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        <title><![CDATA[Uncategorized - Conaway & Strickler]]></title>
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                <title><![CDATA[DOJ Targets Georgia Laboratory Executives in $13.7 Million Medicare Fraud Case]]></title>
                <link>https://www.conawayandstrickler.com/blog/georgia-medicare-fraud-investigation-lab-executives/</link>
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                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Sat, 19 Sep 2026 13:38:07 GMT</pubDate>
                
                    <category><![CDATA[False Claims Act]]></category>
                
                    <category><![CDATA[Health Care]]></category>
                
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                    <category><![CDATA[Atlanta federal health care fraud attorney]]></category>
                
                    <category><![CDATA[False Claims Act]]></category>
                
                    <category><![CDATA[federal criminal investigation]]></category>
                
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                <description><![CDATA[<p>Experienced Atlanta federal health care fraud attorneys keep track of all of the recent cases in the Northern District of Georgia. This past week, the Department of Justice announced a press release stating they filed a major False Claims Act lawsuit against two former executives of an Atlanta-based clinical laboratory, alleging that they caused Medicare&hellip;</p>
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                <content:encoded><![CDATA[
<p class="wp-block-paragraph">Experienced Atlanta federal health care fraud attorneys keep track of all of the recent cases in the Northern District of Georgia.  This past week, the Department of Justice announced a <a href="https://www.justice.gov/usao-ndga/pr/doj-sues-former-georgia-lab-execs-defrauding-medicare-targeting-faith-based" data-type="link" data-id="https://www.justice.gov/usao-ndga/pr/doj-sues-former-georgia-lab-execs-defrauding-medicare-targeting-faith-based">press release </a>stating they filed a major False Claims Act lawsuit against two former executives of an Atlanta-based clinical laboratory, alleging that they caused Medicare to pay approximately $13.7 million for medically unnecessary genetic and respiratory pathogen testing.  In addition, the United States reached settlements with <a href="https://www.justice.gov/archives/opa/pr/georgia-laboratory-owner-pleads-guilty-felony-charge-and-pays-143-million-resolve-liability">Capstone and its owner, Andrew Maloney, for $14.3 million</a> and with <a href="https://www.justice.gov/archives/opa/pr/lab-billing-company-settles-false-claims-act-allegations-relating-unnecessary-respiratory">Capstone’s billing company, VitalAxis, Inc. for $300,479</a> to resolve their potential civil liability under the False Claims Act</p>



<p class="wp-block-paragraph">For physicians, laboratory owners, health care executives, marketers, and billing professionals, the case carries an important warning:</p>



<p class="wp-block-paragraph"><strong>A Medicare billing investigation can become a federal criminal case.</strong></p>



<p class="wp-block-paragraph">The September 17, 2026 announcement from the U.S. Attorney’s Office for the Northern District of Georgia involves both civil False Claims Act allegations and a related federal criminal prosecution.</p>



<p class="wp-block-paragraph">If federal agents, HHS-OIG investigators, or prosecutors are asking questions about your Medicare billing, laboratory testing, physician orders, marketing arrangements, or compensation agreements, the time to develop a defense strategy is before charge<strong>s </strong>are filed—not after an indictment.</p>



<h2 id="h-doj-alleges-13-7-million-in-improper-medicare-laboratory-payments" class="wp-block-heading">DOJ Alleges $13.7 Million in Improper Medicare Laboratory Payments</h2>



<p class="wp-block-paragraph">The United States filed a False Claims Act complaint against former Capstone Diagnostics executives Jay Johnson and Austin Whiles, along with associated entities.</p>



<p class="wp-block-paragraph">Johnson served as Capstone’s Chief Operating Officer and Chief Executive Officer. Whiles served as Chief Sales Officer and Vice President of Business Development.</p>



<p class="wp-block-paragraph">According to DOJ, the defendants allegedly participated in two schemes between 2019 and 2021 that caused Medicare to reimburse approximately $13.7 million for genetic and respiratory pathogen panel testing that the government contends was not medically necessary.</p>



<p class="wp-block-paragraph">These are allegations. The civil defendants have the right to contest the government’s claims, and the criminal charges against Johnson remain pending.</p>



<p class="wp-block-paragraph">But the case illustrates the aggressive investigative theories federal authorities may use when scrutinizing laboratory billing.</p>



<h2 id="h-genetic-testing-at-churches-and-religious-conferences" class="wp-block-heading">Genetic Testing at Churches and Religious Conferences</h2>



<p class="wp-block-paragraph">The first alleged scheme involves genetic testing performed at church-sponsored health fairs and religious conferences.</p>



<p class="wp-block-paragraph">DOJ alleges that attendees were swabbed for genetic testing and that large amounts of testing were subsequently billed to Medicare even though treating physicians had not requested the tests.</p>



<p class="wp-block-paragraph">According to the government’s allegations, physician names, signatures, standing orders, and other paperwork were used without authorization to make the tests appear properly ordered and medically necessary.</p>



<p class="wp-block-paragraph">For laboratories and health care providers, these allegations highlight several issues that frequently become central to federal investigations:</p>



<ul class="wp-block-list">
<li>Who actually ordered the test?</li>



<li>Did the ordering provider determine that the test was medically necessary for the individual patient?</li>



<li>Who selected the diagnosis codes?</li>



<li>Were standing orders permissible and properly documented?</li>



<li>Did sales or marketing personnel participate in the ordering process?</li>



<li>Were physician signatures copied, reused, or electronically applied?</li>



<li>Did compensation depend on testing volume?</li>



<li>Did anyone receive payment for referrals?</li>
</ul>



<p class="wp-block-paragraph">These questions can determine whether the government views a case as a compliance problem, a False Claims Act matter, or a potential criminal fraud prosecution.</p>



<h2 id="h-covid-19-testing-and-respiratory-pathogen-panels" class="wp-block-heading">COVID-19 Testing and Respiratory Pathogen Panels</h2>



<p class="wp-block-paragraph">DOJ’s second alleged scheme involves COVID-19 testing performed for senior living communities.</p>



<p class="wp-block-paragraph">According to the government, Capstone allegedly added respiratory pathogen panels to COVID-19 tests requested by senior communities, increasing Medicare reimbursement.</p>



<p class="wp-block-paragraph">Federal authorities allege that this involved community-wide or chain-wide standing orders, copied physician signatures, standardized diagnosis codes, orders entered by sales personnel instead of treating providers, and unlawful remuneration allegedly paid in violation of the federal Anti-Kickback Statute.</p>



<p class="wp-block-paragraph">Those allegations have not been proven.</p>



<p class="wp-block-paragraph">But they illustrate an increasingly important issue in federal health care investigations: the government may examine the entire process by which a reimbursable test was generated—not merely whether the laboratory actually performed the test.</p>



<h2 id="h-a-billing-problem-is-not-automatically-health-care-fraud" class="wp-block-heading">A Billing Problem Is Not Automatically Health Care Fraud</h2>



<p class="wp-block-paragraph">This distinction is critical.</p>



<p class="wp-block-paragraph">An incorrect Medicare claim does not automatically establish criminal fraud.</p>



<p class="wp-block-paragraph">Medicare and Medicaid billing rules are extraordinarily complicated. Billing disputes can arise from coding mistakes, documentation deficiencies, employee errors, medical-necessity disagreements, billing company mistakes, misunderstood guidance, software problems, or competing interpretations of reimbursement requirements.</p>



<p class="wp-block-paragraph">Criminal health care fraud requires more than simply showing that Medicare should not have paid a claim.</p>



<p class="wp-block-paragraph">In a criminal case, the government must prove the required criminal intent.</p>



<p class="wp-block-paragraph">That makes the evidence concerning <strong>knowledge and intent</strong> extremely important.</p>



<p class="wp-block-paragraph">Experienced federal defense counsel may examine:</p>



<ul class="wp-block-list">
<li>What the client actually knew about the billing practice;</li>



<li>Who developed the challenged procedure;</li>



<li>Whether compliance personnel approved or questioned it;</li>



<li>What physicians and medical personnel understood;</li>



<li>Whether outside consultants or billing companies provided advice;</li>



<li>Whether Medicare guidance was clear at the relevant time;</li>



<li>Whether employees departed from company policies;</li>



<li>Whether potentially unfavorable communications have an innocent context;</li>



<li>Whether the government’s statistical or billing analysis accurately reflects individual claims; and</li>



<li>Whether prosecutors can actually prove that a particular defendant knowingly participated in a fraudulent scheme.</li>
</ul>



<p class="wp-block-paragraph">The difference between a reimbursement dispute and a federal felony can turn on these issues.</p>



<h2 id="h-the-government-is-following-the-money" class="wp-block-heading">The Government Is Following the Money</h2>



<p class="wp-block-paragraph">The DOJ announcement also alleges significant financial transactions.</p>



<p class="wp-block-paragraph">According to the government, Johnson transferred millions of dollars allegedly derived from the schemes to his former wife. DOJ further alleges that Whiles secretly routed approximately $4.75 million in volume-based commissions from independent marketers to himself.</p>



<p class="wp-block-paragraph">Financial evidence frequently becomes a major component of federal health care fraud investigations.</p>



<p class="wp-block-paragraph">Investigators may subpoena or seize:</p>



<p class="wp-block-paragraph">Bank accounts. Emails. Text messages. Marketing agreements. Compensation records. Physician orders. Patient records. Billing data. Electronic health records. Corporate records. Tax returns. Cell phones. Computers. Tax returns are especially useful in their investigations as tax fraud can be another potential charge in these type of cases.  </p>



<p class="wp-block-paragraph">Still, the government may then attempt to use those records to construct a narrative about who knew what and who financially benefited.  It is crucial to not co-mingle business funds with personal funds in these types of situations.</p>



<p class="wp-block-paragraph">These are reasons why retaining defense counsel early is so important.  We work together with you and begin an independent analysis of the situation as early as possible.</p>



<h2 id="h-anti-kickback-allegations-can-turn-a-civil-investigation-into-a-criminal-case" class="wp-block-heading">Anti-Kickback Allegations Can Turn a Civil Investigation Into a Criminal Case</h2>



<p class="wp-block-paragraph">The federal Anti-Kickback Statute creates particularly serious exposure for health care providers and businesses receiving federal program reimbursement.</p>



<p class="wp-block-paragraph">The statute generally prohibits knowingly and willfully offering, paying, soliciting, or receiving remuneration to induce or reward referrals involving items or services reimbursable by federal health care programs.</p>



<p class="wp-block-paragraph">Marketing arrangements can receive heightened scrutiny when compensation is tied to testing volume, collections, referrals, or federal health care program business.</p>



<p class="wp-block-paragraph">A questionable compensation arrangement may expose individuals and companies to multiple theories of liability, including:</p>



<p class="wp-block-paragraph">Anti-Kickback Statute violations, False Claims Act liability, health care fraud, wire fraud, conspiracy, and exclusion from federal health care programs.</p>



<p class="wp-block-paragraph">The precise facts matter. Legitimate marketing and compensation arrangements exist, and the existence of a payment does not itself establish a criminal kickback.</p>



<h2 id="h-the-same-investigation-can-produce-civil-and-criminal-cases" class="wp-block-heading">The Same Investigation Can Produce Civil and Criminal Cases</h2>



<p class="wp-block-paragraph">The Capstone matter demonstrates how civil and criminal health care enforcement can overlap.</p>



<p class="wp-block-paragraph">DOJ reports that Johnson was separately indicted by a federal grand jury in December 2025 on charges of:</p>



<ul class="wp-block-list">
<li>Conspiracy to commit health care and wire fraud;</li>



<li>Health care fraud;</li>



<li>Wire fraud;</li>



<li>Conspiracy to receive and pay kickbacks; and</li>



<li>Payment of kickbacks in connection with a federal health care program.</li>
</ul>



<p class="wp-block-paragraph">Those charges are pending. An indictment is an accusation, not evidence of guilt, and Johnson is presumed innocent unless and until proven guilty.</p>



<p class="wp-block-paragraph">For anyone involved in a federal health care investigation, however, the parallel proceedings demonstrate why it can be dangerous to assume that an investigation is “only civil.”</p>



<p class="wp-block-paragraph">Statements made during a civil investigation can potentially have consequences in a criminal investigation.</p>



<h2 id="h-the-investigation-started-with-a-whistleblower" class="wp-block-heading">The Investigation Started With a Whistleblower</h2>



<p class="wp-block-paragraph">The case also demonstrates the power of the False Claims Act’s <a href="https://www.law.cornell.edu/wex/qui_tam_action" data-type="link" data-id="https://www.law.cornell.edu/wex/qui_tam_action">qui tam,</a> or whistleblower, provisions.</p>



<p class="wp-block-paragraph">According to DOJ, former Capstone laboratory manager Jesse Allen filed the underlying False Claims Act lawsuit. The federal government subsequently intervened in the case on September 4, 2026.</p>



<p class="wp-block-paragraph">Employees and former employees can possess enormous amounts of information about a health care company’s billing practices, compliance procedures, internal communications, and corporate decision-making.</p>



<p class="wp-block-paragraph">An employment dispute or internal compliance complaint can therefore develop into something much larger:</p>



<p class="wp-block-paragraph">A whistleblower complaint. A Civil Investigative Demand. An HHS-OIG investigation. A federal grand jury investigation. And, potentially, a criminal indictment.</p>



<h2 id="h-has-the-fbi-or-hhs-oig-contacted-you" class="wp-block-heading">Has the FBI or HHS-OIG Contacted You?</h2>



<p class="wp-block-paragraph">One of the most important decisions in a federal investigation may occur before anyone has been charged.</p>



<p class="wp-block-paragraph">Federal agents sometimes approach executives, physicians, employees, marketers, and other witnesses unexpectedly and ask to “just ask a few questions.”</p>



<p class="wp-block-paragraph">You are not required to navigate that encounter alone.</p>



<p class="wp-block-paragraph">If agents want to interview you about Medicare billing, health care claims, laboratory testing, kickbacks, physician referrals, or another potential federal offense, speaking with <a href="https://www.conawayandstrickler.com/lawyers/meg-strickler-federal-criminal-defense-lawyer/" data-type="link" data-id="https://www.conawayandstrickler.com/lawyers/meg-strickler-federal-criminal-defense-lawyer/">experienced federal criminal defense counsel</a> <strong>before participating in an interview</strong> can be critical.</p>



<p class="wp-block-paragraph">The same is true if you receive:</p>



<ul class="wp-block-list">
<li>A federal grand jury subpoena;</li>



<li>A Civil Investigative Demand;</li>



<li>An HHS-OIG subpoena;</li>



<li>A search warrant;</li>



<li>A request for billing or patient records;</li>



<li>A Medicare payment suspension;</li>



<li>A target letter;</li>



<li>A request for an FBI interview; or</li>



<li>Information that employees or business partners are being questioned.</li>
</ul>



<p class="wp-block-paragraph">Do not assume that receiving a subpoena means you are merely a witness.</p>



<p class="wp-block-paragraph">Your lawyer can contact the prosecutor or investigating agency, determine what information can be obtained about your status, evaluate potential exposure, preserve favorable evidence, and develop a strategy before critical decisions are made.</p>



<h1 id="h-frequently-asked-questions-about-federal-health-care-fraud-investigations" class="wp-block-heading">Frequently Asked Questions About Federal Health Care Fraud Investigations</h1>



<h2 id="h-what-should-i-do-if-the-fbi-or-hhs-oig-wants-to-interview-me" class="wp-block-heading">What should I do if the FBI or HHS-OIG wants to interview me?</h2>



<p class="wp-block-paragraph">Before agreeing to an interview, consider speaking with a federal criminal defense attorney.</p>



<p class="wp-block-paragraph">Statements to federal investigators can become important evidence in a later prosecution. Even when the underlying conduct is not criminal, knowingly making a materially false statement to federal investigators can itself create potential criminal exposure.</p>



<p class="wp-block-paragraph">Counsel can communicate with investigators, obtain available information concerning the investigation, prepare you for an interview when appropriate, or advise you whether participating is in your interests.</p>



<h2 id="h-does-receiving-a-federal-grand-jury-subpoena-mean-i-am-under-investigation" class="wp-block-heading">Does receiving a federal grand jury subpoena mean I am under investigation?</h2>



<p class="wp-block-paragraph">Not necessarily.</p>



<p class="wp-block-paragraph">A subpoena may be issued to a witness, records custodian, subject, target, company, physician, laboratory, or other person possessing relevant evidence.</p>



<p class="wp-block-paragraph">But a subpoena should never be ignored.</p>



<p class="wp-block-paragraph">An experienced federal defense attorney can review its scope, communicate with prosecutors, determine whether responsive material raises additional concerns, and evaluate whether the subpoena provides clues about the government’s investigative theory.</p>



<h2 id="h-can-medicare-billing-errors-lead-to-criminal-charges" class="wp-block-heading">Can Medicare billing errors lead to criminal charges?</h2>



<p class="wp-block-paragraph">They can, but a billing error is not automatically a crime.</p>



<p class="wp-block-paragraph">The critical issues often include what happened, who was responsible, what the defendant knew, and whether prosecutors can prove the required fraudulent intent.</p>



<p class="wp-block-paragraph">A strong defense may require detailed analysis of individual claims, Medicare rules, medical records, coding decisions, corporate responsibilities, and communications among providers, laboratories, billing personnel, and marketers.</p>



<h2 id="h-what-is-the-difference-between-the-false-claims-act-and-criminal-health-care-fraud" class="wp-block-heading">What is the difference between the False Claims Act and criminal health care fraud?</h2>



<p class="wp-block-paragraph">The False Claims Act is primarily a civil enforcement statute that allows the government to pursue false or fraudulent claims for federal funds and potentially obtain substantial damages and penalties.</p>



<p class="wp-block-paragraph">Criminal health care fraud involves criminal prosecution and can expose a defendant to imprisonment, fines, restitution, forfeiture, and other consequences.</p>



<p class="wp-block-paragraph">The same underlying conduct can sometimes generate both civil and criminal investigations.</p>



<h2 id="h-can-a-kickback-allegation-become-a-criminal-case" class="wp-block-heading">Can a kickback allegation become a criminal case?</h2>



<p class="wp-block-paragraph">Yes.</p>



<p class="wp-block-paragraph">The federal Anti-Kickback Statute contains criminal provisions. Federal prosecutors may investigate compensation arrangements involving physicians, marketers, laboratories, pharmacies, durable medical equipment companies, telemedicine providers, and other participants in federal health care programs.</p>



<p class="wp-block-paragraph">Whether an arrangement violates the law depends on the specific facts and applicable statutory and regulatory requirements.</p>



<h2 id="h-what-if-my-billing-company-submitted-the-claims" class="wp-block-heading">What if my billing company submitted the claims?</h2>



<p class="wp-block-paragraph">Using a third-party billing company does not necessarily end the inquiry.</p>



<p class="wp-block-paragraph">The government may investigate what information was provided to the billing company, who selected codes, who established billing protocols, what executives knew, whether concerns were raised, and how responsibilities were allocated.</p>



<p class="wp-block-paragraph">At the same time, evidence showing that a client reasonably relied on professionals, lacked knowledge of improper billing, or did not participate in challenged decisions may be highly relevant to the defense.</p>



<h2 id="h-when-should-i-hire-a-federal-health-care-fraud-lawyer" class="wp-block-heading">When should I hire a federal health care fraud lawyer?</h2>



<p class="wp-block-paragraph">Ideally, <strong>before speaking with federal investigators or producing potentially sensitive materials in response to a subpoena.</strong></p>



<p class="wp-block-paragraph">Pre-indictment representation can give defense counsel an opportunity to understand the government’s theory, identify weaknesses in the allegations, preserve evidence, investigate witnesses, analyze claims data, address potentially misleading information, and advocate for the client before prosecutors make a charging decision.</p>



<h1 id="h-under-federal-investigation-contact-conaway-amp-strickler-before-you-talk-to-investigators" class="wp-block-heading">Under Federal Investigation? Contact Conaway & Strickler Before You Talk to Investigators.</h1>



<p class="wp-block-paragraph">When the Department of Justice, FBI, HHS-OIG, or a U.S. Attorney’s Office begins investigating health care fraud, the consequences can extend far beyond repayment of disputed Medicare claims.</p>



<p class="wp-block-paragraph"><strong>Your business, professional license, assets, reputation, and freedom may all be at stake.</strong></p>



<p class="wp-block-paragraph">Conaway & Strickler, P.C. represents individuals and businesses in complex federal criminal investigations and prosecutions in Atlanta, throughout Georgia, and across the United States.</p>



<p class="wp-block-paragraph">Our federal criminal defense attorneys represent physicians, health care professionals, business owners, executives, laboratories, marketers, and other individuals facing government investigations involving Medicare fraud, Medicaid fraud, health care fraud, th<strong>e </strong>Anti-Kickback Statute, False Claims Act allegations, wire fraud, conspiracy, and related federal offenses.</p>



<p class="wp-block-paragraph">If you have received a subpoena, been contacted by federal agents, learned that your employees or business associates are being interviewed, or believe that you may be the subject or target of a federal health care investigation, <strong>do not wait for an indictment to begin building your defense.</strong></p>



<p class="wp-block-paragraph"><strong><a href="https://www.conawayandstrickler.com/contact-us/" data-type="link" data-id="https://www.conawayandstrickler.com/contact-us/">Contact Conaway & Strickler, P.C.</a> to speak with an experienced federal criminal defense attorney about protecting your rights and developing a strategy before critical decisions are made.</strong></p>



<p class="wp-block-paragraph"></p>
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                <title><![CDATA[Airport Searches*]]></title>
                <link>https://www.conawayandstrickler.com/blog/airport-searches/</link>
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                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Sat, 08 Aug 2026 13:02:45 GMT</pubDate>
                
                    <category><![CDATA[Federal Crimes]]></category>
                
                    <category><![CDATA[Federal Offenses]]></category>
                
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                    <category><![CDATA[airport searches]]></category>
                
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                <description><![CDATA[<p>Airport Searches: When are they Legal? We all know that when we fly out from the airport, we have to have our luggage checked, and we’ll have to pose inside full-body scanners. Perhaps because of these measures, people may believe that their rights related to search and seizure do not apply in airports. Moreover, people&hellip;</p>
]]></description>
                <content:encoded><![CDATA[
<h2 class="wp-block-heading" id="h-airport-searches-when-are-they-legal"><strong>Airport Searches: When are they Legal?</strong></h2>



<p>We all know that when we fly out from the airport, we have to have our luggage checked, and we’ll have to pose inside full-body scanners. Perhaps because of these measures, people may believe that their rights related to search and seizure do not apply in airports. Moreover, people may believe that, should they be stopped by federal or state police without cause, they have no way to fight for their rights.</p>



<p>The short answer is, that’s not right – <strong>you still have rights, even in an airport.</strong> That said, your rights are altered when in an airport. Here, we discuss a few of the nuances about airport searches, and offer some tips for travel.</p>



<h2 class="wp-block-heading" id="h-what-are-the-rules-for-airport-searches"><strong>What are the rules for airport searches?</strong></h2>



<p>Depending on where you are, the rules shift some for how airport searches work, exactly. That’s because while the United States Supreme Court <em>has</em> passed some rulings related to airport searches, many of the decisions which control airport searches are determined on the circuit level. Which circuit will apply depends on where the airport is.</p>



<p>No matter where you are, the United States Supreme Court has stated that your Fourth Amendment rights do still exist in airport, in cases such as <em><a href="https://supreme.justia.com/cases/federal/us/442/465/">Torres v. Puerto Rico</a></em> and <em><a href="https://supreme.justia.com/cases/federal/us/462/696/" data-type="link" data-id="https://supreme.justia.com/cases/federal/us/462/696/">United States v. Place</a>.</em> However, every circuit has recognized that there are some exceptions which apply to airports, and these allow some of the searches you might already be used to; searches at airport security checkpoints (think TSA) are fine. Many circuits consider these “administrative searches” which put simply are searches which are okay if they are for specific purposes and remain limited in scope.</p>



<p>In the Eleventh Circuit – which is the Circuit that Georgia, Florida, and Alabama are in – the Court has stated that passengers in search areas, even if they withdraw their consent, can be searched. In <em><a href="https://law.justia.com/cases/federal/appellate-courts/F2/723/773/319877/">United States v. Herzbrun</a></em>, a man trying to board a plane, who voluntarily entered an airport security checkpoint, could not revoke his consent. In other words, if you go into a security line at the airport in the Eleventh Circuit, the airport is allowed to scan your things, and you cannot back out once you start.</p>



<p>That said, if police want to search your luggage, they will need <em>probable cause</em> – that is, they need reason to believe that a crime was committed, and evidence of that crime will be found in your luggage. Police may require a warrant to search your things, but they are allowed to detain your luggage to wait for a warrant once they have probable cause, seen in <em>United States v. Place</em>.  </p>



<h2 class="wp-block-heading" id="h-what-if-you-re-flying-in-rather-than-out"><strong>What if you’re flying <em>in</em>, rather than <em>out</em>?</strong></h2>



<p>This depends on where you are flying in from. If you are arriving from another place in the United States, your rights are the same as ever. However, if you fly in on an international flight,&nbsp; the rules apply to you as if you were crossing the border, which means the United States may have expanded search capabilities.</p>



<p>Once again, the exact laws which will apply depend on the circuit you are in. In the Eleventh Circuit, we use the rule established under <em><a href="https://law.justia.com/cases/federal/appellate-courts/ca11/22-10709/22-10709-2025-04-08.html">United States v. Pulido</a></em>, which asks whether there is statutory authority for Customs and Border Patrol to make a search, and then if there are constitutional concerns that apply to the search.</p>



<p>Right now, there is a case pending at the Eleventh Circuit asking whether or not Fourth Amendment protections apply to electronics when brought in internationally. (That case, if you are interested, is <em><a href="https://www.atlantanewsfirst.com/2026/08/07/atlanta-activist-faces-federal-charge-after-airport-phone-search/">United States v. Tunick</a></em>.) However, if you are flying in to somewhere in the Eleventh Circuit – again, Georgia, Florida, and Alabama – you may be automatically subject to a search of your phone even without suspicion, depending on the outcome of the case.</p>



<h2 class="wp-block-heading" id="h-what-can-i-do-if-i-am-getting-ready-to-fly"><strong>What can I do if I am getting ready to fly?</strong></h2>



<p>Take a couple easy steps when flying to ensure you minimize legal trouble:</p>



<ul class="wp-block-list">
<li>Check airport rules, and check your luggage. Make sure you don’t bring anything that could get you into trouble. If you’re flying internationally, make sure you aren’t bringing contraband that could get you in trouble flying out <strong>or</strong> flying in – a few years ago, several Americans were detained in Turks & Caicos for having brought bullets.&nbsp; And currently, there is a <a href="https://www.11alive.com/article/news/local/athens-father-says-he-atlanta-tsa-missed-loaded-magazines-before-jamaican-vacation-now-faces-15-years-in-prison/85-831963f2-03c6-414d-893a-c0df11876c54">Georgia man</a> in the news who accidentally had ammunition in his bag in Jamaica.&nbsp;</li>



<li>Double check your electronics. Make sure there is nothing compromising on your electronics which could get you in trouble, should they be searched.</li>



<li>If you are stopped, remain courteous with airport authorities. Do not offer reasons they could use to detain or search you further.</li>



<li>If airport authorities seek to search your bags outside of a security checkpoint, do not consent to a search. Make sure your denial of consent is audible, and if possible, make sure there is a witness to the search. If police search your things without your consent, <strong>do not physically stop them</strong>. Simply make your refusal to consent known, make sure the search is witnessed, and take careful notes of the circumstances of the search.</li>
</ul>



<h2 class="wp-block-heading" id="h-what-do-i-do-if-i-ve-been-illegally-searched"><strong>What do I do if I’ve been illegally searched?</strong></h2>



<p>If you believe you have been illegally searched at an airport, <a href="https://www.conawayandstrickler.com/contact-us/">contact us</a>. Conaway & Strickler, PC may be able to help you determine if you have been illegally searched, and if there are any ways to vindicate your rights.</p>



<p>*Guest post written by Andrew Paul Smith, future Emory Law 2027 graduate</p>
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                <title><![CDATA[What is a Target Letter?]]></title>
                <link>https://www.conawayandstrickler.com/blog/what-is-a-target-letter/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/what-is-a-target-letter/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Fri, 31 Jul 2026 14:20:35 GMT</pubDate>
                
                    <category><![CDATA[Federal Crimes]]></category>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                    <category><![CDATA[White Collar Crimes]]></category>
                
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                <description><![CDATA[<p>What is a Target Letter? A target letter is a letter from a federal prosecutor informing you that you are the focus of a federal criminal investigation. It indicates that the government possesses substantial evidence linking you to a federal offense and is considering charging you. A target letter will contain key information for your&hellip;</p>
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<p><strong>What is a Target Letter?</strong></p>



<p>A target letter is a <a href="https://www.justice.gov/archives/jm/criminal-resource-manual-160-sample-target-letter" id="https://www.justice.gov/archives/jm/criminal-resource-manual-160-sample-target-letter">letter</a> from a federal prosecutor informing you that you are the focus of a federal criminal investigation. It indicates that the government possesses substantial evidence linking you to a federal offense and is considering charging you.  A target letter will contain key information for your lawyer to assist you.  It will have a description of the suspected offense, and the name of the AUSA handling the case. As soon as we are retained, we reach out to that AUSA to learn more about the situation. </p>



<p> If you receive a target letter, reach out for legal counsel as soon as possible. </p>



<h2 class="wp-block-heading" id="h-what-is-the-difference-between-target-subject-and-witness">What is the difference between Target, Subject and Witness? </h2>



<p></p>



<p>A “target” is someone prosecutors are investigating for having allegedly committed a crime.   A “witness”, on the other hand, is someone whom prosecutors believe may have information that may help investigators. However, they’re not currently suspected of wrongdoing.  </p>



<p>Finally, a “subject” falls in the middle. You are within the scope of the investigation, and your conduct is definitely being investigated, but the government has not decided yet whether to bring charges against you.</p>



<p>These labels are fluid.  Your status can change as the government investigates further. That is why you need a lawyer whether or not you initially fall in any of these three categories.  Remember anything you say can and WILL be used against you.  </p>



<p><strong>What If I Receive a Target Letter</strong> <strong>from the Department of Justice?</strong> </p>



<p><a href="https://www.conawayandstrickler.com/contact-us/" id="https://www.conawayandstrickler.com/contact-us/">Contact us </a>immediately.  </p>



<p>Whether you’re a witness in a federal investigation or already a subject of a federal investigation, you need to know your rights before speaking with the government.  We contact the AUSA immediately, as discussed above, but also we get a full understanding of the allegations against you so that we can begin our defense against any potential charges.  </p>



<p>It is very important to hire legal counsel as soon as possible to protect your rights and assist you on the complex federal criminal justice system.</p>



<p></p>
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                <title><![CDATA[Healthcare Fraud: DOJ 2026 Takedown]]></title>
                <link>https://www.conawayandstrickler.com/blog/healthcare-fraud-doj-2026-takedown/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/healthcare-fraud-doj-2026-takedown/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Sat, 27 Jun 2026 13:23:38 GMT</pubDate>
                
                    <category><![CDATA[False Claims Act]]></category>
                
                    <category><![CDATA[Health Care]]></category>
                
                    <category><![CDATA[Physician License Defense]]></category>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                
                    <category><![CDATA[allografts]]></category>
                
                    <category><![CDATA[False Claims Act]]></category>
                
                    <category><![CDATA[federal criminal investigation]]></category>
                
                    <category><![CDATA[health care fraud]]></category>
                
                    <category><![CDATA[healthcare fraud lawyer]]></category>
                
                    <category><![CDATA[medicaid fraud lawyer]]></category>
                
                    <category><![CDATA[white collar lawyer]]></category>
                
                
                
                <description><![CDATA[<p>On June 23, 2026, the U.S. Department of Justice (DOJ) and Department of Health and Human Services (HHS) announced the results of the 2026 National HealthCare Fraud Takedown, charging 455 defendants in alleged schemes involving more than $6.5 billion in false claims.&nbsp; The Numbers The 2026 Takedown did not match last year’s record numbers.&nbsp; But,&hellip;</p>
]]></description>
                <content:encoded><![CDATA[
<p>On June 23, 2026, the U.S. Department of Justice (DOJ) and Department of Health and Human Services (HHS) announced the <a href="https://www.justice.gov/opa/pr/national-health-care-fraud-takedown-results-455-defendants-charged-connection-over-65">results</a> of the 2026 National HealthCare Fraud Takedown, charging 455 defendants in alleged schemes involving more than $6.5 billion in false claims.&nbsp;</p>



<p><strong>The Numbers</strong></p>



<p>The 2026 Takedown did not match last year’s record numbers.&nbsp; But, 455 defendants, including 90 doctors and other licensed medical professionals were charged.&nbsp; The coordinated enforcement involved a “whole of government” approach which included:</p>



<ul class="wp-block-list">
<li>Actions by the Centers for Medicare and Medicaid Services (CMS) to suspend 1,079 providers and revoke billing privileges for 1,403 providers.</li>



<li>48 Civil Monetary Payment settlements amounting to over $73 million, over 1,400 provider exclusions, and 25 actions by the U.S. Department of Health and Human Services, Office of Inspector General (“HHS-OIG”) under the Civil Monetary Penalties Law seeking more than $10 billion in payments to the Medicare Trust Fund from payments that CMS caught and suspended before the funds were paid to the fraudulent providers.</li>



<li>Civil charges against 13 defendants for $14.8 million in health care fraud schemes, as well as civil settlements with 31 defendants totaling $23 million.</li>



<li>928 administrative cases by the Drug Enforcement Administration (DEA) seeking the revocation of authority to handle and/or prescribe controlled substances since October 1, 2025.</li>
</ul>



<p><strong>Increased “Whole of Government” approach</strong></p>



<p>The government has always used multiple agencies in its efforts to combat fraud.  But the DOJ has now stated they are using “cutting-edge use of data analytics to target the worst actors”, including employing advanced data analytics through its Data Fusion Center. The DOJ is now working to ensure coordination with asset seizure, civil remedies, administrative actions, and payment-policy changes.  As a result, a single health care fraud investigation may now include parallel criminal, civil, administrative, exclusion, payment-suspension, and licensing consequences.  Conaway & Strickler, PC routinely handles licensing and regulatory issues as well as fighting <a href="https://www.conawayandstrickler.com/blog/categories/false-claims-act/" id="https://www.conawayandstrickler.com/blog/categories/false-claims-act/">False Claims Act i</a>ssues at the civil and criminal level.  </p>



<p><strong>Creation of the National Fraud Enforcement Division (“NFED”)&nbsp;</strong></p>



<p>NFED may be the clearest sign of this whole of government approach.&nbsp; According to&nbsp;the April, 2026 DOJ <a href="https://www.justice.gov/ag/media/1435311/dl?inline">memorandum,</a> the NFED’s mission is to “zealously investigate and prosecute” fraud involving taxpayer dollars.&nbsp; The 2026 Takedown appears to be NFED’s first major public health care fraud press release.</p>



<p><strong>TRENDS: Healthcare Fraud in Allografts</strong></p>



<p>Allografts and skin grafts cases have risen significantly from an emerging issue to front-line enforcement target.</p>



<p>The allograft cases are important to note because they clearly show what a healthcare investigation looks like in 2026.&nbsp; The DOJ uses their data driven investigatory prowess to detect high reimbursement, aggressive marketing, alleged kickbacks, vulnerable patients, questionable medical necessity, and patient harm. In the press release for 2026, the DOJ charged 11 defendants in schemes involving allografts, and the press release described Medicare payments for allografts rising sharply before CMS adjusted payment rates. &nbsp;</p>



<figure class="wp-block-image size-full"><img loading="lazy" decoding="async" width="1003" height="575" src="/static/2026/06/screenshot_2026-06-23_100958.png" alt="" class="wp-image-1682" srcset="/static/2026/06/screenshot_2026-06-23_100958.png 1003w, /static/2026/06/screenshot_2026-06-23_100958-300x172.png 300w, /static/2026/06/screenshot_2026-06-23_100958-768x440.png 768w" sizes="auto, (max-width: 1003px) 100vw, 1003px" /></figure>



<p>DOJ’s theory here is like the cancer genetic cases.  Both the allograft and CGx cases show a high payment for the claim which is an area that created an opportunity for fraud, according to the DOJ.  The 2026 Takedown shows how data analysis has moved to the forefront of their investigations. They comb through all the claims, match it with financial tracing and draw conclusions from there.</p>



<p><strong>Thoughts for Health Care Companies</strong></p>



<p>The 2026 Takedown reinforces that health care fraud enforcement is here to stay. As discussed above, the government investigations are becoming more coordinated, targeted and more focused on the numbers.&nbsp;</p>



<p>It is important therefore to respond accordingly and be sure all documentation necessary is on hand before any type of inquiry occurs. &nbsp;</p>



<p>Conaway & Strickler, PC has a deep understanding of these kinds of cases.  Sometimes, prompt disclosure and cooperation is the route to take and sometimes combatting the allegations is the route to take. We continue to monitor enforcement actions to remain aware of all of the newest developments.  <a href="https://www.conawayandstrickler.com/contact-us/" id="https://www.conawayandstrickler.com/contact-us/">Contact us </a>for more information or for assistance.</p>
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                <title><![CDATA[False Claims Act – Zafirov 11th Circuit Ruling Coming Soon]]></title>
                <link>https://www.conawayandstrickler.com/blog/false-claims-act/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/false-claims-act/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Sat, 06 Jun 2026 20:58:10 GMT</pubDate>
                
                    <category><![CDATA[False Claims Act]]></category>
                
                    <category><![CDATA[Federal Crimes]]></category>
                
                    <category><![CDATA[Federal Offenses]]></category>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                
                    <category><![CDATA[healthcare enforcement action]]></category>
                
                    <category><![CDATA[healthcare fraud]]></category>
                
                    <category><![CDATA[healthcare fraud defense]]></category>
                
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                    <category><![CDATA[Qui Tam]]></category>
                
                    <category><![CDATA[Qui Tam Litigation lawyers]]></category>
                
                
                
                <description><![CDATA[<p>The Eleventh Circuit is currently considering the constitutionality of the False Claims Act’s Qui Tam Provisions. The Whistleblower on Trial: The History and Uncertain Future of Zafirov v. Florida Medical For over a century, the False Claims Act (FCA) has been the federal government’s most potent weapon against fraud. At its core sits the qui&hellip;</p>
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                <content:encoded><![CDATA[
<p>The Eleventh Circuit is currently considering the constitutionality of the<a href="https://www.justice.gov/civil/false-claims-act" id="https://www.justice.gov/civil/false-claims-act"> False Claims Act’</a>s Qui Tam Provisions.  </p>



<p></p>



<p><strong>The Whistleblower on Trial: The History and Uncertain Future of <em>Zafirov v. Florida Medical</em></strong></p>



<p><br>For over a century, the False Claims Act (FCA) has been the federal government’s most potent weapon against fraud. At its core sits the <strong>qui tam</strong> provision—a mechanism allowing private citizens (called “relators”) to sue companies on behalf of the government and pocket a portion of the recovered funds.<br></p>



<p>But a case in Florida has put the entire multi-billion-dollar whistleblower framework on trial. The case is <a href="https://www.uschamber.com/cases/false-claims-act/zafirov-v-florida-medical-associates-llc-2" id="https://www.uschamber.com/cases/false-claims-act/zafirov-v-florida-medical-associates-llc-2"><em>United States ex rel. Zafirov v. Florida Medical Associates, LLC</em>.</a> After lower-court rulings and tense appellate arguments in December 2025, the legal and healthcare worlds are anxiously awaiting to see how the Eleventh Circuit Court of Appeals will rule.<br><br><strong>The History of this False Claims Act suit: How We Got Here</strong></p>



<p><br>The story began when Dr. Clarissa Zafirov, a physician in Florida, alleged that her employer and other defendants engaged in systemic <a href="https://www.conawayandstrickler.com/criminal-defense-practice/federal-crimes/federal-white-collar-crimes/federal-fraud/health-care-fraud/" id="https://www.conawayandstrickler.com/criminal-defense-practice/federal-crimes/federal-white-collar-crimes/federal-fraud/health-care-fraud/">Medicare fraud</a> by misrepresenting patient conditions to pad federal reimbursements. The U.S. government chose not to intervene, leaving Dr. Zafirov to spearhead the complex litigation herself.<br></p>



<p>The defendants, however, didn’t just fight the fraud allegations; they attacked the constitutional foundation of the lawsuit. In September 2024, U.S. District Judge Kathryn Kimball Mizelle dropped a bombshell by dismissing Zafirov’s suit. She didn’t rule on whether fraud occurred. Instead, she ruled that the False Claims Act’s qui tam provisions are unconstitutional.<br></p>



<p><strong>The Article II Battleground</strong></p>



<p><br>Judge Mizelle’s ruling hinged on the <a href="https://constitution.congress.gov/browse/essay/artII-S2-C2-3-1/ALDE_00013092/" id="https://constitution.congress.gov/browse/essay/artII-S2-C2-3-1/ALDE_00013092/">Appointments Clause of Article II </a>of the U.S. Constitution.<br><code>Is a Whistleblower an "Officer of the United States"? ├── YES ──> Must be appointed by the President, Courts, or Dept. Head. (FCA Fails) └── NO ──> Private citizen pursuing a claim. (FCA Succeeds)</code></p>



<p><br>Judge Mizelle argued that because a relator wields significant executive power—conducting civil litigation in the name of the United States to vindicate public rights—they act as an “Officer of the United States.” Because Dr. Zafirov appointed herself to this role by simply filing a complaint, her status bypassed constitutional appointment protocols.  <em>“Zafirov has determined which defendants to sue, which theories to raise, which motions to file, and which evidence to obtain… Yet no one… appointed Zafirov to the office of relator. Instead… Zafirov appointed herself. This she may not do.”</em><br>— <strong><a href="https://ecf.flmd.uscourts.gov/cgi-bin/show_public_doc?2019-01236-346-8-cv" id="https://ecf.flmd.uscourts.gov/cgi-bin/show_public_doc?2019-01236-346-8-cv">Judge Kathryn Kimball Mizelle</a></strong><br></p>



<p>While decades of judicial precedent across the country had uniformly rejected this argument, Judge Mizelle’s ruling breathed real life into a legal theory previously sparked by Supreme Court Justice Clarence Thomas in a 2023 dissenting opinion (<em>U.S. ex rel. Polansky</em>), where Justices Kavanaugh and Barrett also expressed interest in reviewing the issue.<br><br><strong>The Eleventh Circuit Showdown</strong></p>



<p> <br>The Department of Justice and Dr. Zafirov promptly appealed, leading to highly anticipated <a href="https://www.ca11.uscourts.gov/oral-argument-recordings?field_oar_case_name_value=zafirov&field_oral_argument_date_value%5Bmin%5D=&field_oral_argument_date_value%5Bmax%5D=" id="https://www.ca11.uscourts.gov/oral-argument-recordings?field_oar_case_name_value=zafirov&field_oral_argument_date_value%5Bmin%5D=&field_oral_argument_date_value%5Bmax%5D=">oral arguments </a>before a three-judge panel of the Eleventh Circuit on December 12, 2025.<br></p>



<p>The panel –  Circuit Judges Elizabeth L. Branch, Robert J. Luck, and Senior District Judge Federico A. Moreno—focused intensely on the concept of control.</p>



<p><br>The arguments were mainly over two competing perspectives:<br></p>



<p>1. The Government’s and Relator’s Defense<br>The DOJ shifted its strategy slightly at oral arguments, focusing heavily on the “continuing position” prong of officer status. They argued that an “officer” must occupy a permanent, continuous government seat (like the Secretary of State). A whistleblower is a temporary, self-interested private actor whose role dissolves when the case ends. Furthermore, they argued the government retains ultimate control because it can step in and dismiss or settle the case at any time.<br></p>



<p>2. The Defense and Amici Pushback<br>Attorneys for Florida Medical and supporting business groups argued that when the government declines to intervene (which occurs in roughly 80% of FCA cases), the relator is entirely “in the driver’s seat.” They exercise massive, unaccountable federal authority to issue subpoenas, freeze corporate assets, and force massive settlements without answering to the President.<br><br><strong>Prediction: How Might the 11th Circuit Rule?</strong></p>



<p><br>Predicting appellate outcomes is tricky, but the panel’s questioning in December 2025 offered some clues.  The judges did not treat the constitutionality of the FCA as a settled matter. They repeatedly pressed the DOJ on why Justice Thomas’s strict separation-of-powers logic was wrong.<br></p>



<p>The court essentially faces three paths:<br><br>1) <strong>Reverse the Dismissal</strong> <em>(Uphold the FCA)</em><br>The court aligns with decades of historical practice and other circuits (like the Sixth Circuit’s January 2026 ruling), finding that private bounty-hunters are not public “officers.”  Therefore it would remain business as usual. Whistleblower cases proceed normally in Florida, Georgia, and Alabama.<br></p>



<p>2) <strong>Affirm the Dismissal</strong> <em>(Strike down Qui Tam)</em><br>The panel adopts Judge Mizelle’s and Justice Thomas’s strict textualist view that prosecuting public fraud is an exclusively executive function that cannot be outsourced to unappointed citizens.  This would create Immediate chaos. Hundreds of pending qui tam cases in the Southeast would face dismissal, crippling a primary source of federal fraud recovery.</p>



<p><br>3) <strong>The Middle Ground</strong> <em>(Narrow Procedural Fix)</em><br>The court rules that qui tam actions are only unconstitutional <em>if</em> the government completely declines to intervene, or suggests a fix where the DOJ must sign off on major litigation steps.  A logistical headache for the DOJ, which would be forced to actively micromanage cases it initially wanted no part of.</p>



<p><br><strong>The Verdict on the Horizon</strong></p>



<p><br>Given the conservative, textualist leanings of the Eleventh Circuit panel, an affirmance (ruling the qui tam provision unconstitutional) is a highly distinct possibility. The judges seemed genuinely troubled by the lack of day-to-day executive oversight in declined whistle-blower lawsuits.  <br></p>



<p>However, regardless of whether the Eleventh Circuit upholds the law or strikes it down, <em>Zafirov</em> is on a fast track to the ultimate destination. Because a stark circuit split is opening up between courts upholding the False Claims Act and those questioning it, this case is highly likely to end up before the U.S. Supreme Court, where the future of American whistleblower law will be decided once and for all.</p>
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                <title><![CDATA[Healthcare Enforcement Actions FAQ- Collateral Consequences]]></title>
                <link>https://www.conawayandstrickler.com/blog/healthcare-enforcement-actions-faq-collateral-consequences/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/healthcare-enforcement-actions-faq-collateral-consequences/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Fri, 22 May 2026 12:38:30 GMT</pubDate>
                
                    <category><![CDATA[False Claims Act]]></category>
                
                    <category><![CDATA[Health Care]]></category>
                
                    <category><![CDATA[Nursing License Defense]]></category>
                
                    <category><![CDATA[Physician License Defense]]></category>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                
                    <category><![CDATA[False. Claims Act]]></category>
                
                    <category><![CDATA[healthcare enforcement action]]></category>
                
                    <category><![CDATA[healthcare lawyer]]></category>
                
                    <category><![CDATA[Medicare Fraud]]></category>
                
                    <category><![CDATA[physician license defense]]></category>
                
                
                
                    <media:thumbnail url="https://conawayandstrickler-com.justia.site/wp-content/uploads/sites/908/2026/05/istockphoto-1456035852-612x612-1.jpg" />
                
                <description><![CDATA[<p>Healthcare enforcement actions encompass criminal and civil charges, but, there are several important collateral consequences that need to be considered as well. What type of charges are considered Healthcare fraud? Providers who are alleged to have engaged in fraud and abuse are subject to sanctions under a number of Federal and State laws. Sanctions under&hellip;</p>
]]></description>
                <content:encoded><![CDATA[
<p>Healthcare enforcement actions encompass criminal and civil charges, but, there are several important collateral consequences that need to be considered as well.  </p>



<p><strong>What type of charges are considered Healthcare fraud? </strong> </p>



<p>Providers who are alleged to have engaged in fraud and abuse are subject to sanctions under a number of Federal and State laws. Sanctions under Federal law, for example, can take the form of administrative, civil, and criminal penalties. These penalties range from monetary fines and damages to prison time and exclusion from the Federal health care programs, including Medicaid. Becoming familiar with common types of fraud, will better position providers to ensure they are not involved in such conduct. Providers will also be better equipped to identify and report others who may be engaged in fraud.   Allegations can include: Medical Identity Theft, Billing for Unnecessary Services or Items, Billing for Services or Items Not Furnished, Upcoding, Kickbacks, False Claims, among others.  A non exhaustive list of recent enforcement actions can be found <a href="https://oig.hhs.gov/fraud/enforcement/?type=criminal-and-civil-actions" id="https://oig.hhs.gov/fraud/enforcement/?type=criminal-and-civil-actions">here.</a>  </p>



<p><strong>What are common federal medicare fraud charges?</strong></p>



<p>Healthcare Fraud (18 USC §1347)<br>Aggravated Identity Theft (18 USC §1028(A)<br>Wire Fraud (18 USC §1343)<br>Money Laundering (18 USC §§1956 and 1957)<br>Conspiracy (18 USC §371)</p>



<p>Please see <a href="https://www.justice.gov/criminal/criminal-fraud/health-care-fraud-unit/2025-national-hcf-case-summaries" id="https://www.justice.gov/criminal/criminal-fraud/health-care-fraud-unit/2025-national-hcf-case-summaries">here </a>for some recent criminal actions.  <a href="https://www.conawayandstrickler.com/criminal-defense-practice/federal-crimes/federal-white-collar-crimes/federal-fraud/medicaid-medicare-fraud/" id="https://www.conawayandstrickler.com/criminal-defense-practice/federal-crimes/federal-white-collar-crimes/federal-fraud/medicaid-medicare-fraud/">Medicare fraud</a> prosecutions continue to be the focus of various task forces throughout the country.  </p>



<p><strong>What are the five most important Federal fraud and abuse laws that apply to physicians?</strong></p>



<ol class="wp-block-list">
<li>False Claims Act (FCA) 31 U.S.C. § § 3729-3733</li>



<li>The Anti-Kickback Statute (AKS) 42 U.S.C. § 1320a-7b(b)</li>



<li>The Physician Self-Referral Law (Stark law) 42 U.S.C. § 1395nn</li>



<li>The Exclusion Authorities 42 U.S.C. § 1320a-7</li>



<li>The Civil Monetary Penalties Law (CMPL) 42 U.S.C. § 1320a-7a</li>
</ol>



<p><strong>What is the NPDB</strong>?</p>



<p>The <a href="https://www.npdb.hrsa.gov/index.jsp" id="https://www.npdb.hrsa.gov/index.jsp">National Practitioner Data Bank</a> is a web-based repository of reports containing information on medical malpractice payments and certain adverse actions related to health care practitioners, providers, and suppliers. Established by Congress in 1986, it is a workforce tool that prevents practitioners from moving state to state without disclosure or discovery of previous damaging performance.  If a  negative report about a physician<br>is made to the National Practitioner Databank, for example, the physician is greatly affected. </p>



<p>We work with the government to try and negotiate on the language and terms that will be reported to the National Practitioner Databank. We hope to provide as much clarity on the facts surrounding the matter that led to the suspension that is being reported.  </p>



<p><strong>What is the OIG LEIE?</strong></p>



<p>The OIG LEIE is the List of Excluded Individuals and Entities, a database maintained by the U.S. Department of Health and Human Services (HHS) Office of Inspector General. It lists healthcare professionals and organizations banned from participating in or billing federally funded healthcare programs like Medicare and Medicaid.  </p>



<p>OIG’s LEIE provides information to the health care industry, patients and the public regarding individuals and entities currently excluded from participation in Medicare, Medicaid and all other Federal health care programs. Individuals and entities who have been reinstated are removed from the LEIE.  The federal government gives a wonderful <a href="https://oig.hhs.gov/faqs/exclusions-faq/" id="https://oig.hhs.gov/faqs/exclusions-faq/">FAQ page</a> to answer basic questions about the exclusions list.  </p>



<p>Search the federal list <a href="https://exclusions.oig.hhs.gov/" id="https://exclusions.oig.hhs.gov/">here</a> and the state of Georgia <a href="https://dch.georgia.gov/office-inspector-general/georgia-oig-exclusions-list" id="https://dch.georgia.gov/office-inspector-general/georgia-oig-exclusions-list">here.</a></p>



<p>Conaway & Strickler, PC has experienced healthcare attorneys ready to help with any further questions. <a href="https://www.conawayandstrickler.com/contact-us/" id="https://www.conawayandstrickler.com/contact-us/">Contact us </a>at any time to get answers on your matter.  </p>



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                <title><![CDATA[The DOJ has just announced that recoveries from False Claims Act settlements and judgments in fiscal year 2025 exceeded $6.8 billion]]></title>
                <link>https://www.conawayandstrickler.com/blog/the-doj-has-just-announced-that-recoveries-from-false-claims-act-settlements-and-judgments-in-fiscal-year-2025-exceeded-6-8-billion/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/the-doj-has-just-announced-that-recoveries-from-false-claims-act-settlements-and-judgments-in-fiscal-year-2025-exceeded-6-8-billion/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Thu, 22 Jan 2026 14:07:43 GMT</pubDate>
                
                    <category><![CDATA[False Claims Act]]></category>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                
                    <category><![CDATA[False Claims Act]]></category>
                
                    <category><![CDATA[federal criminal investigation]]></category>
                
                    <category><![CDATA[health care fraud]]></category>
                
                    <category><![CDATA[Qui Tam]]></category>
                
                
                
                    <media:thumbnail url="https://conawayandstrickler-com.justia.site/wp-content/uploads/sites/908/2026/01/image001.jpg" />
                
                <description><![CDATA[<p>Under the False Claims Act, individuals or entities can be held liable for knowingly submitting false or fraudulent claims for payment to the government. The FCA allows private individuals, known as “whistleblowers” or “relators,” to file lawsuits on behalf of the government and share in any monetary recovery. These health care fraud lawsuits are known&hellip;</p>
]]></description>
                <content:encoded><![CDATA[
<p>Under the <a href="https://www.conawayandstrickler.com/blog/recent-overview-of-the-false-claims-act/">False Claims Act,</a> individuals or entities can be held liable for knowingly submitting false or fraudulent claims for payment to the government. The FCA allows private individuals, known as “whistleblowers” or “relators,” to file lawsuits on behalf of the government and share in any monetary recovery. These health care fraud lawsuits are known as qui tam actions. If the government intervenes in the lawsuit and recovers funds, the whistleblower is typically entitled to receive a portion of the recovered amount, often ranging from 15% to 30%. In fiscal year 2023, whistleblowers filed 712 qui tam suits, and this past year the Justice Department reported settlements and judgments exceeding $2.3 billion in these and earlier-filed suits.</p>



<p>“The False Claims Act imposes treble damages and penalties on those who knowingly and falsely claim money from the United States or knowingly fail to pay money owed to the United States. The False Claims Act thus safeguards government programs and operations that provide access to medical care, support our military and first responders, protect American businesses and workers, help build and repair infrastructure, offer disaster and other emergency relief, and provide many other critical services and benefits.”  Settlements and judgments under the False Claims Act <a href="https://www.justice.gov/opa/pr/false-claims-act-settlements-and-judgments-exceed-68b-fiscal-year-2025">exceeded $6.8 billion </a>in the fiscal year ending Sept. 30, 2025, Deputy Attorney General Todd Blanche and Assistant Attorney General Brett A. Shumate, head of the Justice Department’s Civil Division announced in mid January of 2026. Healthcare fraud dominated recoveries, with approximately $5.7 billion of the total $6.8 billion tied to healthcare-related matters that included managed care, prescription drugs, and medically unnecessary services.</p>



<p>In addition, relators also set a new record with 1,297 new <a href="https://www.fedbar.org/blog/understanding-the-basics-of-qui-tam-law/">qui tam suits </a>filed, breaking FY 2024’s record of 980 qui tam suits and nearly doubling the average number of new qui tam suits during <a href="https://www.justice.gov/archives/opa/media/1384546/dl">FY 2010 to FY 2023.</a></p>



<p>it is important for clients to make sure your compliance programs are designed to mitigate<a href="https://www.justice.gov/civil/false-claims-act">FCA</a> risk. Please <a href="https://www.conawayandstrickler.com/contact-us/">contact us</a>, we are here to help whether it is the beginning of an investigation, on the eve of trial, at the appellate stage or during settlement discussions.</p>



<p></p>
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                <title><![CDATA[White House Designates Fentanyl as Weapon of Mass Destruction]]></title>
                <link>https://www.conawayandstrickler.com/blog/white-house-designates-fentanyl-as-weapon-of-mass-destruction/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/white-house-designates-fentanyl-as-weapon-of-mass-destruction/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Wed, 17 Dec 2025 16:16:15 GMT</pubDate>
                
                    <category><![CDATA[Drug Charges]]></category>
                
                    <category><![CDATA[Drug Crimes]]></category>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                
                    <category><![CDATA[federal criminal defense attorney]]></category>
                
                    <category><![CDATA[federal criminal investigation]]></category>
                
                
                
                <description><![CDATA[<p>President Donald Trump signed an executive order this week classifying fentanyl as a weapon of mass destruction. This will now expand enforcement tools and give the government additional powers to combat illegal trafficking of the fentanyl. What will this mean to clients charged with trafficking or possessing fentanyl? This concept has been debated for a&hellip;</p>
]]></description>
                <content:encoded><![CDATA[
<p>President Donald Trump signed an<a href="https://www.whitehouse.gov/presidential-actions/2025/12/designating-fentanyl-as-a-weapon-of-mass-destruction/"> executive order </a>this week classifying fentanyl as a weapon of mass destruction.  This will now expand enforcement tools and give the government additional powers to combat illegal trafficking of the fentanyl.</p>



<p>What will this mean to clients charged with trafficking or possessing fentanyl?  This concept has been debated for a few years now.  Unfortunately, it is now official.  This executive order will increase the penalties.  <a href="https://www.law.cornell.edu/uscode/text/18/2332a">18 U.S.C. §2332</a> imposes a maximum sentence of life in prison for violation of this statute, and, if death results, this statute permits bringing the death penalty.   </p>



<p>Despite intensified measures targeting drug supply and trafficking, there remains a lack of substantial efforts directed toward treatment, prevention, and broader accountability. Issues surrounding pharmaceutical companies such as the Sacklers, Purdue Pharma, and the ongoing opioid epidemic continue to be areas of public concern and debate.  </p>



<p>While federal enforcement efforts are intensifying, the current approach may further strain the criminal justice system, especially as courts and correctional facilities contend with rising caseloads linked to fentanyl offenses. The broader public health response—including investments in addiction recovery, harm reduction, and community education—remains crucial to preventing future tragedies and supporting individuals affected by substance use disorders. As policy shifts continue, we will need to balance aggressive enforcement with meaningful support for those impacted by the opioid crisis. </p>



<p>The Department of Justice is currently citing “office policy” of very tough resolutions to drug trafficking cases with zero thought on the individual details of each case.  </p>



<p><a href="https://www.conawayandstrickler.com/contact-us/">Contact us</a> should you or a loved one be facing a possession with intent to distribute or drug trafficking charge.  </p>



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                <title><![CDATA[Why it is Important to have Professional License Defense]]></title>
                <link>https://www.conawayandstrickler.com/blog/why-it-is-important-to-have-professional-license-defense/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/why-it-is-important-to-have-professional-license-defense/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Fri, 19 Sep 2025 17:19:02 GMT</pubDate>
                
                    <category><![CDATA[Health Care]]></category>
                
                    <category><![CDATA[Nursing License Defense]]></category>
                
                    <category><![CDATA[Physician License Defense]]></category>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                
                    <category><![CDATA[federal criminal attorney]]></category>
                
                    <category><![CDATA[federal criminal investigation]]></category>
                
                    <category><![CDATA[health care fraud]]></category>
                
                    <category><![CDATA[Professional License Defense]]></category>
                
                
                
                <description><![CDATA[<p>Professional license defense is vital. Various professionals must have a valid, active license. When there are allegations of an arrest, substance abuse issues, misconduct or compliance failures, this can lead to disciplinary actions. Understanding what is involved and knowing how to navigate this is crucial for any professional facing such challenges. Over the past three&hellip;</p>
]]></description>
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<p>Professional license defense is vital. Various professionals must have a valid, active license. When there are allegations of an arrest, substance abuse issues, misconduct or compliance failures, this can lead to disciplinary actions. Understanding what is involved and knowing how to navigate this is crucial for any professional facing such challenges.</p>



<p>Over the past three decades, Conaway & Strickler, PC has represented physicians, nurses, dentists, CPAs, chiropractors, financial advisors, educators, lawyers, and many others. The <a href="https://georgia.gov/get-professional-certification-or-license">list of licenses</a> 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.</p>



<p>It is important to <a href="https://www.conawayandstrickler.com/contact-us/">contact</a> 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 <a href="https://medicalboard.georgia.gov/what-does-it-mean-if-physicians-license-status-listed-probation-suspension-or-revocation">suspension, probation or revocation.  </a>It is important to have experienced legal counsel to effectively navigate these uncertain waters.  </p>



<p>Here is a list of the <a href="///Users/megstrickler/Downloads/Top%2010%20of%20the%20Most%20Common%20Disciplinary%20Actions%20Against%20Healthcare%20Professionals.pdf">top 10 of the Most Common Disciplinary Actions Against Healthcare Professionals</a> published recently by GCMB.  It helps explain some common pitfalls and responsibilities outlined by<br>the GCMB.  </p>



<p>If you are facing any issues with your professional license, we are here to help.  </p>
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                <title><![CDATA[Medicaid Fraud Nuts and Bolts]]></title>
                <link>https://www.conawayandstrickler.com/blog/medicaid-fraud-nuts-and-bolts/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/medicaid-fraud-nuts-and-bolts/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Sun, 23 Jun 2024 03:46:10 GMT</pubDate>
                
                    <category><![CDATA[Health Care]]></category>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                
                    <category><![CDATA[health care fraud]]></category>
                
                    <category><![CDATA[healthcare fraud defense]]></category>
                
                    <category><![CDATA[medicaid fraud]]></category>
                
                
                
                <description><![CDATA[<p>What is Medicaid? Medicaid is a joint federal and state program that helps cover medical costs for some people with limited income and resources. 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&hellip;</p>
]]></description>
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<p><strong>What is Medicaid</strong>? Medicaid is a joint federal and state program that helps cover medical costs for some people with limited income and resources.</p>


<p><strong>What is Georgia Medicaid</strong>? <a href="https://medicaid.georgia.gov/organization/about-georgia-medicaid/what-medicaid" rel="noopener noreferrer" target="_blank">Medicaid</a> 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.”</p>


<p>
<strong>What is Medicaid Fraud</strong>?</p>


<p><a href="https://www.cms.gov/medicare-medicaid-coordination/fraud-prevention/medicaid-integrity-education/downloads/infograph-there-are-many-types-medicaid-fraud-%5Bmay-2016%5D.pdf" rel="noopener noreferrer" target="_blank">Medicaid Fraud</a> can come in many different forms – some elaborate and some not so elaborate.</p>


<p><strong>What are some types of fraud</strong>?</p>


<p>-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</p>


<p><strong>Who prosecutes these cases</strong>?</p>


<p>The DOJ’s <a href="https://www.justice.gov/criminal/criminal-fraud/health-care-fraud-unit" rel="noopener noreferrer" target="_blank">Health Care Unit.</a> or in Georgia, the <a href="https://law.georgia.gov/about-us/organization-office" rel="noopener noreferrer" target="_blank">Georgia Medical Fraud Division</a> of the Office of the Attorney General</p>


<p><strong>What are some examples of prosecutions</strong>?</p>


<p><a href="https://www.justice.gov/criminal/criminal-fraud/arpo-strike-force" rel="noopener noreferrer" target="_blank">Opioid prosecutions</a>
<a href="https://www.justice.gov/opa/pr/national-health-care-fraud-enforcement-action-results-charges-involving-over-14-billion" rel="noopener noreferrer" target="_blank">National Health Care Fraud Enforcement</a> – “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.”</p>


<p>In the 2019 <a href="https://www.justice.gov/opa/pr/federal-indictments-and-law-enforcement-actions-one-largest-health-care-fraud-schemes" rel="noopener noreferrer" target="_blank">Operation Brace yourself</a> 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!</p>


<p>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.  <a href="/contact-us/">Contact us</a> to learn more – do not go at this alone.</p>


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                <title><![CDATA[Startup Online Telehealth Company Executives Indicted]]></title>
                <link>https://www.conawayandstrickler.com/blog/startup-online-telehealth-company-executives-indicted/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/startup-online-telehealth-company-executives-indicted/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Sun, 16 Jun 2024 16:40:32 GMT</pubDate>
                
                    <category><![CDATA[Health Care]]></category>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                
                    <category><![CDATA[health care fraud]]></category>
                
                    <category><![CDATA[medicaid fraud]]></category>
                
                    <category><![CDATA[Qui Tam]]></category>
                
                
                
                    <media:thumbnail url="https://conawayandstrickler-com.justia.site/wp-content/uploads/sites/908/2024/06/IMG_1317-scaled-1.jpeg" />
                
                <description><![CDATA[<p>On June 13, 2024, two health care executives of Done Global Inc were indicted for health care fraud related charges. The indictment alleges that the two participated in a scheme to distribute Adderall over the internet, conspire to commit health care fraud in connection with the submission of false and fraudulent claims for reimbursement for&hellip;</p>
]]></description>
                <content:encoded><![CDATA[

<p>On June 13, 2024, two health care executives of Done Global Inc were <a href="https://www.justice.gov/usao-ndca/media/1355871/dl?inline" rel="noopener noreferrer" target="_blank">indicted </a>for health care fraud related charges.  The indictment alleges that the two participated in a scheme to distribute Adderall over the<a href="https://www.donefirst.com/homepage-special-99?utm_source=google&utm_medium=cpc&utm_content=NonBrand-ADHD-CPA2&utm_medium=cpc&utm_source=google&campaignid=20935659831&adgroupid=156387494383&creative=687636644617&matchtype=e&network=g&device=c&keyword=done%20online&gad_source=1&gclid=CjwKCAjwmrqzBhAoEiwAXVpgotqhjM4T0ptF4V80oqw7UegBPcbJU8jZCX8Ad7fn6cJMMqUTqvbfohoCBAEQAvD_BwE" rel="noopener noreferrer" target="_blank"> internet</a>, conspire to commit health care fraud in connection with the submission of false and fraudulent claims for reimbursement for Adderall and other stimulants, and obstruct justice.</p>


<p>“As alleged, these defendants exploited the COVID-19 pandemic to develop and carry out a $100 million scheme to defraud taxpayers and provide easy access to Adderall and other stimulants for no legitimate medical purpose,” said Attorney General Merrick B. Garland.   These arrests mark the DOJ’s 1st criminal drug distribution prosecutions related to prescribing via telemedicine, the agency said.
</p>


<p>Conaway & Strickler represent healthcare providers in fighting against allegations such as these by agencies such as the DOJ, HHS-OIG, FBI, Georgia Medicaid Fraud Control Units and cases nationwide.  We have litigated federal healthcare cases in NJ, NY, LA, FL, TX and GA.  We also represent healthcare providers in medical and professional licensing board matters as well.</p>


<p>
Remember, physicians have to report issues to their professional liability carrier, insurers, etc. AND to the <a href="https://medicalboard.georgia.gov/" rel="noopener noreferrer" target="_blank">Georgia Composite Board</a>.  Thus, it is important to <a href="/contact-us/">contact us</a> immediately when an agent comes knocking asking “for just a few files” or “just a few questions”.  Do not go it alone.</p>


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                <title><![CDATA[Health Care Fraud]]></title>
                <link>https://www.conawayandstrickler.com/blog/health-care-fraud/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/health-care-fraud/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Sat, 29 Jul 2023 17:15:19 GMT</pubDate>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                
                    <category><![CDATA[health care fraud]]></category>
                
                
                
                <description><![CDATA[<p>By: Onisuru Ojegba, Legal Intern to Firm J.D. Candidate, Class of 2025 The George Washington University Law School Health care fraud consists of an individual, a group of people, or a company knowingly misrepresenting the type, scope, or nature of the medical treatment or service provided, for the purpose of making illicit profits or benefits.&hellip;</p>
]]></description>
                <content:encoded><![CDATA[

<p>By: Onisuru Ojegba, Legal Intern to Firm</p>


<p>J.D. Candidate, Class of 2025
The George Washington University Law School</p>


<p>Health care fraud consists of an individual, a group of people, or a company knowingly misrepresenting the type, scope, or nature of the medical treatment or service provided, for the purpose of making illicit profits or benefits. These crimes can be committed by medical providers and patients alike, with both parties using different methods for their respective roles. Common fraud committed by medical professionals can include:</p>


<p>* Double billing, in which multiple claims for the same service are submitted to an insurance company</p>


<p>* Phantom billing, where a medical provider bills for a service visit or supplies the patient never received,</p>


<p>* Unbundling, which involves Submitting multiple bills for the same service, and Upcoding, where a patient is Billed for a more expensive service than what they actually received.</p>


<p>Common fraud committed by patients or other individuals can include</p>


<p>* false marketing to convince people to provide their health insurance identification number and other personal information to bill for non-rendered services, steal their identity, or enroll them in a fake benefit plan</p>


<p>* Identity theft/identity swapping by using another person’s health insurance or allowing another person to use your insurance</p>


<p>* Impersonating a health care professional through providing or billing for health services or equipment without a license</p>


<p>Health care fraud is governed by Title 18 of the United States Code, Section 1347, which makes it a federal crime to defraud any health care benefit program or obtain, by fraudulent means, any money or property from a health care benefit program. (18 U.S.C. § 1347). The FBI is the primary agency responsible for investigating healthcare fraud, for both federal and private insurance programs. The FBI investigates these crimes in partnership with: Federal, state, and local agencies, Healthcare Fraud Prevention Partnership, and insurance groups such as the National Health Care Anti-Fraud Association and the National Insurance Crime Bureau.</p>


<p>The consequences of a health care fraud conviction are severe and carry many penalties along with the possibility of a lengthy prison sentence. For medical professionals convicted of health care fraud, there is a high likelihood of losing a medical license or being blackballed by the industry. Under the federal exclusion statute, individuals may be excluded from participating in any federal healthcare program if they were convicted of a criminal offense related to the delivery of an item or service under Medicare or a state health care program. These exclusions may also be mandatory, as the Office of the Inspector General (OIG) has no discretion in imposing the mandatory exclusions if the elements are satisfied.</p>


<p>Navigating the federal criminal system is a task that should not be endured alone. If you have a health care fraud matter that you would like to discuss with experienced federal criminal defense lawyers, please contact our team today for more information about what we can do to help.</p>


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                <title><![CDATA[Insurance Fraud]]></title>
                <link>https://www.conawayandstrickler.com/blog/793-2/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/793-2/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Sat, 29 Jul 2023 17:11:21 GMT</pubDate>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                
                    <category><![CDATA[insurance fraud]]></category>
                
                
                
                <description><![CDATA[<p>By: Onisuru Ojegba Legal Intern to the firm Insurance fraud consists of crimes where an individual consumer or insurance company, agent, or adjuster commits deliberate deception to obtain illicit profits or benefits. While the classification of insurance fraud is broad and consists of many different variations, including health care fraud, life insurance fraud, and unemployment&hellip;</p>
]]></description>
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<p>By: Onisuru Ojegba Legal Intern to the firm</p>


<p>Insurance fraud consists of crimes where an individual consumer or insurance company, agent, or adjuster commits deliberate deception to obtain illicit profits or benefits. While the classification of insurance fraud is broad and consists of many different variations, including health care fraud, life insurance fraud, and unemployment fraud, the crime occurs in the same manner; during the process of buying, selling, or underwriting insurance.</p>


<p>While every state has its own laws which criminalize insurance fraud, federal law does not specifically address the crime. Instead, federal law addresses insurance fraud through The Violent Crime Control and Law Enforcement Act (1994), which gives the Federal Government jurisdiction over insurance fraud once a transaction crosses state lines (either physically or through wire). The alleged fraud then falls into the federal government’s jurisdiction and will be prosecuted at the federal level. Title 18 U.S. Code § 1033: specifically outlines this jurisdiction as Crimes by or affecting persons engaged in the business of insurance whose activities affect interstate commerce. This law separates insurance fraud into 5 categories including:</p>


<p>* Knowingly making any materially false statement or report or willfully overvaluing the value of land, property, or security for insurance purposes.</p>


<p>* Willfully embezzling, abstracting, or misappropriating premiums, credits, or other money or property of an insured.</p>


<p>* Knowingly falsifying information about the financial state of a business with the intent to deceive insurers, examiners, or regulatory agencies.</p>


<p>* Making threats or attempting to impede the efforts of insurance examiners or regulatory agencies from the “due and proper administration of the law”.</p>


<p>* Engaging in the business of insurance if you have been previously of convicted any criminal felony involving dishonesty or a breach of trust</p>


<p>Insurance fraud is investigated internally, through private companies, and through state and federal law enforcement agencies like the Federal Bureau of Investigation (FBI) and the Internal Revenue Service (IRS). Insurance companies that investigate internally have special divisions responsible for identifying fraud, denying insurance claims, and reporting suspicious activity to law enforcement.</p>


<p>Insurance fraud is a serious crime that carries severe penalties both legally and peripherally.</p>


<p>Depending on the nature of the offense, a conviction for this crime may have you facing anywhere from 10 to 15 years in prison, and the disqualification of ever working within the insurance business. Navigating these charges should not be endured alone. The moment you become the target of a federal insurance investigation, contact our team of experienced federal criminal defense lawyers to learn how you can protect your freedom.</p>


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                <title><![CDATA[Q&A with Meg Strickler]]></title>
                <link>https://www.conawayandstrickler.com/blog/qa-with-meg-strickler/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/qa-with-meg-strickler/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Wed, 12 Apr 2023 20:35:17 GMT</pubDate>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                
                
                
                <description><![CDATA[<p>Meg Strickler recently signed up for some new adverting with Avvo So, after filling out all of these various things for the Avvo profile, we decided to ask some direct questions of managing partner, Meg Strickler</p>
]]></description>
                <content:encoded><![CDATA[
<p>Meg Strickler recently signed up for some new adverting with <a href="https://www.avvo.com/attorneys/30309-ga-margaret-strickler-345401.html" rel="noopener noreferrer" target="_blank">Avvo</a></p>



<p>So, after filling out all of these various things for the Avvo profile, we decided to ask some direct questions of managing partner, Meg Strickler
</p>



<ol class="wp-block-list">
<li>Where did you go to law school?  Emory law</li>



<li>Have you tried jury trials at both the state and federal level? yes</li>



<li>Give me an example of one of your cases you tried and got a not guilty?   Rape Fulton County 2020</li>



<li>Do you practice any other type of law beside criminal defense?  NO never have</li>



<li>Do you do any pro bono? yes, I do a limited amount through Georgia Justice Project</li>



<li>Do you have a “motions practice”?  This is kind of a silly question as of course we prepare all cases ready to file and ARGUE motions if necessary to achieve the desired result in a case</li>



<li>Do you mentor younger lawyers? I am an adjunct professor at Georgia State College of Law teaching Advanced Evidence. And I also teach trial techniques at Emory Law at their annual trial technique program each spring for 2Ls.</li>



<li>Dog person or cat person? Both -have 2 dogs and 1 cat</li>



<li>What do you do when not practicing law? working on my French up through Duolingo</li>



<li>What disparities do you see in your practice?  I hate to see the inconsistent meting out of justice.</li>
</ol>
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                <title><![CDATA[Covid Related Fraud Enforcement Update]]></title>
                <link>https://www.conawayandstrickler.com/blog/covid-related-fraud-enforcement-update/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/covid-related-fraud-enforcement-update/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Sun, 19 Feb 2023 18:32:46 GMT</pubDate>
                
                    <category><![CDATA[Criminal Defense]]></category>
                
                    <category><![CDATA[Cyber Crime]]></category>
                
                    <category><![CDATA[Cybercrime]]></category>
                
                    <category><![CDATA[EIDL fraud]]></category>
                
                    <category><![CDATA[Federal Crimes]]></category>
                
                    <category><![CDATA[Identity Theft]]></category>
                
                    <category><![CDATA[PPP loan fraud]]></category>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                
                    <category><![CDATA[EIDL fraud]]></category>
                
                    <category><![CDATA[federal criminal attorney]]></category>
                
                    <category><![CDATA[Federal Criminal Lawyer]]></category>
                
                    <category><![CDATA[PPP Loan Fraud]]></category>
                
                
                
                <description><![CDATA[<p>On May 17, 2021, U.S. Attorney General Merrick Garland announced the establishment of the COVID-19 Fraud Enforcement Task Force. On March 10, 2022, Garland announced Associate Deputy Attorney General Kevin Chambers as the Director For Covid-19 Fraud Enforcement. In August, 2022, President Biden signed laws that give the Department of Justice and other federal agencies&hellip;</p>
]]></description>
                <content:encoded><![CDATA[

<p>On May 17, 2021, U.S. Attorney General Merrick Garland announced the establishment of the <a href="https://www.justice.gov/opa/pr/attorney-general-announces-task-force-combat-covid-19-fraud" rel="noopener noreferrer" target="_blank"><strong>COVID-19 Fraud Enforcement Task Force.</strong></a></p>


<p>On March 10, 2022, Garland <a href="https://www.justice.gov/opa/speech/attorney-general-merrick-b-garland-delivers-remarks-covid-19-fraud-enforcement-task-force" rel="noopener noreferrer" target="_blank">announced</a> Associate Deputy Attorney General Kevin Chambers as the Director For Covid-19 Fraud Enforcement.</p>


<p>In August, 2022, President Biden signed laws that give the Department of Justice and other federal agencies more time to investigate and prosecute Covid-19 fraud. It extended the statute of limitations for fraud charges involving PPP and EIDL fraud to<strong> ten years</strong>.</p>


<p>And on September 14, 2022, the DOJ <a href="https://www.oig.dhs.gov/sites/default/files/assets/pr/2022/dojpr-091422-justice-department-announces-covid-19-fraud-strike-force-teams.pdf" rel="noopener noreferrer" target="_blank">announced</a> the establishment of three Strike Force teams created to enhance the Department’s existing efforts to combat and prevent COVID-19 related fraud.  The Strike Force teams will operate out of U.S. Attorney’s Offices in the Southern District of Florida, the District of Maryland, and a joint effort between the Central and Eastern Districts of California.</p>


<p>Concerned about PPP loan or EIDL loan fraud investigations?  Our firm has represented both companies and individuals facing questions from the bank or investigators.  Please <a href="/contact-us/">contact us</a> before interacting with any investigators or agents.</p>


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                <title><![CDATA[School Threats Resulting in Criminal Charges]]></title>
                <link>https://www.conawayandstrickler.com/blog/school-threats-resulting-in-criminal-charges/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/school-threats-resulting-in-criminal-charges/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Wed, 28 Sep 2022 19:31:35 GMT</pubDate>
                
                    <category><![CDATA[Blog]]></category>
                
                    <category><![CDATA[Criminal Defense]]></category>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                    <category><![CDATA[Zero Tolerance]]></category>
                
                
                    <category><![CDATA[Criminal defense]]></category>
                
                    <category><![CDATA[Criminal Lawyer]]></category>
                
                    <category><![CDATA[federal criminal attorney]]></category>
                
                    <category><![CDATA[federal criminal investigation]]></category>
                
                
                
                <description><![CDATA[<p>Schools across the state of Georgia are facing an increase in threats of violence. It has led schools to step up security. Each and every threat must be taken seriously. Some of these threats turn out to be real, so officials have beefed up security everywhere, including for example, Fulton County Schools implementing license plate&hellip;</p>
]]></description>
                <content:encoded><![CDATA[

<p>Schools across the state of Georgia are facing an increase in threats of violence.  It has led schools to step up security.   Each and every threat must be taken seriously.  Some of these threats turn out to be real, so officials have beefed up security everywhere, including for example, <a href="https://www.ajc.com/education/fulton-county-schools-to-install-license-plate-cameras-at-all-campuses/BPAWTBDQ5BAP7EVFVZ7PSYCSCQ/" rel="noopener noreferrer" target="_blank">Fulton County Schools implementing license plate readers on all of its campuses.</a></p>


<p>But,what if a threat is simply a result of a prank?  What charges could result from calling in a threat that is not real? Criminal defense attorney <a href="/lawyers/meg-strickler/">Meg Strickler</a> recently <a href="https://www.11alive.com/article/news/local/increasing-threats-in-metro-atlanta-schools/85-b157727b-61f2-4072-bab0-a195c6918861" rel="noopener noreferrer" target="_blank">commented</a> on NBC 11 Alive News about this very issue.  Calling in a threat to a school can be very disruptive and it will always involve law enforcement.  Teens can thus face charges ranging from misdemeanor to federal charges.  And, the school can also suspend or expel a student for this conduct.</p>


<p>It is a complex situation especially in these times.</p>


<p>Contact Conaway & S Strickler, PC to discuss.    We are here to help protect you and your loved ones’ rights.</p>


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                <title><![CDATA[Search Warrants – What are they/How are they gotten/What occurs?  Answers in light of Trump Mar-a-Lago FBI search]]></title>
                <link>https://www.conawayandstrickler.com/blog/search-warrants-what-are-they-how-are-they-gotten-what-occurs-answers-in-light-of-trump-mar-a-lago-fbi-search/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/search-warrants-what-are-they-how-are-they-gotten-what-occurs-answers-in-light-of-trump-mar-a-lago-fbi-search/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Wed, 10 Aug 2022 21:11:09 GMT</pubDate>
                
                    <category><![CDATA[Criminal Defense]]></category>
                
                    <category><![CDATA[Federal Crimes]]></category>
                
                    <category><![CDATA[Federal Offenses]]></category>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                
                    <category><![CDATA[#moneylaundering]]></category>
                
                    <category><![CDATA[Criminal Lawyer]]></category>
                
                    <category><![CDATA[search warrants]]></category>
                
                    <category><![CDATA[tax evasion]]></category>
                
                    <category><![CDATA[tax fraud]]></category>
                
                    <category><![CDATA[trump]]></category>
                
                
                
                    <media:thumbnail url="https://conawayandstrickler-com.justia.site/wp-content/uploads/sites/908/2022/08/240_F_364672906_PW3hCfsjsglFBZ1r8HFAz7lfQlOmx1AC.jpg" />
                
                <description><![CDATA[<p>The Fourth Amendment of the U.S. Constitution protects against unlawful searches and seizures by the government. When the government wants to obtain a search warrant, an affidavit must be drafted and application must be made to a U.S. Magistrate judge (in federal matters). The affidavit can be more than a hundred pages at the minimum&hellip;</p>
]]></description>
                <content:encoded><![CDATA[

<p>
The <a href="https://constitution.congress.gov/constitution/amendment-4/" rel="noopener noreferrer" target="_blank">Fourth Amendment of the U.S. Constitution</a> protects against unlawful searches and seizures by the government.  When the government wants to obtain a search warrant, an affidavit must be drafted and application must be made to a U.S. Magistrate judge (in federal matters).  The affidavit can be more than a hundred pages at the minimum in complex cases.  The affidavit will begin with an introduction and the background of the agent (his/her experience).  In this section, statements beginning with “Based on my training and experience” are plentiful.  The next section generally addresses <a href="https://www.law.cornell.edu/wex/probable_cause" rel="noopener noreferrer" target="_blank">probable cause</a> and sets forth facts that show probable cause has been established to support the issuance of a search warrant and that items listed have a reasonable probability of being found during the search.  Finally, it will detail what needs to be searched and what items the government is seeking.  Law enforcement often request search warrants when seeking documents, electronic devices, money, drugs, paraphernalia, ledgers, photos, receipts etc.  A warrant can be requested for real property, a person, electronically stored information from your phone, iPad, computer, external hard drives, a tracking device on a car, the car itself, and/or other modes of transportation such as a boat.
</p>


<p>Once the search warrant is signed by the judge, the search warrant will be executed.  Generally, the government will work to execute the warrant with local law enforcement officials. The search can take hours, and often times, questioning will occur at the same time.  NEVER SPEAK TO LAW ENFORCEMENT at this juncture without a lawyer.  This interview at your home or office is often recorded by body cam, audio, and other video devices.  It can be difficult to get those statements excluded at trial for a variety of reasons.</p>


<p>
After the execution of the search warrant, a copy of the search warrant inventory will be left, and it will list out exactly what was seized.  In the case of the execution of the search warrant for Donald Trump, there is a search warrant, sworn affidavit, and application filed, but it is under seal.  Mr. Trump also received a search warrant inventory. Hopefully, these documents will be released to the public sooner than later.</p>


<p>For more information on search warrants, see <a href="https://www.federalrulesofcriminalprocedure.org/title-viii/rule-41-search-and-seizure/" rel="noopener noreferrer" target="_blank">here</a>,</p>


<p>For more blogs on this topic, see <a href="/blog/categories/federal-crimes/">here</a>.</p>


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                <title><![CDATA[PPP Loan Fraud Prosecutions Continue]]></title>
                <link>https://www.conawayandstrickler.com/blog/ppp-loan-fraud-prosecutions-continue/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/ppp-loan-fraud-prosecutions-continue/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Tue, 13 Jul 2021 16:27:24 GMT</pubDate>
                
                    <category><![CDATA[Federal Crimes]]></category>
                
                    <category><![CDATA[Federal Offenses]]></category>
                
                    <category><![CDATA[PPP loan fraud]]></category>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                
                    <category><![CDATA[doj]]></category>
                
                    <category><![CDATA[PPP Loan Fraud]]></category>
                
                    <category><![CDATA[SEC]]></category>
                
                    <category><![CDATA[SEC Complaint]]></category>
                
                
                
                    <media:thumbnail url="https://conawayandstrickler-com.justia.site/wp-content/uploads/sites/908/2021/07/unnamed-1.jpg" />
                
                <description><![CDATA[<p>When the PPP program was first created, it was meant to assist business left struggling by the Covid-19 pandemic. One of the key provisions of the program, was that the Small Business Administration (SBA) would guarantee the loan which meant that borrowers could secure loans more easily. As mentioned in a previous blog, the government&hellip;</p>
]]></description>
                <content:encoded><![CDATA[

<p>When the PPP program was first created, it was meant to assist business left struggling by the Covid-19 pandemic.  One of the key provisions of the program, was that the Small Business Administration (SBA) would guarantee the loan which meant that borrowers could secure loans more easily.  As mentioned in a previous <a href="/blog/newest-developments-ppp-loan-fraud/">blog</a>, the government in the spring of 2020 started to go after the most egregious and problematic PPP loan applications and payments and really ramped up prosecutions.</p>


<p>But now, the DOJ, IRS, SEC etc are shifting their focus to more complex investigations.  We have clients where the government is scrutinizing <em>every </em>aspect of the loan application such as </p>


<p>-was the box checked stating that you only had one entity</p>


<p>-were the necessity calculations correct</p>


<p>-were the payroll calculations correct</p>


<p>-was there an EIDL advance?</p>


<p>-was number of employees not correct due to using 1099s?</p>


<p>When applying for a PPP loan, you sign and certify that “the funds will be used to retain workers and maintain payroll; or make payments for mortgage interest, rent, utilities, covered operations expenditures, covered property damage costs, covered supplier costs, and covered worker protection expenditures as specified under the Paycheck Protection Program Rules; I understand that if the funds are knowingly used for unauthorized purposes, the federal government may hold me legally liable, such as for charges of fraud.” </p>


<p>The SBA is now auditing every loan worth over $2 million. Since you certify on the loan application: “I understand that loan forgiveness will be provided for the sum of documented payroll costs, covered mortgage interest payments, covered rent payments, covered utilities, covered operations expenditures, covered property damage costs, covered supplier costs, and covered worker protection expenditures, and not more than 40% of the forgiven amount may be for non-payroll costs. If required, the Applicant will provide to the Lender and/or SBA documentation verifying the number of full-time equivalent employees on the Applicant’s payroll as well as the dollar amounts of eligible expenses for the covered period following this loan.” It is easy for the government to try and not forgive the loan/pursue a civil judgement/pursue criminal charges.</p>


<p>Criminal charges can include: </p>


<p>18 USC § 1001 false statements </p>


<p>18 USC § 1014 loan fraud </p>


<p>18 USC § 1344 bank fraud</p>


<p>18 USC § 1341 mail fraud</p>


<p>18 USC § 1343 wire fraud</p>


<p>But also can include</p>


<p>18 USC § 1028A aggravated identity theft </p>


<p>Tax charges</p>


<p>Forfeiture
<a href="https://www.sec.gov/news/press-release/2021-120" rel="noopener noreferrer" target="_blank">SEC enforcement actions</a></p>


<p>(Please see, for example, <a href="https://www.sec.gov/litigation/complaints/2021/comp-pr2021-120.pdf" rel="noopener noreferrer" target="_blank">Parallax SEC Complaint</a>)</p>


<p>The government can also use the False Claims Act to enforce settlements relating to PPP loan issues.  In January 2021, the DOJ announced its first civil settlement stemming from PPP loan fraud against SlideBelts, Inc., a California company who agreed to pay $100,000 in damages and penalties for making a misrepresentation in its application about its involvement in a bankruptcy proceeding among other things.  </p>


<p>If the bank is asking a lot of questions about your PPP loan or application for forgiveness, or if the situation has been referred to the fraud department, call and seek a legal consultation with us here at Conaway & Strickler or contact us <a href="/contact-us/">here</a>.</p>


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                <title><![CDATA[NEWEST DEVELOPMENTS – PPP Loan Fraud]]></title>
                <link>https://www.conawayandstrickler.com/blog/newest-developments-ppp-loan-fraud/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/newest-developments-ppp-loan-fraud/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Wed, 24 Feb 2021 17:26:01 GMT</pubDate>
                
                    <category><![CDATA[PPP loan fraud]]></category>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                
                    <category><![CDATA[Criminal Lawyer]]></category>
                
                    <category><![CDATA[False Claims Act]]></category>
                
                    <category><![CDATA[FCA]]></category>
                
                    <category><![CDATA[Federal Criminal Lawyer]]></category>
                
                    <category><![CDATA[PPP Loan Fraud]]></category>
                
                    <category><![CDATA[wire fraud]]></category>
                
                
                
                    <media:thumbnail url="https://conawayandstrickler-com.justia.site/wp-content/uploads/sites/908/2021/02/Paycheck-protection-PPP-filing-claims.jpg" />
                
                <description><![CDATA[<p>PPP Loan Fraud -NEWEST DEVELOPMENTS As we continue to see in the news, many cases are being charged by the Department of Justice for PPP (Payroll Protection Program) issues. There continues to be a lot of confusion out there over the Paycheck Protection Program (PPP). Understandable since information continues to change about how to apply,&hellip;</p>
]]></description>
                <content:encoded><![CDATA[

<p>PPP Loan Fraud -NEWEST DEVELOPMENTS

As we continue to see in the news, many cases are being charged by the Department of Justice for PPP (Payroll Protection Program) issues.  There continues to be a lot of confusion out there over the Paycheck Protection Program (PPP). Understandable since information continues to change about how to apply, whether to apply for forgiveness, and the second round of PPP loans being rolled out.  Due to the rules and the program itself changing frequently, it is important to not fall under scrutiny by the DOJ.

</p>


<p>

The Department of Justice (DOJ) has already charged and convicted many cases of PPP loan fraud.  But, the purpose of this post is that, recently, the DOJ announced the <em>first</em> (publicized) civil settlement resolving PPP loan fraud allegations against a company and its owner.   The owner and SlideBelts, Inc  was required to pay a $100k civil penalty per FIRREA civil penalty provision 12 USC 1833a and the False Claims Act (FCA) 31 USC 3729 in the Eastern District of California.  The DOJ continues to be aggressive and swift in bringing criminal charges, but, this is the first public civil settlement.  Please see  <a href="https://www.justice.gov/usao-edca/press-release/file/1352931/download" rel="noopener noreferrer" target="_blank">https://www.justice.gov/usao-edca/press-release/file/1352931/download</a> to read it in its entirety.

The SlideBelts loan application for $350k was misleading as to whether or not the company was in bankruptcy.  This means that each and every box checked/information provided was scrutinized.  The bank reviewed the application and still paid the loan but then the DOJ argued that the PPP loan application was false and misleading.  In this case, SlideBelts worked with law enforcement and the bankruptcy court to acknowledge the issue and worked to settle the case without criminal charges.
Claims made by PPP loan borrowers can and will continue to be scrutinized by the DOJ.  And even in the absence of clear false statements, it is becoming increasingly clear that the DOJ is investigating and auditing PPP Loan cases.  SBA continues to audit applications, especially those over $2 million.

If you are unclear whether you need assistance with your loan or PPP or EIDL loan application or if you are being investigated, call federal criminal lawyers, Conaway & Strickler, PC</p>


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                <title><![CDATA[PPP Loan Fraud Explained]]></title>
                <link>https://www.conawayandstrickler.com/blog/ppp-loan-fraud-explained/</link>
                <guid isPermaLink="true">https://www.conawayandstrickler.com/blog/ppp-loan-fraud-explained/</guid>
                <dc:creator><![CDATA[Conaway & Strickler, P.C.]]></dc:creator>
                <pubDate>Fri, 04 Sep 2020 19:08:48 GMT</pubDate>
                
                    <category><![CDATA[Uncategorized]]></category>
                
                
                
                
                <description><![CDATA[<p>News stories continue to pour in about Paycheck Protection Program loan fraud (see https://www.nbcnews.com/business/economy/congressional-investigation-finds-over-1-billion-ppp-fraud-n1239001). The Paycheck Protection Program (“PPP”) was authorized as part of the Coronavirus Aid, Relief, and Economic Security Act to provide forgivable loans to eligible small businesses. Under the PPP, small businesses can apply for loans that must be used for payroll&hellip;</p>
]]></description>
                <content:encoded><![CDATA[

<p>News stories continue to pour in about Paycheck Protection Program loan fraud (see</p>


<p><a href="https://www.nbcnews.com/business/economy/congressional-investigation-finds-over-1-billion-ppp-fraud-n1239001" rel="noopener noreferrer" target="_blank">https://www.nbcnews.com/business/economy/congressional-investigation-finds-over-1-billion-ppp-fraud-n1239001</a>).  The Paycheck Protection Program (“PPP”) was authorized as part of the Coronavirus Aid, Relief, and Economic Security Act to provide forgivable loans to eligible small businesses. Under the PPP, small businesses can apply for loans that must be used for payroll expenses, interest on mortgage, rent, and/or utilities only. The amount of a PPP loan that a business could receive is generally 2.5 times (or 250%) the business’s average monthly payroll cost.  The United States Small Business Administration oversees the PPP, but individual PPP loans are issued by private, approved lenders and banks, which are federally insured financial institutions.</p>


<p>How does the government identify potential fraud?  They review the following, among other things:</p>


<ol class="wp-block-list">
<li><strong>The PPP Borrower</strong> <strong>Application Form</strong> – An applicant must provide information related to their loan application, including the amount of the business’s average monthly payroll, the number of employees, and the purpose of the loan, with options for payroll, lease/mortgage interest, utilities, etc. The lender will use this information to calculate the amount of the loan that a business is eligible to receive. The Application Form also requires certain representations and certifications, including certifications as to the accuracy of the information included in the application itself and in any supporting documents and a certification that the funds will be used to retain workers and maintain payroll or to make mortgage interest payments, lease payments, and utility payments. So, anything on this form, <em>anything</em>, that is incorrect can be an issue.</li>
<li><strong>IRS Form 941 </strong>– These are Employer’s Quarterly Federal Tax Returns.  Generally, in an application for PPP, one needs to upload Form 941s to supplement the application.  These forms are used to report payroll for each quarter and must be provided for 2019 and 2020, at least. Any figures on the uploaded forms that don’t match IRS records will raise a flag.</li>
<li><strong>Bank statements</strong> – A PPP application requires the business to upload recent bank statements.  Here, one can get in trouble if the statements uploaded don’t match bank records. Also, the government can confirm previous payroll by reviewing these statements, and can use them to confirm business revenue and expenses.</li>
<li><strong>W2s</strong> – If these are uploaded as part of the application, they must match IRS records.</li>
<li><strong>Articles of Incorporation</strong> – The government will have records from the Secretary of State as to when a business was officially incorporated.  Any officers currently listed on the Secretary of State may have criminal liability should a PPP loan application be defective.</li>
</ol>


<p>To understand what charges can result from issues with a PPP Loan application, please click here:  <a href="/blog/could-you-face-prosecution-for-paycheck-protection-program-ppp-loan-fraud/">https://www.conawayandstrickler.com/blog/2020/06/could-you-face-prosecution-for-paycheck-protection-program-ppp-loan-fraud/</a></p>


<p>Additional documentation can be required for a PPP loan to be processed successfully.  If your business has had its PPP loan proceeds frozen for any reason, it is wise to contact us immediately. We can work with the banks and investigators to ensure a positive resolution.</p>


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