U.S. Supreme Court considers freezing of assets in Medicare fraud case.
The prospect of a federal investigation for Medicare fraud is terrifying. The prosecutorial powers of the federal government are vast, and prosecutors in Southern Florida and across the nation are under pressure to aggressively root out fraud and abuse related to federal programs. This means that they employ many tools to ascertain what appears to be fraud and then use that immense power to extract plea agreements.
The recent charges filed against numerous persons in South Florida this summer demonstrate how aggressive the U.S. Attorney's Office and other federal law enforcement agencies will be in pursuing Medicare fraud. The charges were filed against 73 individuals as part of a nationwide "takedown" involving 243 individuals in 17 cities. This massive operation was executed by the Medicare Fraud Strike Force.
The Attorney General noted that, "This action represents the largest criminal health care fraud takedown in the history of the Department of Justice, and it adds to an already remarkable record of enforcement." They charged individuals involved at all levels of the health care industry.
The danger with transactions involving Medicare is that they are complex and many of the billing rules are very technical, meaning mistakes that may have been inadvertent may nonetheless appear to federal investigators as part of a pattern and practice of billing abuse and lead to federal charges of Medicare fraud.
For health care providers, doctors and pharmacists, the risk is that some action will trigger an interest and perhaps an investigation into your billing practices. This can mean that any unusual activity, odd billing patterns, mistakes or other issues with your billing can come under scrutiny.
In a related issue, the U.S. Supreme Court heard arguments on a case involving a woman who had been charged with Medicare fraud. Her home health care agency was charged with billing fraud, alleging that she billed for services that were not provided.
The government froze all of her assets, including those not related to her alleged fraud. Her attorney argued that freezing all assets deprived her of her Sixth Amendment right to counsel, as she could not afford to hire an attorney.
The Court, however, was skeptical of those arguments, with Justice Alito pointing out the fact that "money is fungible." They seemed worried at how to draw the line between tainted and untainted assets. On the other hand, Chief Justice Roberts and Justice Kennedy noted that the government's argument could be applied to virtually every law, making it very difficult for many defendants to obtain counsel in a criminal prosecution.
Given the divided nature of questions expressed by the Supreme Court Justices, it is difficult to predict how the Court may rule in the future. The troubling growth in the use of civil forfeiture by law enforcement and concerns over the abuse of that practice could lead the Court to attempt to prevent overreaching and abusive forfeitures by the government.
No matter how the Court rules in this matter, if you are under investigation for any issues related to Medicare fraud, you need to obtain representation by an attorney familiar with these types of fraud, as the consequences of a federal civil or criminal action can be devastating.
Rob, Former Client
Ted, Former Client
Anonymous, Former Client
Roshelle P., Former Client
Randy P., Former Client