Blog, Preparation, Sentence Mitigation

THE FBI HAS BEEN TO YOUR PRACTICE, OR HOSPITAL ASKING QUESTIONS

BY THE TIME YOU HEAR THAT – YOU’RE THE LAST TO FIND OUT.

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THE DOJ CONVICTION RATE IS 95%+

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The Department of Justice’s Healthcare Fraud Unit.

  • This is relevant to individual practice physicians – healthcare systems, or hospital executives, especially if you believe the DOJ-HHS Healthcare Fraud Unit is asking questions. All other providers, suppliers, and support businesses are also subject to oversight. If this is the case, you need Legal Representation.


The First case involved an Arizona doctor sentenced for healthcare fraud. This information appeared on my computer on October 24th, a few days ago. The fraudulent claims were made by a physician who billed for services as the treating provider, even though other professionals—such as a nurse practitioner, social worker, unlicensed psychologist, intern, or wound care nurse—provided the services independently. The total loss was 3.7 million. Restitution was $1,100,000 to the insurance carrier and a civil monetary penalty of $2,500,000.

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In the Second case, a doctor was charged $32.7 million in Medicare fraud. This case involved a pain management practice that operated an in-house drug testing laboratory. Allegedly, the physician billed Medicare over $32 million for drug testing across 22 different classes of drugs in urine specimens despite a lack of documentation or evidence suggesting the use of these illicit substances. The physician faced one count of conspiracy to commit fraud and five counts of healthcare fraud.

Reading your indictment – it’s not a great feeling, but something you must do.

  • I’m assuming that no doctor goes out of their way after undergraduate school training, medical school training, years of fellowship, and years of residency to throw it all away to do something illegal and wind up in prison.
  • These charges paint a dire picture, and while it’s not the end of the world, consider advocating – participating in your defense. How? More on this later.
  • No one can guarantee what the judge will do if someone does – move on.
  • So, let’s peek inside the Department of Justice window and see their planning.

The Healthcare Fraud Unit has many sections, and this map grids it from the East to the West Coast.

  • The New England Task Force investigates schemes related to healthcare fraud, including doctors, financial crimes, money laundering, and kickbacks.
  • Northeast Task Force, here they combat the opioid crisis and fraudulent providers.
  • National Rapid Response Task Force. They investigate and prosecute significant healthcare fraud cases involving individuals and corporations, impacting public and private insurance payers. They coordinate national enforcement actions for multi-jurisdictional investigations, collaborating with agencies like the Fraud Section, Consumer Protection Branch, Medicaid Fraud Control Units, the FBI, HHS, and the OIG.
  • Prescription Task Force—Appalachian Regional Prescription Opioid Strike Force. They prosecute white-collar offenses involving prescription drugs.
  • Midwest strike force, money laundering, kickbacks, you know, complex fraud schemes
  • Gulf Coast Strike Force also deals with healthcare fraud, kickbacks, money laundering as well as opioid.
  • Los Angeles is the federal district with the most Medicare spending, so the DOJ FRAUD Department uses Advanced Data Analytics and Algorithmic Methods wherever you practice in the US. You will need legal representation if you do billing outside the norm for your general area and get flagged.
  • Florida Strike Force
  • Texas Strike Force

Any Judge you will encounter understands that the,

  1. The Department of Justice wants a conviction.
  2. Prosecutors want jail time.
  3. Your attorneys are paid to say nice things about you and to keep you out of prison – but your attorney knows nothing about you.

Therefore, you are the one person the judge knows nothing about. It would benefit you to humanize yourself to your judge – and your attorney so they can provide your best defense. If you’re still concerned, call me: 240.888.7778, the Consultation is free and I personally return all calls.

The most important person you’ll meet is your probation officer. Before your meeting, use this opportunity to prepare your autobiography, including your criminal history, medical background, and social history.

The probation officers encounter many individuals, and before they meet you, you’re simply an alphanumeric number as they read your Indictment, which is not very favorable.

If you do nothing, that’s how they’ll first know you.

To facilitate a smoother process with your probation officer, providing all the necessary documents they’ve requested, including your medical records and any pertinent background information is essential. Gather character reference letters and create a complete overview of your experiences. This should include your diplomas and highlights of your achievements.

  • Additionally, it’s powerful to include a personal narrative or autobiography that candidly discusses the highs and lows of your life, elaborating on the circumstances that led to your offense. Ensure you take responsibility for your actions and express genuine remorse for the affected victims, avoiding excuses.
  • Make sure everything is well-organized and free of spelling errors. Present this comprehensive packet to your probation officer at least a week before your interview. Doing so demonstrates respect for their time, allowing them to seamlessly incorporate your information into their report. They will undoubtedly appreciate your thoughtful preparation.

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So now, when you meet, they have time to get to know you personally. And maybe they may come away from that meeting feeling that you’re not that horrible person that the indictment references. When you meet the judge at sentencing, they may have already spoken with your probation officer.

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If you choose not to take any action, the judge will have no choice but to base your sentencing solely on your indictment. I understand that this can feel overwhelming. To help you prepare in the best way possible, it might be helpful to consider a few steps. While they may seem quite simple, remember that even the most important journeys often start from the basics. It’s okay to take things one step at a time.

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  1. Write a Personal Narrative: This should convey your story and perspective.
  2. Develop a Release Plan:
  3. Acknowledge Responsibility: Recognize the pain you have caused to your victims.
  4. Utilize Your Time Wisely: Describe how you will use your time in prison for self-reflection and personal development through programs such as education (FSA), post-secondary education, and mentoring others.
  5. Create a Routine: Plan a daily routine starting from Day 1 of your sentence.
  6. Before your arrival, familiarize yourself with the dos and don’ts of prison life.
  7. Request Character Reference Letters: Seek letters from individuals who can speak positively about your character.
  8. Practice Your Allocution: Prepare to address the judge at sentencing; your judge will want to know your plan not to return to their courtroom. Believe them!

Counsel: Considering Preparing Your Client For Their PSI?

  • Personal Narrative
  • Release Plan
  • Allocution
  • What to Expect in Prison Day One.
  • FSA Programs: Which ones will help with your placement request?
  • Sample Placement Request Packet for the Judge, FPC Alderson
  • Preparation For The Presentence Interview.
  • Your One Chance To Make A Great First Impression
  • You Have Questions.
  • We May Have Answers.

Dr. Blatstein
Call Today: 240.888.7778
PPRSUS.com,
Physician Prison Consultants, Presentence Report Service