Receiving notice from a patient that the patient was contacted by an investigatorReceipt of a subpoena for records from the Office of the Inspector General (OIG), U.S. Attorney or State Attorney GeneralBeing approached and questioned by a government agentThe arrest of other professionals with whom you do businessThe execution of a search warrant for your recordsReceiving notice from an employee or former employee that he/she was contacted by an investigatorThe seizure of your bank accounts by a government agencyReceipt of a demand letter in a Medicare False Claims Act caseReceipt of a target letter from the U.S. Attorney's Office notifying you that you are a possible target in a criminal investigationReceiving a telephone call from a government agent or local law enforcement official to ask you questions
Representing Medicare providers in responding to subpoenasRepresenting Medicare providers in questioning by investigatorsRepresenting Medicare providers in responding to Medicare auditsRepresenting Medicare providers in defending qui tam (False Claims Act or "whistle blower" law suits)Representing Medicare providers in responding to ZPIC and RAC auditsRepresenting Medicare providers in defending litigation for civil monetary penaltiesRepresenting Medicare providers in federal criminal actions against themRepresenting Medicare providers in becoming "cooperating witnesses" to assist them in targeting the correct criminal
Billing for services that were not renderedBilling for services provided by someone not properly licensed or trained to provide that serviceBilling for services provided by someone who was not a Medicaid provider Over-billing or upcoding (billing for more services, more time or a higher level of care than was actually delivered)Billing for items, services, drugs, or treatments which the state's Medicaid program that it does not specifically coverBilling for those who should not receive treatment (dead patients, mentally incapacitated patients)Billing for drugs, equipment or supplies that were previously provided to the Medicaid provider at no cost
Being excluded from the Medicare Program for one year or many yearsBeing terminated as a state Medicaid providerBeing placed on the U.S. government's "debarred list" and barred form all government contracting activitiesAction against the state licenseAction against the facility licenses of any other health facilities or organizations in which the person is an owner, officer or employeeLoss of DEA registrationLoss of hospital or health facility clinical privilegesHaving participation on provider panels of health insurers terminated
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