reports, or tips from patients or staff. Often, it’s an automated system—not a person—that flags providers for audit or investigation.
We defend against accusations of:
Our attorneys can also defend client from errors made by staff, third-party billers, or outdated software.
Yes. Medicaid fraud is a serious offense that can result in criminal charges, including felonies punishable by prison time and steep fines. Early legal counsel can help reduce or avoid these charges altogether.
In many cases, findings from a Medicaid fraud investigation are referred to licensing boards. This could lead to disciplinary actions like suspension, probation, or full revocation of your license.
We represent the full spectrum of healthcare providers including individual practitioners, group practices, hospitals, home health agencies, DME suppliers, pharmacies, laboratories, and other healthcare businesses of all sizes.
