For health care providers, making informed decisions during a Medicarefraud investigationis critical to avoiding unnecessary consequences. While this means complying with the government’s requests for records and informationto the extent required, it also means knowing when you are within your rights to refuse to comply with federal authorities’ demands. During Medicare fraud investigations, health care providers must be careful to avoid other costly mistakes as well. For doctors, pharmacists, hospice owners and other health care providers targeted by the Department of Justice (DOJ), Office of Inspector General (OIG) of the Department of Health and Human Services (DHHS) and other federal agencies, here are some important considerations to keep in mind: Understanding Health Care Providers’ Obligations Regarding . . .Interview Requests In the early stages of Medicare fraud investigations, federal agents will often seek to interview licensed practitioners, billing administrators and other staff members informally. In most cases, providers can – and generally should – decline these requests unless advised otherwise by their attorneys. Civil Investigative Demands A civil investigative demand is a formal request which, in the context of Medicare fraud investigations, typically comes from the DOJ. Health care providers have an obligation to respond to these demands; however, responding does not necessarily mean providing the documents or information requested. OIG Subpoenas The OIG has special authority to issue subpoenas to health care providers during Medicare fraud investigations. Similar to civil investigative demands from the DOJ, subpoenas from the OIG require a timely response. However, here too, health care providers must determine whether it is in their best interests to fully comply or to challenge the subpoena, either in whole or in part. Grand Jury Subpoenas Being served with a grand jury subpoena is an extremely serious matter that requires immediate attention. If you are being called before a grand jury as the subject of a Medicare fraud investigation, this means that federal prosecutors are seeking an indictment for criminal charges. Search Warrants If federal agents show up at your practice or facility with a search warrant, you have the right to request to see the warrant, and the agents executing the warrant must limit the scope of their search to what is authorized in the warrant. You also have the right to legal counsel, and you should contact your attorney promptly. Record Retention While under investigation, health care providers must take care to ensure the retention of all potentially-relevant documents and computer files. Deleting records intentionally, and even allowing records to be destroyed in the normal course of business, has the potential to lead to charges for obstruction. Truthfulness Making false statements during a Medicare fraud investigation can potentially lead to criminal charges as well. Health care providers who are under investigation are entitled to the privilege against self-incrimination; however, this does not authorize providers to overtly mislead federal authorities. Speak With a Miami, FL Medicare Fraud Defense Lawyer in Confidence Ultimately, if your business or practice is under investigation, the best thing you can do to protect yourself is to promptly engage experienced legal representation. To speak with a Medicare fraud defense lawyer at our Miami, FL law offices in confidence, call 305-371-9686 orrequest a consultation onlinenow.
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