Health Care Fraud Defense: Georgia Attorneys Serving Clients Nationwide

Griffin Durham Tanner & Clarkson is a law firm with attorneys who have a well-earned reputation for successfully navigating clients through the complexity of health care fraud investigations. This type of fraud is a high priority area of enforcement for the government, and a large number of people find themselves targeted by investigators each year. 

Founded by decorated former federal prosecutors, Griffin Durham Tanner & Clarkson has unique insight into how the government investigates and prosecutes. Our attorneys have led fraud investigations in some of the largest and most complex cases in the country. Our attorneys have served as:

  • United States Attorneys;
  • Criminal Chief;
  • Criminal Health Care Fraud Coordinators;
  • Civil Health Care Fraud Coordinator;
  • Affirmative Civil Enforcement Coordinator; and
  • Instructors of health care fraud for DOJ attorneys

If you are suspected, accused, or indicted on charges of health care fraud, you need the knowledge and experience our criminal defense team provides.

What Is Health Care Fraud?

This type of fraud involves a wide range of conduct involving how claims are billed to programs and improper relationships between parties in the medical field. These investigations typically involve allegations of defrauding Medicare, Medicaid, Tricare, workers’ compensation, or private insurance companies. 

This type of fraud can involve medical professionals, executives, marketers, or those who work in hospitals, laboratories, testing services, rehabilitation or nursing facilities, outpatient surgical centers, drug stores, or pharmaceutical companies. Since billions of dollars are lost in health fraud crimes annually, those convicted of perpetrating them can be sentenced to decades behind bars, restitution, fines, and loss of state licenses.

Have You Been Accused of One of the Following Types of Health Care Fraud?

A broad spectrum of misconduct is categorized as health care fraud. Our accomplished attorneys will customize strategies to protect you from any of the following charges:

  • Billing for services not provided or goods never delivered
  • Billing for services deemed “medically unnecessary” 
  • Unlicensed or excluded services for which those submitting claims did not follow appropriate enrollment procedures
  • “Upcoding” of claims, i.e. inflating the level of service provided in order to obtain higher reimbursement
  • Misrepresenting diagnoses or procedures to maximize payments
  • “Unbundling” procedures, i.e. artificially separating procedures that are normally performed and billed as one kind of treatment
  • Submitting duplicate claims
  • Altering medical records or reports (changing dates, services, patient names) 
  • Soliciting or receiving kickbacks for goods or services (e.g. receiving referrals, drugs, or money)

If you have been accused of any of these, you face serious consequences. We know exactly what we are doing, and we can help. 

Your Opponents Are Formidable

These investigations are led by sophisticated and well-resourced DOJ units and agencies.

Most investigations will be handled by a local U.S. Attorney’s office. In U.S. Attorney’s offices across the country, each district has a designated health care fraud coordinator to handle criminal and civil cases. Many offices have specialized prosecutors and teams who focus on fraud prosecutions.

At DOJ, there are also prosecutors assigned to the Criminal Division, headquartered out of Washington D.C., assigned to various DOJ’s Health Care Fraud Strike Force. As described by the DOJ, the Strike Force uses advanced data analysis techniques to determine “hot spots” – cities with high levels of billing fraud – combined with traditional investigative techniques. DOJ has Strike Force operations in Miami, FL; Los Angeles, CA; Detroit, MI; Houston, TX; Brooklyn, NY; the Gulf Coast; Tampa, FL; Orlando, FL; Chicago, IL; Newark, NJ and Philadelphia, PA; Dallas, TX; the Appalachian Region (Tennessee, Alabama, Ohio, Kentucky, Virginia, and West Virginia); and Washington, DC (National Rapid Response Strike Force).   

Top-level government agencies: 

This is no project for amateurs. It requires one of our capable professional, highly trained defense attorneys. 

How Griffin Durham Tanner Clarkson LLC Can Help

While the federal and state governments have enormous resources, our health care fraud defense attorneys have intricate knowledge of the inner workings of how they operate. Our fraud defense lawyers have worked with every agency that investigates these types of fraud claims. We also have established relationships with retired federal agents, including FBI and HHS-OIG, who we can bring on board to assist our defense team. We are well-prepared to defend against audits, investigations, grand jury proceedings, state Medicaid Fraud Control Unit (“MFCU”) teams, FCA investigations, Controlled Substances Act diversion investigations, misbranding investigations, and the entire range of fraud or kickback charges.

From the moment you become our client, our health care fraud defense attorneys will be proactive. We will undertake our own investigation — examining data, speaking to witnesses, and seeking the advice of experts who may give testimony on your behalf at trial. We may be able to identify weaknesses in the government’s case upfront and be able to discourage prosecution, cast doubt on your intentional participation in a crime, or at least reduce the exposure you or your company may face.

Contact Our Georgia Health Care Fraud Defense Attorney Today 

Located in Georgia (Atlanta and Savannah), we handle health care fraud investigations across the country. We will work tirelessly to protect your finances, your freedom, and your reputation from the prosecution’s onslaught. We are dedicated to bringing you the best possible outcome under the particular circumstances of your case. Contact our skilled attorneys today for help.