One lucky Florida ophthalmologist managed to snare a cool $21 million from his medicare billings last year. A hundred less fortunate doctors made due by sharing $610 million from the total doctor’s billings to medicare of $600 billion. All of this information was disclosed when medicare finally opened its books on individual doctors share of medicare billings. The strategy and tactics of robust billings allow some of our lowly medicare doctors to make even more money than those fancy doctors on television. But when does robust billing become fraud worthy of an FBI investigation?
|Is there a Doctor in my House?
Hidden behind the rush of these recent news stories is the fact that federal investigators will begin shifting thru the cloud of statistics in order to begin targeting individual doctors in hundreds of fraud investigations.
Indicting doctors and other health care providers allegedly involved in health care fraud will become a high priority of the FBI and the United States Attorney’s Office not only in the Middle District of Florida but throughout the entire country.
Medicare fraud typically arises from either over billing or from fake billings. To prove over billing or fake billing the FBI will investigate doctors for medicare fraud under Plan B in the following ways:
First, the FBI will be look for an average mean medicare billing for each specialty. For example, it might not be unreasonable for larger billings in specialties which require more expertise.
Second, the FBI will look for an average mean in medicare billing for each part of the country segregating the billings based on the costs and history of billings in every location.
Third, the FBI will target doctors and hospitals that have billed medicare for more than the average mean of specialty and location.
Fourth, the FBI will look for disgruntled employees and former employees to gain insight as to whether there was a criminal conspiracy to over-bill medicare. Employees will be given two significant incentives of not being indicted laced with the possibility of whistle blower status with financial reward. Employees who fail to co-operate by remaining faithful to the hospital or doctor may find themselves indicted as part of a criminal conspiracy to defraud medicare.
Fifth, the FBI will gain access to business records by utilizing search warrants for criminal conduct. This can temporarily shut down the doctor’s office inducing enough immediate financial hardship to scare the doctor into co-oporating with the Government.
With the Government focused on lowering health care costs, it’s clear that it will soon declare war on doctors who may have robustly billed medicare. The ultimate objective of the Government will be the arrest, conviction and imprisonment of imminent doctors to deter others from who received payments from Medicare under Part B.
Doctors who are under investigation may not receive target letters informing them of the fact. In fact in most medicare fraud investigations a target letter is only sent after a completed investigation as a prelude to a possible negotiation with the doctor to avoid a grand jury indictment by allowing him or her to plead guilty in federal court to a significant federal crime. Any doctor who believes he or she may be a target of a federal investigation concerning medicare billing should secure immediate help from a knowledgeable federal criminal defense lawyer to avert federal indictment and prosecution.
|Florida Governor Rick Scott?
Just after the Florida election an unusual note made its way to my office. The letter looked at first to be a prank; like a blackmailer’s note every word was cut out from magazines and pasted to the page. The envelope bore a Tallahassee postmark yet no return address.
Here’s the note:
I’m a hard-working entrepreneur, a people person, a man of character and integrity, a reformer as well as a powerful former CEO indirectly involved in a $400 million health care fraud, which was a mere misunderstanding I had nothing to do with, as I was never indicted. Since then I’ve done my best to lead a law abiding lie, errr… life.
I was doing fine until the people swept me into office making me the Governor of a desolate, backward Southern State with some 29 electoral votes and no high speed rail. I enjoy being Governor except for the foul tasting seafood people eat here and the damn elections folks demand every few years. My god, these people are always wanting to vote instead of just finding jobs!
Recently some friends in the Government and I made voting more orderly by restricting the number of polling places, reducing the number of voting days and making it possible for some folks to wait up to eight hours to vote – no wonder they don’t have jobs!
Now I’m worried about investigations and indictments. Could even a people person’s Governor be indicted for being part of a criminal conspiracy to restrict votes? Would it be a better defense to say I didn’t know what I was doing, that I knew what I was doing but didn’t know it was unlawful or that I’m just incompetent?
While we all can agree that you’re incompetent, it still might be difficult for you to avoid an indictment if criminal conduct was established at Grand Jury hearings where absolute immunity could be granted for those testifying against you. If the Grand Jury found you were in fact part of a criminal conspiracy with others to restrict voting among minorities, women and those who enjoy Florida seafood, you could face indictment and a lengthy term in prison.
Many Americans are under the impression that the right to vote is one of the cherished rights of a democracy that unites us as Americans and protects us from people like you.
Clearly, your best defense is that you and other co-conspirators in the Florida Government were making broad political decisions to reduce the vote among minorities rather than conducting a criminal conspiracy. Even more than the restrictions on voting you implemented, criminalizing politics by punishing the losers, folks like you and your friends, with jail terms could undermine democracy. Anyway, to the anonymous letter writer, good luck and if you ever find yourself as an indicted Governor in need of Clearwater Criminal Defense Lawyers feel free to call.
What should you do if you find you have an active arrest warrant issued from another state? Here’s a question your Clearwater Criminal Defense Lawyer was recently asked:
I’m very scared of being arrested for something I didn’t do. What happens when another state issues an arrest warrant? I moved to Florida several years ago. I’ve just found out that there is a felony arrest warrant for Fraud or Scheme to Defraud in Atlanta, Georgia. From what I can figure out the warrant was issued from the company I used to work for and is a misunderstanding that I thought was already cleared up and I have the paperwork to prove it. Will Florida police arrest me for this? If I’m innocent can I resist the arrest? What should I do?
|Renoir, The Oarsmen, 1879
You may think it was just a ‘misunderstanding’ in Georgia, I hope for your sake you’re right, but a Georgia Judge signed an arrest warrant based on probable cause that you committed Felony Fraud in Georgia. You’ll need to hire an attorney in Georgia to persuade the prosecutor that the criminal case against you should be dismissed. Prosecutors in Georgia will not likely look into your case until after you turn yourself in, make a court appearance and only then will you be allowed to seek a bond.
If you choose not to turn yourself in to Georgia authorities, then you need to understand that at anytime you may be stopped by Tampa Bay Police and arrested in Florida as an arrest warrant from another state will be honored by Florida law enforcement.
Although it’s true that you can resist an unlawful arrest in Florida without using violence, a Florida arrest based on a warrant from Georgia will be deemed lawful and any attempt to resist the arrest will result in Florida criminal charges of resisting arrest without violence.
If you are arrested under the Georgia warrant in Florida, you will be kept in detention without a bond as you’ll be deemed a flight risk. Instead Florida will contact Georgia to determine if Georgia wants you to be extradited back to Georgia to face the Felony Fraud charge. In Florida you will be given an extradition hearing to determine if Georgia has the right bring you back and that you are the person whom Georgia seeks with matching fingerprints or DNA. At an extradition hearing a Clearwater Criminal Defense Attorney could argue any false identity issues, but will not be permitted to argue the underlying merits of the Felony Fraud or Scheme to Defraud case against you nor your innocence as those issues are for a Georgia Court to determine.
The smartest thing for you to do is not to wait for the arrest warrant to come to you, rather you must go to it by cleaning up the matter in Georgia immediately.
The Bureau of Justice Statistics (Bureau of Justice Statistics (BJS) – Data Analysis Tools) has the legal tool you’ve been waiting for – The Arrest Data Analysis Tool. This cite allows you, by choosing “Agency-Level Counts” to see the specific number of arrests made by each law enforcement agency in your jurisdiction, further itemized by year, type of crime, age bracket of the person arrested, gender, and race. Potentially this is useful in determining Police Misconduct, Inappropriate Arrests and Misuse of Police Resources.
In the Tampa Bay Area including Clearwater and St. Petersburg the statistics show law enforcement is blindly and foolishly focused on arresting nonviolent crimes, including drug crimes, white collar crimes and fraud, rather than attempting to protect citizens from violent acts and immediate harm.
Here is the Methods Guide: Bureau of Justice Statistics (BJS) – Data Analysis Tools
Here is the User’s Guide: http://www.bjs.gov/arrests/resources/documents/adat_user_guide.pdf
This is useful information as long as the numbers given by each law enforcement agency are based on undiluted facts.
White Collar Crime Criminal Defense Attorney in Clearwater, FL
Violent Crimes Criminal Defense Attorney in Clearwater, FL