Nicholas B. Johnson
Former Prosecutor
Lynette Byrd
Former Assistant
U.S. Attorney
John Sellers
Former DOJ
U.S. Attorney
Linda Julin McNamara
Former Assistant U.S. Attorney
Dr. Nick Oberheiden
Attorney & Founder
The DOJ is Targeting Importers of Fentanyl Precursor Chemicals in Civil and Criminal Cases
Skin substitute grafts, cellular- and tissue-based, can be an essential form of care for patients undergoing eye surgeries, burn treatment, ulcer treatment, and other procedures. However, they have come under scrutiny in recent years. With a Biden-era plan intended to restrict Medicare coverage for wound grafts—and skin substitutes in particular—set...
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Authorities are Targeting Healthcare Providers and Manufacturers in DME Fraud Investigations Involving Powered Wheelchairs (PWCs)
We have recently seen multiple instances of federal authorities conducting durable medical equipment (DME) fraud investigations involving powered wheelchairs (PWCs). The U.S. Department of Justice (DOJ), U.S. Department of Health and Human Services Office of Inspector General (HHS OIG), and other authorities are targeting both healthcare providers and durable medical...
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DOJ Targets Black Market Prescription Drug Diversion, Signaling Possible New Enforcement Trend
Over the past year the U.S. Department of Justice (DOJ) has publicized two criminal enforcement cases targeting black market prescription drug diversion. In these cases, the DOJ targeted pharmacists, pharmaceutical distributors and sales representatives, and their associates—charging them with knowingly providing prescription medications for non-medical use to third parties for...
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DOJ Announces First-of-Its-Kind Prosecution of Alleged Fraudulent Online Adderall Distribution Scheme
While the U.S. Department of Justice (DOJ) continues to target healthcare providers for unlawful opioid distribution, it is now also setting its sights on Adderall. On June 13, 2024, the DOJ announced a first-of-its kind prosecution targeting the CEO and Clinical President of a telemedicine company who are accused of...
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How Long Does a Medicaid Investigation Take?
Medicaid investigations present substantial risks for participating healthcare providers, health care facilities and nursing homes, medical supply companies, and pharmacies. Knowing what to expect during the process is critical—as this is the only way to develop and execute a targeted and timely defense strategy. One aspect of knowing what to...
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What Healthcare Providers Need to Know About the Anti-Kickback Statute
The federal Anti-Kickback Statute is one of the most important laws for healthcare providers in the United States. It is also one of the most misunderstood. The Anti-Kickback Statute prohibits the payment of compensation (or "remuneration") for referrals or other business that results in the receipt of federal funds. This...
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Filing a Qui Tam Lawsuit
An Overview of the Process The qui tam provisions of the False Claims Act allow private citizens to help the federal government hold government contractors, healthcare providers, and other entities accountable for fraud, waste, and abuse (FWA). By filing qui tam lawsuits, private citizens can notify the government of FWA...
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How to Win a Medicare Appeal
If you own or operate a medical practice or other business in the healthcare industry and have questions about Medicare appeals, you are not alone. According to data from the U.S. Department of Health and Human Services (DHHS), about 10% of all Medicare fee-for-service claims are denied, and about 3%...
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DOJ Targets COVID-19 Test Fraud
While federal authorities are continuing to aggressively investigate and prosecute Paycheck Protection Program (PPP) and Economic Injury Disaster Loan (EIDL) fraud—which has been called the "biggest fraud in a generation"—this isn't the only form of COVID-19 fraud that remains on the government's radar. The U.S. Department of Justice (DOJ) is...
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What are Some Compliance Standards That IV Therapy Providers Have to Meet?
Intravenous (IV) therapy is one of the newest popular trends in medicine, particularly among the wealthy and celebrities. Common therapies are IV drips of vitamins, which purport to boost the immune system, and low-level painkillers that claim to cure a hangover. Enough people have sought them out that many spas...
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