Articles Posted in Uncategorized

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 fraud, the crime occurs in the same manner; during the process of buying, selling, or underwriting insurance.

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:

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 more time to investigate and prosecute Covid-19 fraud. It extended the statute of limitations for fraud charges involving PPP and EIDL fraud to ten years.

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 readers on all of its campuses.

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 Meg Strickler recently commented 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.

It is a complex situation especially in these times.

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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 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 probable cause 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.

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.

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.

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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 in the spring of 2020 started to go after the most egregious and problematic PPP loan applications and payments and really ramped up prosecutions.

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

-was the box checked stating that you only had one entity

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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.
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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 first (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  https://www.justice.gov/usao-edca/press-release/file/1352931/download to read it in its entirety.

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 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.

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

In Operation Brace Yourself, DME and medical brace manufacturers were alleged to have paid “kickbacks” and “bribes” to doctors and nurse practitioners working with telemedicine companies for exchange for Medicare patient referrals for medically unnecessary braces.

In Operation Double Helix, patients nationwide were allegedly lured into providing their DNA for testing in a widespread genetic testing fraud scheme powered by a large telemarketing network. The doctors and nurse practitioners involved were paid to write orders prescribing the testing without any patient interaction or with only a brief telephone conversation.

Healthcare fraud remains a key target of the United States Department of Justice (DOJ). The DOJ uses civil penalties, as well as criminal charges, to punish healthcare fraud. The DOJ views healthcare fraud as a major issue.

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