white collar lawyer

Trends in Healthcare Fraud Enforcement

Published on: July 9, 2025 | By Conaway & Strickler, P.C.

The DOJ boasted their record-breaking 2025 healthcare fraud take down in a recent press release that we discussed more generally in another blog post. This post focuses on some of the specific actions taken by the government and highlights the trends across enforcement.

DME Fraud

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

Largest U.S. Health Care Fraud Takedown: 324 Charged, $14.6 B Alleged Loss

Published on: July 1, 2025 | By Conaway & Strickler, P.C.

On June 30, 2025, the Department of Justice announced its largest-ever National Health Care Fraud Takedown, unveiling criminal charges against 324 individuals, including 96 doctors, nurse practitioners, pharmacists, and other licensed medical professionals across 50 federal districts and 12 state attorney general offices. The alleged schemes involved over $14.6 billion in intended losses—a record more than double the previous $6 billion takedown

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

Enormous monetary scale: Again, the federal government alleges $14.6 billion in intended losses in total across the criminal cases. Law enforcement has already seized $245 million in cash, luxury vehicles, cryptocurrency, and assets from alleged fraudsters. The Centers for Medicare and Medicaid Services (CMS) also proactively prevented $4 billion in fraudulent payments, suspended billing privileges of 205 providers.

Department of Justice Fraud Prosecutions

Published on: May 28, 2025 | By Conaway & Strickler, P.C.

Fraud is a concept that has been in the criminal justice system forever. Google defines it as an intentional deception used to gain an unfair advantage or benefit, often involving financial gains. How does the Department of Justice prosecute fraud? Below is a non exhaustive list of charges that the DOJ can bring.

Wire fraud
Mail fraud

Legal Considerations for Healthcare Billing

Published on: April 25, 2025 | By Conaway & Strickler, P.C.

Billing to the United States government presents a unique set of legal requirements for healthcare professionals. Physicians who participate in federal healthcare programs like Medicare and Medicaid are subject to strict billing regulations. Even inadvertent errors can lead to severe legal consequences, including criminal charges. Understanding these laws and the potential risk of noncompliance is crucial for healthcare providers.

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

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

Cryptocurrency Money Laundering

Published on: March 24, 2025 | By Conaway & Strickler, P.C.

Cryptocurrency fraud has become increasingly prevalent in recent years. The lack of a centralized authority governing crypto along with the relative anonymity of transactions has contributed to this rise in digital financial crime. Specifically, cryptocurrency money laundering has grown significantly in recent years with billions of dollars stolen through hacks, Ponzi schemes, mixers. A recent report from Chainalysis estimates illicit cryptocurrency addresses received more than 50 billion dollars in 2024.

Crypto money laundering follows the same pattern used for fiat (government-issued) currencies by “cleaning” funds gained through illicit means, before exchanging or withdrawing them for cash. Traditionally, money laundering involves disguising financial assets so they can be used without detection of the illegal activity that produced them. In the context of crypto, tokens are moved through various digital addresses to obscure their illegal origin and make them more difficult to trace.

The privacy-preserving nature of crypto has opened the door for criminals to conceal the origin of illicitly gained funds through a variety of methods. Cybercriminals ultimately funnel assets through several businesses and online addresses to hide the money trail before transferring the funds to a seemingly legitimate source.

Collateral Consequences of a Physician’s Arrest

Published on: January 17, 2025 | By Conaway & Strickler, P.C.

Physicians who are arrested face a multitude of other issues. They will face possible termination from their job. But, also they will face issues with the Georgia Composite Board. It is very important to understand that those who are arrested may hire a firm like us and enter into an informal resolution to avoid formal proceedings, additional costs, and potentially more severe sanctions with the Composite Board. It is important to be aware of other possible consequences of such stipulations, including the following:

NPDB Reports. Licensing boards are generally required to report such these informal agreements involving physicians to the National Practitioners Data Bank (“NPDB”). (See45 CFR § 60.8). Hospitals and other entities are required or permitted to check the NPDB during the physician credentialing process. An NPDB report can permanently tarnish a physician’s record and career, unless it is removed, and it may also result in the additional actions outlined below.
Reciprocal Actions by Other State Licensing Boards. Many if not all state licensing boards automatically impose reciprocal sanctions against providers who were sanctioned in another state; thus, the action in one state may result in similar actions in other states in which the provider is licensed. That, of course, compounds the physician’s problems.

What to Expect in a Federal Criminal Trial

Published on: January 12, 2025 | By Conaway & Strickler, P.C.

A federal criminal trial consists of several different stages. The below will analyze a ONE defendant trial. But, more often than not, trials can consist of multiple defendants at trial. This just augments the time needed for each stage.

Jury Selection also known as Voir Dire

Jury selection is one of the most important parts of a federal criminal trial. It will start with about 40 potential jurors brought in. Usually we move our chairs to the other side of the table to face them. We ask general questions, then individual questions. Then, we deliberate on who to choose. Then, the court asks us to do our strikes, and then a jury is empaneled.

White Collar Crime at a Crossroads: The Implications of Kousisis on Federal Fraud

Published on: December 16, 2024 | By Conaway & Strickler, P.C.

This month, the Supreme Court heard oral arguments in Kousisis v. United States, a case that could have significant implications on the future of federal white-collar prosecutions. Specifically, the Court is considering the boundaries of federal fraud statutes in scenarios where deceptive practices are employed without causing direct financial harm to the victim.

Kousisis comes before the Court after a Philadelphia-area government contractor was found guilty of fraud after it failed to comply with a contract provision intended to promote diversity. Stamatios Kousisis and Alpha Painting and Construction Co., Inc. (Alpha) secured two substantial contracts with the Pennsylvania Department of Transportation (PennDOT). These contracts mandated a certain percentage of work to be allocated to Disadvantaged Business Enterprises (DBEs). Kousisis and his company misrepresented their compliance with this requirement by using a DBE as a mere pass-through entity, thereby falsely claiming adherence to the DBE participation goals. Despite this deception, the contracted work was completed to PennDOT’s satisfaction, and no direct financial loss was incurred by the department.

Federal prosecutors charged Kousisis and Alpha with wire fraud, conspiracy to commit wire fraud, and making false statements. The prosecution’s argument was based on the “fraudulent inducement” theory, suggesting that the defendants obtained the contracts through deceptive promises, even though PennDOT did not suffer a financial loss. Ultimately, Kousisis was sentenced to 70 months’ imprisonment for the multi-million dollar fraud he perpetrated following a jury trial in 2018.

Nursing License Defense FAQs

Published on: October 25, 2024 | By Conaway & Strickler, P.C.

As a nurse, your license is one of your most valuable assets. Yet, complaints or accusations against you could jeopardize your ability to practice. At Conaway & Strickler, P.C., we understand the gravity of these situations and are here to help. Attorney Meg Strickler is experienced license defense attorney who has handled these issues for years. Below are some questions and answers that will help you navigate any issues you might having with the Nursing Board.

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

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

Criminal Consequences for Unruly Airline Passengers: The FAA’s Push for Prosecution

Published on: October 5, 2024 | By Conaway & Strickler, P.C.

In recent years, unruly behavior on flights has become a growing concern, prompting the Federal Aviation Administration (FAA) to escalate its enforcement efforts. Since 2021, the FAA has referred over 310 cases of severe incidents to the FBI for criminal prosecution. These cases involve dangerous acts like physical assaults, attempts to breach the cockpit, and sexual misconduct, all of which have serious legal consequences.

The FAA’s zero-tolerance policy, implemented in 2021, marked a shift from warnings to immediate enforcement. With incidents like physical assaults on passengers and crew members, the FAA has consistently referred the most egregious cases to the FBI. The FAA can impose civil penalties up to $37,000 per violation, but when these cases are referred for criminal prosecution, offenders face much harsher outcomes.

In 2023, over 1,240 incidents of unruly passenger behavior were reported. Of those, 43 cases were referred to the FBI for criminal prosecution due to their severity. These cases often involve physical altercations or inappropriate behavior that pose a threat to the safety of everyone on board. The FAA’s clear stance on holding individuals accountable shows that passengers who engage in such behavior will face serious repercussions.You can read more about the FAA’s referral process and efforts in their official statement and in further detail from FAA’s unruly passenger policy page.