Healthcare fraud attorneys assist medical professionals who are facing allegations of False Claim Act violations. The False Claims Act “FCA” is an act that holds any person who knowingly submits, or causes to submit, false claims to the government civilly liable.  In general, such claims come from problematic practices related to billing federal government programs such as Medicare, Medicaid, and/or Tricare.  Any violation of federal regulations can cause issues.  

What types of Healthcare Fraud does the Government Target?

In general, the government will investigate situations involving:

-Billing for services not rendered

-Billing under the incorrect code

-Billing for services derived from illegal monetary kickbacks 

-Billing for services that are not medically necessary.  

How can the government Bring a Claim?

The Falsc Claims Act “FCA” is an act that holds any person who knowingly submits, or causes to submit, false claims to the government civilly liable.  

How can an individual purse a claim? 

In addition to allowing the government to pursue investigations on its own, the FCA allows private citizens to file suits on behalf of the government (called “qui tam” suits) against those who have defrauded the government.  Private citizens who successfully bring qui tam actions may receive a portion, (normally around 30 % of the recovered funds) of the government’s recovery.  Many DOJ investigations arise from qui tam actions.

What are the damages under the civil FCA?

If a lawsuit filed under the FCA is lost, the doctor or medical business owner will be liable for damages.  The district court is required to award damages in two ways: 

1. Triple the actual value of the fraudulently obtained funds and 
2. Mandatory fine per false claim submitted.  

A recent press release by the DOJ show settlements and judgments under the False Claims Act exceeded $6.8 billion in the fiscal year ending Sept. 30, 2025.  

It is important to reach out and secure counsel, such as the experienced health care fraud attorneys at Conaway & Strickler PC as soon as practicable.  It is always the hope to navigate the situation prior to the situation being investigated for criminal charges. 

Over the past three decades, Conaway & Strickler, PC has represented physicians, nurses, dentists, CPAs, chiropractors, financial advisors, educators, lawyers, and many others. The list of licenses for the state of Georgia shows how many professionals rely on licensure for their livelihood. We provide strong defenses to protect your professional license and preserve your reputation and career longevity.

It is important to contact Conaway & Strickler, PC very early on so that we can make strategic steps to protect your livelihood. For example, a physician who is facing allegations of misconduct may face suspension, probation or revocation. It is important to have experienced legal counsel to effectively navigate these uncertain waters.

Here is a list of the top 10 of the Most Common Disciplinary Actions Against Healthcare Professionals published recently by GCMB. It helps explain some common pitfalls and responsibilities outlined by
the GCMB.

If you are facing any issues with your professional license, we are here to help.

DME Fraud

Durable Medical Equipment (DME) fraud remains a cornerstone of federal enforcement as seen in the recent takedown. An indictment in the Western District of New York charges a medical doctor with billing roughly $29.6 million for fictious DME and $5.6 million for audio-only telehealth visits, which were brief or never occurred. That doctor produced and maintained false and fictitious medical records and fraudulently certified orders for braces without regard to medical necessity. The doctor now faces federal criminal charges of conspiracy to commit health care fraud, health care fraud, and false statements relating to health care matters.

In “Operation Gold Rush,” prosecutors in the Eastern District of New York indicted 11 defendants, including two pharmacists, members of a transnational criminal organization based in Russia and Eastern Europe. These individuals allegedly orchestrated a massive Medicare fraud and money-laundering scheme that billed over $10.6 billion to federal health programs—making it the largest case by loss amount ever charged by the DOJ. The group used foreign straw owners to acquire dozens of U.S.-based DME suppliers, then submitted fraudulent claims for equipment such as urinary catheters and glucose monitors that never delivered, exploiting stolen identities and confidential patient data. To date, 19 defendants have been charged in the case, including multiple arrests abroad (Estonia) and at U.S. entry points.

COVID-19 Testing Kickbacks

COVID-19 testing kickback schemes typically involve health care providers or marketers billing Medicare for over-the-counter or lab-based COVID-19 tests that were unnecessary, never provided, or obtained through illicit referrals. These cases often rely on the same core tactics as DME fraud: using stolen or misused patient information, paying illegal kickbacks for referrals, and submitting inflated or false claims to federal programs. In both types of fraud, the perpetrators exploit gaps in oversight during high-demand periods—such as the pandemic or public health emergencies—to rapidly bill large amounts to Medicare, often with little or no patient interaction or verification.

These 2025 takedown includes criminal indictments and civil settlement agreements targeting this type of COVID-19 fraud. An indictment out of Illinois charged multiple individuals, including a physician, for their roles in a kickback scheme. According to the indictment, the defendants caused laboratories in Illinois and Texas to submit fraudulent claims to the HRSA COVID-19 Uninsured Program, ultimately receiving over $293 million in payments. The physician involved allegedly misused patient information—including data from a former hospital employer—to falsely claim that uninsured individuals had submitted samples for COVID-19 testing. In reality, many of the patients had not submitted samples at all. Defendants submitted claims through Texas labs they owned, despite those labs being non-operational. The proceeds were then laundered through various financial accounts to disguise the funds’ origin. Charges include wire fraud, conspiracy to commit money laundering, HIPAA violations, and conspiracy to defraud the United States. Authorities have seized a Rolls Royce Phantom and more than $104 million in assets linked to the fraud.

The charges being brought by the federal government in these cases carry significant criminal penalties and collateral consequences, especially for licensed medical professionals. At Conaway & Strickler, we are highly experienced in defending against these types of claims. Contact us to schedule a consultation and discuss your case.

The DOJ’s Health Care Fraud Unit coordinated the investigation with the help of strike forces across the nation. Key aspects of the historical take down include the following:

• Enormous monetary scale: Again, the federal government alleges $14.6 billion in intended losses in total across the criminal cases. Law enforcement has already seized $245 million in cash, luxury vehicles, cryptocurrency, and assets from alleged fraudsters. The Centers for Medicare and Medicaid Services (CMS) also proactively prevented $4 billion in fraudulent payments, suspended billing privileges of 205 providers.
• Civil charges and settlements: In addition to criminal charges being levied, law enforcement has also sought civil penalties from other providers and medical professionals. This includes civil charges against 20 defendants for $14.2 million in alleged fraud, as well as civil settlements with 106 defendants totaling $34.3 million.
• Transnational criminal networks: A major component—Operation Gold Rush—alleges a global ring used foreign straw owners to submit $10.6 billion in false claims for durable medical equipment. Though CMS blocked all but ~$41 million in Medicare payouts, insurers received about $900  Individuals abroad and co-conspirators in the U.S. used encrypted messaging and assumed identities to facilitate the purchase of medical supply companies and subsequent fraud by exploiting the stolen identities of over one million Americans spanning all 50 states and using their confidential medical information to submit the fraudulent claims.
• Telemarketing/genetic testing schemes: One $703 million scheme involved deceptive telemarketing, AI-generated “consent” calls, and stolen Medicare IDs—all to bill labs and DME suppliers
• Wound-care fraud on vulnerable patients: Roughly $1.1 billion in fraudulent Medicare submissions for amniotic allografts were applied to terminally‑ill or hospice patients, without medical need or oversight
• Opioid prescription diversion: 74 defendants, including 44 medical professionals, are accused of diverting over 15 million pills (e.g., oxycodone, hydrocodone), feeding the illegal drug trade
• Genetic testing & telemedicine: At least 49 defendants were tied to over $1.17 billion in telemedicine/genetic testing fraud, a key enforcement focus of the Takedown.

These are just some of the schemes and methods alleged as health care fraud. Additional cases totaling approximately $1.84 billion involved medically unnecessary tests and treatments, kickbacks, and stolen controlled substances. DOJ’s Health Care Fraud Unit, along with FBI, HHS‑OIG, DEA, CMS, and state AGs, led this nationwide operation. The Government was able to leverage cloud computing, artificial intelligence, and advanced analytics to identify emerging health care fraud schemes. Specifically, a new Data Fusion Center used AI to spot suspicious billing patterns

Professionals in the medical industry could face disruptions based on these trends. Individuals could be criminally indicted despite a lack of financial gain for any peripheral involvement in these schemes. With over 205 providers with billing privileges already suspended or revoked, firms must evaluate billing practices and ensure compliance before audits or criminal actions escalate. Medical professionals and individuals in the industry should be proactive in address any potential problems. Assessing practices through comprehensive billing audits, tightening consent documentation and patient qualification protocols, and reviewing prescribing practices are key to ensuring compliance.

Given the unprecedented scope of this takedown, anyone involved in Medicare/Medicaid billing—especially in telemedicine, genetic testing, wound care, DME supply, opioid prescribing—should evaluate their practices now. Protecting your license, assets, and reputation hinges on early legal counsel, transparent operations, and robust documentation. Upon any contact from law enforcement, individuals should secure legal counsel immediately. The presumption of innocence matters, and charges are allegations—not convictions. Early intervention and strong representation can shift outcomes. Medical providers should document everything diligently. Medical necessity, patient consent, referrals, and codes must be in writing and defensible.

Even if charges carry potential fines or incarceration, negotiated resolutions mitigating those consequences are viable. At Conaway & Strickler, we are highly experienced in federal health care fraud cases. Contact us to discuss your situation confidentially—we’re here to protect your rights and your future.

When the federal government is paying for items or services rendered to Medicare or Medicaid beneficiaries, federal fraud and abuse laws apply. Healthcare professionals influence what services patients receive and are responsible for the documentation of those services. That documentation is the basis for bills sent to insurers, and ultimately, the Government’s payment of a beneficiary’s medical claims.

If a physician knew or should have known that the submitted claim was false, the attempt to collect unearned money constitutes a violation. Federal fraud and abuse laws include the following:

• False Claims Act (31 U.S.C. §§ 3729-3733)
• Anti-Kickback Statute (42 U.S.C. §§ 1320a-7b(b))
• Physician Self-Referral (Stark Law).
• Exclusion Statute (42 U.S.C. § 1320a-7).
• Civil Monetary Penalties Law (42 U.S.C. § 1320a-7a).

These laws aim to prevent improper billing practices and financial incentives that could compromise patient care. These laws further grant powerful enforcement tools to federal agencies to penalize violations, ranging from civil fines to criminal charges.

The government can audit claims and investigate providers when there is a reason to suspect fraud. Unusual billing patterns or reports from others, including staff, competitors, and patients, may raise suspicion of fraud and abuse. If you’re a doctor who bills government healthcare programs, compliance with these rules and procedures is critical, as violations can lead to severe legal consequences.

One of the most critical aspects of government payer compliance is coding and billing insurers accurately for services rendered. Physicians may inadvertently engage in practices that violate federal billing regulations. Common billing violations include:

• Upcoding: Billing for more expensive services than those actually provided.
• Unbundling: Separately billing services that are typically bundled together.​
• Unnecessary Services: Providing services that are not medically necessary to increase reimbursement.​
• Kickbacks: Receiving or offering remuneration for patient referrals.
• Billing for services that an improperly supervised or unqualified employee performed.

In addition to maintaining compliance with billing regulations, these laws set forth requirements for maintaining accurate patient records, protecting patient privacy, and more.

Given the complexity and severity of potential penalties, healthcare professionals who find themselves under federal scrutiny for billing practices should seek the counsel of a federal criminal defense attorney as soon as possible. Physicians must be vigilant in adhering to federal billing regulations to avoid severe legal consequences. Understanding the legal framework and implementing proactive measures can safeguard against inadvertent violations and protect your practice’s integrity. Contact us to schedule a consultation.

Experienced federal criminal defense attorneys like those at Conaway & Strickler, PC may suggest early on about the possibility of entering into a “deferred prosecution agreement” which is essentially a contract with the Department of Justice. DPAs are frequently used in cases involving corporate fraud, bribery, and antitrust violations.  These pretrial agreements may involve an admission of wrongdoing, the payment of fines, and the implementation of compliance measures.  Charges may be dropped if the defendant complies with the requirements of the agreement.  Generally, the Assistant United States Attorney will file the criminal complaint and the DPA with the court, so it is of public record. This will be accompanied by a formal request to the court that any prosecution be delayed according to the terms of the DPA, allowing the defendant to fulfill its agreed-upon actions.  This is very similar to conditional discharge / pre trial diversion agreements found at the state level.

An example of a DPA would be one that was entered in to by the DOJ and Teva Pharmaceuticals USA, Inc in August 2023 in response to the company’s involvement in a price fixing conspiracy involving several pharmaceuticals.   As seen in this example, terms can include paying a fine, waiving certain rights, agreeing to a factual basis for the charges, and an agreement to cooperate and compliance monitoring and of course, agreeing to what will happen if there is a breach of the agreement.

The central benefit to entering in to a DPA is that the individual or business entity is not convicted of any crime. It offers an opportunity to have the federal criminal charges dismissed or dropped once the accused completes all the required conditions.

Here is an another example of a DPA entered in to with the NDGA and Avanir Pharmaceuticals.  This pharmaceutical manufacturer based in Aliso Viejo, California, was charged for paying kickbacks to a physician to induce prescriptions of its drug Nuedexta.   Of note in that case – the Northern District of Ohio indicted four individuals, including former Avanir employees and one of the top prescribers of Nuedexta in the country, who were involved in the kickback scheme.  So, the company itself entered in to a DPA but there was still fall out with respect to some individuals and receiving criminal indictments.

Early intervention is key in a successful resolution in health care criminal matters.  We have extensively blogged about health care fraud.   Contact us if you need an experienced federal criminal defense litigator.  Our firm has vast experience in white collar criminal investigations including False Claims Act and antitrust investigations.

1. NPDB Reports. Licensing boards are generally required to report such these informal agreements involving physicians to the National Practitioners Data Bank (“NPDB”). (See45 CFR § 60.8). Hospitals and other entities are required or permitted to check the NPDB during the physician credentialing process. An NPDB report can permanently tarnish a physician’s record and career, unless it is removed, and it may also result in the additional actions outlined below.
2. Reciprocal Actions by Other State Licensing Boards. Many if not all state licensing boards automatically impose reciprocal sanctions against providers who were sanctioned in another state; thus, the action in one state may result in similar actions in other states in which the provider is licensed. That, of course, compounds the physician’s problems.
3. Adverse Action by Other Agencies. Other agencies may initiate their own investigation based on the board’s order. For example, an order with terms relevant to prescribing practices can trigger an investigation by the state pharmacy board. A stipulation involving inappropriate conduct with the patient might lead to criminal charges by the local law enforcement agency. Although such collateral investigations are fairly rare and are usually limited to situations involving egregious facts, there is no guarantee that the physician will be able to avoid lengthy and costly investigations or proceedings by other agencies.
4. Adverse Employment Action. Employment contracts often condition employment on an unrestricted license and require the provider to disclose or represent that the provider has not been the subject of adverse licensure action. Depending on the language of the contract and the mood of the employer, a seemingly innocuous board order may result in loss of employment. At the very least, it will likely undermine the provider’s position with the employer.
5. Adverse Credentialing Actions. Like employment contracts, hospitals or other facilities consider adverse licensure actions in their credentialing decisions. Depending on the medical staff bylaws and credentialing policies, licensure stipulations may allow the hospital or facility to deny, suspend, restrict, or terminate a provider’s medical staff membership or privileges, thereby limiting the provider’s practice options. Such adverse credentialing actions may also adversely affect the physician’s employment or relationships with payers who are affiliated with the hospital.
6. Adverse Publicity. In most states, the licensing board is permitted or required to publish the action. Colleagues, patients and others in the community are likely to learn of the stipulation, resulting in professional embarrassment, diminished reputation, and loss of business.
7. Malpractice Insurance. Depending on underwriting requirements, a board order may adversely affect the provider’s ability to secure or maintain professional liability insurance or the premiums charged for such insurance.
8. Litigation. Finally, the stipulation may result in civil lawsuits. The stipulation may spark suits by plaintiffs affected by the underlying concerns. In addition, plaintiffs’ lawyers may attempt to use the stipulation in subsequent litigation against the provider. Even though the stipulation will likely be irrelevant and inadmissible to most malpractice cases, it can still cause discomfort and increase the costs of defense.

Given the potential penalties, providers should carefully consider the consequences of any consent order entered into with the Board. If there is no effective defense to the allegations, the provider may have little choice but to agree to an appropriate stipulation to minimize costs and avoid potentially worse sanction; however, the provider should attempt to negotiate the terms in the stipulation to minimize his or her exposure. For example, the board might be willing to agree to a private censure or public reprimand instead of imposing restrictions or conditions on licensure. Alternatively, the provider might be able to modify the stipulation to confirm that it does not constitute a restriction on the license, does not limit the physician’s practice, and there was no harm or risk to patients. The provider might try to include other provisions that mitigate the harm or minimize the need for future disclosures. As appropriate, the provider should work with a knowledgeable attorney to help evaluate the risks and craft the stipulation in a manner to minimize the damage it will undoubtedly cause. For a consultation, contact us today.

Question: What types of issues come before the State of Georgia Nursing Board?

Answer: Below are some common issues the Board handles. Many of these issues may overlap, as most of this conduct also constitutes a crime.

1. Mishandling/misuse of drugs. This includes diverting medications intended for patients, taking medications for your own use, failing to document or inventory medications correctly, or submitting unauthorized prescriptions to pharmacies.
2. Sexual misconduct. This could include allegations of inappropriate sexual relationships with patients or sexually harassing colleagues.
3. Patient abuse or neglect. If a nurse physically, verbally, or mentally abuses a patient, or fails to provide them with timely or sufficient treatment, this could result in the loss of the nurse’s license.
4. Fraud. This may include allegations of falsifying patient records, misrepresenting credentials like education credits or diplomas, sending incorrect or inflated bills to insurance companies, etc.
5. Criminal convictions. Many convictions can disqualify nurses from practicing (such as driving under the influence or drug possession). Importantly, you can also lose your license if you do not disclose a past conviction (see below for more on the license renewal process).

Question: What happens when a complaint is filed against you?

Answer: If a complaint is filed against you with the board of nursing, the Board will review the complaint and open an investigation. If the allegations are serious, the board can issue an emergency temporary suspension of your license during the disciplinary process. Depending on the allegations, an investigator may be appointed to gather all necessary information, including documents, witness testimony, etc. The board may also ask you to submit a written response to the allegations in the complaint, along with any supporting evidence. The board will then decide whether there is enough evidence to support the allegations against you and move forward.

The Board may offer a consent order, allowing you to accept penalties without a formal hearing. The consent order typically involves admission to the wrongdoing and submitting to the disciplinary action recommended. If you decline, a formal hearing will be held, and disciplinary actions may follow. If no consent order is agreed to, you will be asked to appear at a formal hearing to defend yourself against the charges. After the hearing, the board will make a final determination. This could range from public reprimand to the suspension or revocation of your license. Even a minor disciplinary action can become a matter of public record, affecting your career and permanent reputation. It is critical to have a qualified attorney guiding you through this process.

Question: Why hire a nursing license defense attorney?

Answer: When a complaint is filed against you, the board of nursing does not consider you innocent until proven guilty, immediately putting you at a disadvantage. The Nursing Board’s primary goal is to protect the public, not defend nurses. With your career at stake, navigating the complexities of an investigation without legal assistance can be risky. Retaining a nursing license defense attorney ensures that your rights are protected, representing your best interests every step of the way.

Question: What if you are concerned about the license renewing process?

Answer: If you’ve been arrested or convicted since your last renewal, you need to proactively address these issues with the board. Building a mitigation packet and addressing any concerns early can significantly increase your chances of renewing your license without penalties. At Conaway & Strickle, PC, we are experienced in working with professionals to mitigate adverse Board actions related to arrests, substance abuse, and mental health issues. We can assist with not only getting your criminal case reduced or dismissed, but also renewing your license without sanctions.

Question: How can a DUI affect your nursing license in Georgia?

Answer: A DUI conviction in Georgia can result in probation and other penalties, such as random alcohol screenings, mental health evaluations, and restrictions on your nursing practice. These probationary conditions can last for years, depending on the severity of the case.

Below is a list of common probationary conditions that can be place on you following a DUI or an impaired driving under the influence of drugs charge in Georgia.

• Three years minimum probation (must be three years of continuous compliance, so the probationary period could be extended if you slip up)
• Psychotherapy Evaluation by a physician board certified in addiction medicine
• Psychotherapy Course of Treatment completion
• Quarterly Reports from Psychotherapist
• Mental and Physical Evaluation, with favorable finding pertaining to ability to perform duties
• Continuing Education Coursework
• Quarterly Reports from Employer
• Quarterly Reports from yourself
• Quarterly Reports from a Substance Abuse Treatment Aftercare program approved by the Board of Nursing
• Monthly PEth (blood alcohol) testing for first 12 months
• Bi-monthly random urine drug screens for duration of probationary period
• Random alcohol screens
• Enrollment in an Affinity Program, like the one offered by the Georgia Nurses Association
• Restrictions on nursing practice, often including an inability to practice in the following areas without prior Board of Nursing Approval: Agency/Pool Assignments; Private Duty Nursing; In-Home Nursing; Internal Float Pools; Travel Nursing; In-Home Hospice.
• Abstaining from alcohol, and mood-altering substances, including controlled substances unless prescribed.
• If prescribed any medication, providing a letter from the prescriber to both the Board of Nursing and the treatment/aftercare provider within 10-days of receiving such subscription.

Conclusion

If you’re facing challenges related to your nursing license, it’s important to act quickly. With the complexities of nursing board investigations and the potential damage to your reputation, having an experienced nursing license defense attorney is crucial. For more information, contact us today.

Who makes up the Composite Board? The Board is made up of fifteen members appointed by the Governor. Thirteen of those members are physicians, and two of those members are public representatives who have no ties to medicine. Each Board member typically serves a four-year term.

What does the Board do? The Board’s functions include screening candidates for licensure, issuing licenses to qualified professionals, developing rules and guidelines for healthcare practice, and disciplining licensees when necessary. In Georgia, the Composite Board licenses and monitors healthcare professionals including the following: Medical doctors (MDs), Doctors of osteopathic medicine (DOs), Physician assistants (PAs), Anesthesiologist assistants (AAs), Acupuncturists, and pain management clinics. However, the Composite Board does not license or regulate podiatrists, chiropractors, dentists, marriage and family therapists, social workers, professional counselors, physical therapists, registered nurses, or licensed practical nurses – those professions are regulated by the Office of the Secretary of State.

As a healthcare professional, should you retain a lawyer for interacting with the Board? When your professional license could be at stake, an experienced attorney can assist you with navigating the Board’s procedures and hearings. For licensing applicants, there may be issues from the past that require disclosure to the Board. For example, while a past criminal conviction will not necessarily prevent an applicant from obtaining a healthcare license, the failure to make an adequate and timely disclosure could jeopardize licensure and require a hearing before the Board. For licensed healthcare professionals, the Board will handle challenges to your license that arise from allegations of any professional or criminal misconduct. Once the Board has notified you of a pending disciplinary action, consulting with legal counsel is crucial to best protect your license and career.

At Conaway & Strickler, we have experience representing healthcare professionals before the Board in matters including the disclosure and mitigation of criminal issues and the defense of alleged professional misconduct. If your healthcare license is at stake, our attorneys can help guide you through the process of safeguarding your career. Schedule a free consultation to discuss potential issues facing your professional license.

What happens when the Medical Board investigates you? First, a complaint is filed. The Board will reach out to you and let the you know of the existence of the complaint and ask for a response. This is where you immediately need to seek out legal advice. At Conaway & Strickler, PC we have attorneys very versed on the intricacies of the complaint process. Once the Investigative Committee reviews the complaint and response, they can recommend a variety of options ranging from closing the case to disciplinary action. It is imperative that you and your lawyer really work with the Investigative Committee to ensure they know all of the facts and circumstances to ensure the best resolution.

Cases are resolved in three main ways – closure, private action or public action. The public action is a notation on the GCMB web site.

Contact us for more information and how we can help you.

Note if your asset has been SEIZED, that means the government has taken possession of your property, but it does not mean the government owns the property legally YET….See here for details on the most recent DOJ seizures and forfeiture manual.

Criminal Forfeiture

This is taken verbatim from DOJ website

In personam (against the person) action against a defendant that includes notice of the intent to forfeit property in a criminal indictment. A criminal conviction is required, and forfeiture is part of the defendant’s sentence. Criminal forfeiture is limited to the property interests of the defendant, including any proceeds earned by the defendant’s illegal activity. Criminal forfeiture is generally limited to the property involved in the particular counts on which the defendant is convicted. As part of sentencing, a court may order the forfeiture of a specific property listed in the indictment, a sum of money as a money judgment, or other property as substitute property. The government must establish by a preponderance of the evidence the requisite connection between the crime of conviction and the asset. After a preliminary order of forfeiture is entered, a separate, ancillary proceeding begins to determine any third-party ownership interests in the property the government seeks to forfeit. The court then will enter a final order of forfeiture

Civil Forfeiture

In rem (against the property) court proceeding brought against property that was derived from or used to commit an offense, rather than against a person who committed an offense. Unlike criminal forfeiture, there is no criminal conviction required, although the government is still required to prove in court by a preponderance of evidence that the property was linked to criminal activity. The proceeding allows the court to gather anyone with an interest in the property in the same case and resolve all the issues with the property at one time.

In a civil forfeiture case, the government is the plaintiff, the property is considered the defendant, and any person who claims an interest in the property is a claimant. Civil forfeiture allows the government to file cases against property that would not be reachable through criminal forfeiture, such as property of fugitives, terrorists, and other criminals located outside the United States. Civil forfeiture also permits recovery of assets of defendants who have died or where the wrongdoer cannot be identified.

Administrative Forfeiture In rem (against the property) action that permits personal property to be forfeited to the United States without filing a case in federal court. The administrative forfeiture process occurs before the agency that seized the assets when no one has filed a claim contesting the seizure. There are many procedural requirements, including strict time limits and noticing requirements, designed to protect the interests and rights of property holders. Any seizure of property subject to administrative forfeiture must be based on probable cause. The primary benefit of administrative forfeiture is to avoid burdening the courts with judicial actions when no one contests the forfeiture of the seized property.

This last one (administrative forfeiture) needs translated a bit. You need to first assert a claim to the property and then it goes to the civil forfeiture route.

A person who files an administrative petition is not contesting the forfeiture. The petitioner either wants his/her interest in the asset to be recognized or is a victim of the crime(s) underlying the forfeiture. If the asset is forfeited to the government, the petitioner wants to be compensated for his/her interest.

But, a person who files an administrative claim is contesting the seizure and is requesting to pursue the matter in court. The claimant believes the asset was not part of an illegal activity and was not purchased through ill-gotten gains. To contest forfeiture in federal court you must file a claim.

Once you file a timely claim, it will stop the administrative forfeiture proceeding and it is then forwarded to the U.S. Attorney’s Office for further proceedings.

Any time deadlines are missed, the assets may be forfeited to the government. In just ONE year, in just ONE district, the Northern District of Georgia was responsible for collections and forfeitures of over U.S. Attorney Ryan K. Buchanan announced that the Northern District of Georgia was responsible for collections and forfeitures of over $31 million in Fiscal Year 2023. $31 million in Fiscal Year 2023.

Please contact us so we can help you protect your assets.

But, also he made sure to point out that in addition to the charges and arrests being announced, that the government also seized over $230 million in cash, luxury vehicles, gold, and other assets in connection with these cases.

The government comes after you with search warrants, warrants to freeze and seize your assets and subpoenas for your records. Do not attempt to deal with these things alone Contact us so we can protect your license, your livelihood and your assets.

What is Georgia Medicaid? Medicaid is a “medical assistance program that helps many people who cannot afford medical care pay for some or all of their medical bills. Medicaid is administered by the Georgia Department of Community Health and pays medical bills with state and federal tax money.”

What is Medicaid Fraud?

Medicaid Fraud can come in many different forms – some elaborate and some not so elaborate.

What are some types of fraud?

-Billing for Unnecessary Services or Items -Intentionally billing for unnecessary medical services or items. -Billing for Services or Items Not Provided – Intentionally billing for services or items not provided. -Unbundling Billing for multiple codes for a group of procedures that are covered in a single global billing code. -Upcoding Billing for services at a higher level of complexity than provided. -Card Sharing -Knowingly treating and claiming reimbursement for someone other than the eligible beneficiary. -Collusion – Knowingly collaborating with beneficiaries to file false claims for reimbursement. Kickbacks -Offering, soliciting, or paying for beneficiary referrals for medical services or items. Program Eligibility – Knowingly billing for an ineligible beneficiary

Who prosecutes these cases?

The DOJ’s Health Care Unit. or in Georgia, the Georgia Medical Fraud Division of the Office of the Attorney General

What are some examples of prosecutions?

Opioid prosecutions National Health Care Fraud Enforcement – “The Department of Justice announced today criminal charges against 138 defendants, including 42 doctors, nurses, and other licensed medical professionals, in 31 federal districts across the United States for their alleged participation in various health care fraud schemes that resulted in approximately $1.4 billion in alleged losses.”

In the 2019 Operation Brace yourself prosecution press release, the DOJ had a call to action stating, “Any doctors or medical professionals who have been involved with alleged fraudulent telemedicine and DME marketing schemes – including Video Doctor USA, AffordADoc, Web Doctors Plus, Integrated Support Plus and First Care MD should call to report this conduct to the FBI. Nope, call a lawyer first!

Conaway & Strickler, PC has experienced healthcare fraud defense lawyers ready to assist if you receive a subpoena, a “friendly visit by agents”, a request for some patient files, or an interview request from the Medicaid Fraud Control Unit. Contact us to learn more – do not go at this alone.