Hospice Fraud Defense
Former DOJ Fraud Section Prosecutors. Nationwide Defense for Hospice Owners, Medical Directors, Certifying Physicians, Nurses, Marketers, and Executives in Federal Investigations, CMS Payment Suspensions, and Medicare Revocation Proceedings.
Based in Washington, D.C., Armstrong & Bradylyons PLLC defends hospice owners, certifying physicians, medical directors, directors of nursing, clinical staff, marketers, management company operators, and investors in federal hospice fraud matters nationwide. The work spans criminal prosecutions, False Claims Act litigation, CMS payment suspensions, and Medicare enrollment revocations.
The firm’s healthcare fraud defense practice is built on nearly a decade of combined service at the Healthcare Fraud Unit of DOJ’s Fraud Section, now part of the Department’s National Fraud Enforcement Division. Scott Armstrong and Drew Bradylyons built healthcare fraud cases as senior DOJ prosecutors, and the firm’s attorneys tried 17 federal jury trials in healthcare fraud cases at DOJ involving over $2.8 billion in alleged false claims.
The posture of hospice enforcement changed in 2026. On May 13, 2026, CMS imposed a nationwide six-month moratorium on new hospice and home health Medicare enrollment, and it has suspended payments to roughly 800 hospices and home health agencies in Los Angeles alone. For most providers the first event is now administrative: a payment suspension, a prepayment review, or a revocation notice, with the criminal case following months later.
The government tries these cases. DOJ’s Healthcare Fraud Unit completed nine jury trials through early June 2026, convicting in all of them, after 17 trials in 2025. Hospice sentences reach 20 years. A defense built on the assumption that the matter will resolve quietly is a defense built on a bad assumption.
The firm’s attorneys know how these cases are built because they built them. Scott Armstrong served nearly a decade at DOJ’s Fraud Section as lead trial counsel in 16 federal jury trials and as Director of DOJ’s Appalachian Regional Prescription Opioid Strike Force. Drew Bradylyons served as Chief of EDVA’s Financial Crimes and Public Corruption Unit and supervised a Healthcare Fraud Unit strike force at DOJ, overseeing parallel criminal, civil, and administrative proceedings.
Hospice cases turn on terminal prognosis, which is a clinical judgment made under uncertainty and then reviewed by the government with the benefit of hindsight. The firm builds the record early: retaining hospice and palliative care physicians, reconstructing what the certifying physician knew at the time of each certification, testing the government’s utilization analysis, and developing impeachment of cooperating employees before they are locked into testimony.
The Nationwide Enrollment Moratorium
On May 13, 2026, CMS imposed a six-month nationwide moratorium on new Medicare enrollment for hospices and home health agencies, coordinated with the White House Task Force to Eliminate Fraud. The moratorium reaches initial enrollments, new practice locations, and certain changes in majority ownership, and CMS may extend it in additional six-month increments. CMS stated it would use the period to intensify investigations, deploy advanced analytics, and accelerate removal of suspected providers from the program.
The announcement rested on the payment-side campaign already underway. CMS had suspended payments to approximately 800 hospices and home health agencies in Los Angeles alone, providers responsible for $1.4 billion in Medicare spending the prior year. A suspension freezes revenue on a credible allegation of fraud under 42 C.F.R. § 405.371, with no hearing and no formal appeal. The provider has 15 days to submit a written rebuttal that is not privileged and that criminal investigators can read.
Operation Never Say Die and the 2026 Takedown
On April 2, 2026, the U.S. Attorney’s Office for the Central District of California announced Operation Never Say Die, arresting eight defendants, including three nurses, a chiropractor, and a purported psychologist, in schemes involving more than $50 million in intended losses. Several cases targeted sham hospices that enrolled beneficiaries who were not terminally ill.
The June 23, 2026 National Health Care Fraud Takedown charged a hospice owner and two marketers in a $27.7 million scheme in the Central District of California. The allegations show how closely the government now watches outlier metrics. Concerned that Medicare and law enforcement monitor the percentage of patients discharged from hospice alive, the owner allegedly paid a funeral home employee $1,000 to $3,000 per decedent for information on recently deceased Medicare beneficiaries, billed a few days of hospice for people who had received no care, and created backdated records to improve his data.
State enforcement runs alongside the federal effort. In January 2026, the California Attorney General charged seven defendants in Monterey County, including three medical directors, a head nurse, and three owners, alleging that patients without terminal diagnoses were enrolled and then transferred among three hospice companies after six months to avoid scrutiny.
Prepayment Review and Revocations
CMS launched the Provisional Period of Enhanced Oversight in July 2023 for newly enrolled hospices and ownership changes in California, Arizona, Nevada, and Texas, and expanded it to Georgia and Ohio in December 2025. Through December 2025, 817 hospices had been subject to PPEO review and CMS revoked the Medicare enrollment of 181 of them, a 22 percent revocation rate. Revocation proceeds under 42 C.F.R. § 424.535 and carries a reenrollment bar. PPEO findings increasingly become the factual foundation for criminal referrals.
Sentences
Hospice sentences are among the most severe in healthcare fraud. The owner of a Texas hospice group that billed $150 million received 20 years, and its chief executive received 15. A Louisiana hospice owner convicted at trial on 23 counts received 20 years and was ordered to repay $42 million. In the Central District of California, the lead defendant in a $16 million sham hospice scheme received 12 years, and four co-defendants were sentenced through late 2025 to terms ranging from 15 to 57 months. Medical directors in these cases have received multi-year sentences for signing certifications.
A hospice matter rarely stays on one track. A payment suspension, a prepayment review, a revocation notice, a sealed qui tam complaint, and a grand jury investigation can run at once, and each generates statements the others can use.
Terminal Illness Certification and Medical Necessity
The government’s case usually rests on the claim that patients were not terminally ill when certified. The firm retains hospice and palliative care physicians to review records, certifications, and clinical documentation, and to establish that the certifying physician’s judgment was reasonable at the time, that the patient met applicable Local Coverage Determination criteria, and that the clinical trajectory supported continued enrollment. A patient who outlives a six-month prognosis is not proof of fraud, and expert testimony is what keeps hindsight out of the analysis.
Challenging Utilization and Outlier Analysis
Investigators flag hospices on average length of stay, live discharge rate, concentration of dementia and debility diagnoses, census growth, and per-patient reimbursement against peer benchmarks. The firm retains analysts to test the comparator set, the time period, the exclusions, and the statistical method, and to supply the clinical and operational explanations the model omits, including referral sources, facility-based census, and diagnosis mix. A billing anomaly is not fraud, and aggregate data does not establish that any individual certification was false.
Payment Suspensions, Prepayment Review, and Revocation
A fraud-based suspension under 42 C.F.R. § 405.371 stops revenue with no hearing, and the 15-day rebuttal is a sworn account that prosecutors will read. Revocation under 42 C.F.R. § 424.535 carries a reenrollment bar and its own short deadlines for reconsideration and corrective action. The firm handles the administrative response and the criminal exposure together, because they are one problem.
Electronic Medical Records and Metadata
The government reconstructs certification practices from the EMR. Metadata shows when a certification or note was created, when it was modified, who accessed the record, and whether an entry was backdated, and agents use templated language across patients to argue documentation was not individualized. The firm engages forensic specialists to test those conclusions, because system defaults, late entries permitted by policy, amendment workflows, and vendor architecture routinely produce patterns the government reads as fabrication.
Referral Relationships and Medical Director Compensation
Prosecutors examine payments to marketers, community liaisons, facility operators, and physicians under the Anti-Kickback Statute, and treat medical director fees that track certification volume as disguised kickbacks. The firm analyzes each arrangement against the applicable safe harbors, documents the services actually performed and the fair market value support, and separates legitimate community outreach from payment for referrals.
Good Faith, Cooperators, and Parallel Proceedings
Healthcare fraud requires knowing and willful conduct. The firm develops evidence of compliance programs, interdisciplinary group review, physician independence, and reliance on counsel, and attacks cooperating former employees on their agreements, exposure, and incentives. It also sequences the response across forums, since an audit reply, a rebuttal statement, or a revocation submission made without regard to the criminal exposure can become the government’s best exhibit.
These investigations reach every level: the owner who set the census targets, the medical director who signed, the nurses who documented, the marketers who recruited, and the management companies and investors above them.
Hospice Owners, Executives, and Investors
Owners are the primary targets. Prosecutors pursue those who allegedly directed or tolerated enrollment of patients who were not terminally ill, set compensation that rewarded census growth, paid for referrals, operated sham hospices through straw owners, or flipped licenses to evade scrutiny. The government also reaches management services organizations and investors who exercised operational control. The defense contests personal knowledge, direction, and intent, and tests the loss figure that drives the guidelines and forfeiture.
Medical Directors and Certifying Physicians
Certifying physicians face charges when the government alleges they signed without adequate face-to-face evaluation, recertified patients who no longer met eligibility criteria, or accepted medical director fees tied to certification volume. Medical directors have received multi-year federal sentences in these cases. The defense establishes the clinical basis for each certification, the information available at the time of signing, and the independence of the physician’s judgment from the hospice’s business objectives.
Directors of Nursing and Clinical Staff
Nurses are charged when the government alleges fabricated assessments, documented decline that did not occur, falsified plans of care, or visit notes for visits never made. EMR metadata and templated language drive these allegations. The defense establishes that documentation reflected actual patient care, accounts for charting practices and system behavior, and separates workflow problems from intentional falsification.
Marketers and Patient Recruiters
Marketers and community liaisons face exposure when the government alleges they recruited patients who were not terminally ill, misrepresented what hospice is to patients and families, or received compensation tied to referral volume in violation of the Anti-Kickback Statute. Two marketers were charged alongside the owner in the $27.7 million case announced in the June 2026 Takedown. The defense examines the compensation structure, the representations actually made, and what the marketer knew about eligibility determinations made by clinicians.
Providers Facing Suspension or Revocation Without Charges
Most providers caught in the 2026 campaign have not been indicted. They received a payment suspension, a prepayment review demand, or a revocation notice. Those proceedings carry short deadlines, no hearing on the suspension itself, and consequences that can end a business before any charging decision is made. The firm represents hospices through rebuttal statements, corrective action plans, reconsideration requests, and the criminal exposure that often sits behind them.
These investigations follow a recognizable sequence. Knowing it tells a hospice what the government already has.
Claims Analytics and Outlier Metrics
HHS-OIG, CMS, and the FBI screen hospice billing for long average lengths of stay, high live discharge rates, heavy concentration of dementia and debility diagnoses, rapid census growth, and reimbursement well above peer averages. The Health Care Fraud Data Fusion Center converts those flags into referrals. Providers should assume the government knows its own outlier ranking before the first contact, and the 2026 charges show defendants manipulating records specifically to move those numbers.
Certification and Recertification Audits
Reviewers examine whether each patient met eligibility at initial certification and at every benefit period: whether the physician conducted an adequate evaluation, whether documentation supports a six-month prognosis if the disease runs its normal course, and whether the clinical trajectory justified continued enrollment. Patients who lived years beyond certification are the first records pulled.
Payment Suspension and Prepayment Review
Money now stops before agents knock. A fraud-based suspension follows CMS consultation with OIG and, as appropriate, DOJ, which means criminal investigators may already be engaged when the notice arrives. Prepayment review under the PPEO produces the same effect more slowly. Whatever the provider says in response becomes an early sworn account that later positions must match.
Employee, Patient, and Family Interviews
Agents interview current and former employees, patients, families, and referral sources, looking for witnesses who will say patients were not dying, certifications were signed without evaluation, documentation was fabricated, or marketers were paid for referrals. Cooperators supply the narrative that connects data to intent, and each arrives with exposure, an agreement, and an incentive to describe what the owner knew rather than what the witness saw.
Kickback and Referral Analysis
Investigators trace payments to marketers, facility operators, and physicians and compare them to referral and certification volume. Medical director compensation is examined against fair market value and against the hours actually worked. The 2026 charges extended this analysis to a funeral home employee paid for information about deceased beneficiaries.
Search Warrants, Devices, and EMR Data
Agents seize phones, laptops, and cloud accounts under 18 U.S.C. § 2703 and subpoena electronic medical records from providers and EMR vendors. Text messages among owners, medical directors, and marketers are frequently the strongest evidence at trial. EMR metadata showing creation, modification, and access times is used to argue that certifications and notes were backdated or created after the fact.
Central District of California
Los Angeles is the center of hospice enforcement. The county accounts for roughly 18 percent of national home health and hospice Medicare billing, and CMS suspended payments to approximately 800 providers there. Operation Never Say Die, the $27.7 million Takedown case, and the $16 million sham hospice prosecutions all arose in this district. California imposed a moratorium on new state hospice licenses in 2021, and the district is both a PPEO state and a Strike Force district.
Arizona, Nevada, and the West Coast Strike Force
Arizona and Nevada were among the four original PPEO states, and both saw the enrollment surges CMS identified as oversaturation. In April 2026, DOJ launched a West Coast Health Care Fraud Strike Force operating from San Francisco, Las Vegas, and Phoenix, with hospice among its stated priorities. Providers in these markets now face a dedicated prosecutorial unit alongside the prepayment review regime.
Texas
The Southern District of Texas produced one of the largest criminal hospice prosecutions on record, a $150 million scheme across dozens of locations that resulted in a 20-year sentence for the owner, 15 years for the chief executive, and multi-year sentences for medical directors. Texas is a PPEO state with an aggressive healthcare fraud posture across its districts.
Georgia, Ohio, and Strike Force Districts
Georgia and Ohio entered the PPEO in December 2025, so newly enrolled hospices and ownership changes there now face prepayment review and unannounced site visits. Enforcement also runs through established Strike Force districts including the Southern District of Florida, the Eastern District of Michigan, and the Northern District of Illinois. With the 2026 moratorium applying nationwide, no market is outside the program’s reach.
Hospice prosecutions stack counts across fraud, kickback, and money laundering statutes, with forfeiture attached and administrative consequences running in parallel.
Healthcare Fraud (18 U.S.C. § 1347)
Section 1347 is the primary charge, covering false terminal illness certifications, enrollment of patients who were not terminally ill, billing for services not rendered, and billing at higher levels of care such as general inpatient without clinical support. The maximum is 10 years per count, rising to 20 years where serious bodily injury results and to life where death results.
Conspiracy and Aiding and Abetting (18 U.S.C. §§ 1349, 371, 2)
Section 1349 carries the same maximum as the underlying offense and requires no overt act. With Section 371 and Section 2, it lets the government reach owners and executives who never signed a certification or submitted a claim, on proof that they caused others to do so.
Anti-Kickback Statute (42 U.S.C. § 1320a-7b)
The Anti-Kickback Statute reaches payments to marketers, patient recruiters, facility operators, and physicians for referrals, and medical director fees structured around certification volume. Violations carry up to 10 years each, and every claim for a patient referred through a tainted arrangement becomes a false claim for civil purposes.
Money Laundering and Forfeiture (18 U.S.C. §§ 1956, 1957, 982)
Money laundering counts follow proceeds into real estate, vehicles, and transfers through straw entities, and carry up to 20 years each. Forfeiture allegations accompany the indictment and often reach operating accounts before trial. Restitution in hospice cases has reached $42 million against a single defendant.
False Claims Act (31 U.S.C. §§ 3729–3733)
The False Claims Act imposes treble damages and per-claim penalties, and hospice claim counts run into the thousands across benefit periods. Many matters begin as sealed qui tam complaints filed by former nurses, administrators, or marketers, and civil and criminal tracks frequently proceed together.
Payment Suspension and Revocation (42 C.F.R. §§ 405.371, 424.535)
CMS may suspend payment on a credible allegation of fraud under § 405.371 with no hearing and no formal appeal, and may revoke Medicare enrollment under § 424.535 with a reenrollment bar. Neither requires a charge. For a hospice drawing most of its census from Medicare, a suspension can decide the outcome by attrition long before any indictment.
Exclusion and Licensure Consequences
A conviction for a program-related offense triggers mandatory exclusion from Medicare, Medicaid, and all federal healthcare programs for a minimum of five years. For physicians and nurses, exclusion ends the practical ability to practice. State medical and nursing boards proceed independently and often act on an indictment rather than a verdict.
What Did the 2026 Medicare Enrollment Moratorium Change for Hospice Providers?
On May 13, 2026, CMS imposed a six-month nationwide moratorium on new Medicare enrollment for hospices and home health agencies, coordinated with the White House Task Force to Eliminate Fraud. It applies in all states and territories, reaches initial enrollments, new practice locations, and certain changes in majority ownership, and may be extended in six-month increments.
The transactional consequences are immediate. Applications not received before the effective date are not processed, and ownership changes structured to transfer a Medicare billing number may be blocked or may trigger new enrollment requirements. Investors and operators planning acquisitions during the period face a materially different risk profile.
The enforcement consequences matter more. CMS stated it would use the moratorium period to intensify targeted investigations, deploy advanced analytics, and accelerate removal of suspected providers. Existing hospices are therefore operating in a window in which the agency has committed publicly to more audits, more revocations, and more referrals.
What Is a CMS Payment Suspension Based on a Credible Allegation of Fraud?
Under 42 C.F.R. § 405.371(a)(2), CMS may suspend Medicare payments when it has consulted with HHS-OIG and, as appropriate, DOJ, and determined that a credible allegation of fraud exists. The suspension can be imposed without prior notice, in whole or in part, and there is no hearing and no formal administrative appeal of the suspension itself.
The provider may submit a written rebuttal within 15 days, and CMS responds internally. Fraud-based suspensions are not subject to the ordinary time limits: CMS reevaluates every 180 days, and the suspension can continue for 18 months or longer where DOJ requests continuation based on a pending or anticipated case.
The rebuttal carries risk beyond cash flow. A fraud-based suspension exists only because CMS consulted OIG and DOJ, so criminal investigators may already be engaged. The rebuttal is not privileged, and every factual assertion and attached document is available to prosecutors. Roughly 800 Los Angeles hospices and home health agencies were suspended in the current campaign, and officials report that most never responded at all.
What Is the Provisional Period of Enhanced Oversight and What Happens on a Failed Review?
The PPEO subjects newly enrolled hospices and ownership changes in designated states to prepayment medical review, additional documentation requests, and unannounced site visits for up to one year. CMS launched it in July 2023 for California, Arizona, Nevada, and Texas, and added Georgia and Ohio in December 2025.
The failure rate is substantial. Through December 2025, 817 hospices had been subject to PPEO review and CMS revoked the Medicare enrollment of 181 of them, a rate of roughly 22 percent. Revocation under 42 C.F.R. § 424.535 carries a reenrollment bar and must be challenged through reconsideration on a short deadline.
PPEO review is also an evidence-gathering exercise. The certifications, plans of care, and clinical documentation produced during prepayment review are the same records a grand jury would subpoena, and findings are routinely referred for criminal investigation.
Can a Medical Director Be Charged for Signing Certifications of Terminal Illness?
Yes. Medical directors and certifying physicians are high-priority targets, and they have received multi-year federal sentences. The government does not need to prove the physician submitted a claim. It is sufficient that the physician signed certifications knowing they would generate Medicare claims.
The theories are consistent: certification without an adequate face-to-face evaluation, recertification of patients who no longer met eligibility criteria, volume of signatures inconsistent with the time available, and medical director fees that tracked certifications rather than documented services. In the Texas hospice group prosecution, a medical director received over four years for certifying patients who were not terminally ill in exchange for trips and other benefits.
The defense is built on the clinical record. It addresses what the physician reviewed before signing, the documented basis for the prognosis, the physician’s independence from census pressure, and the distinction between a prognosis that proved wrong and a certification the physician knew was false.
How Does the Government Use Length of Stay and Live Discharge Data?
Both metrics are screening tools. Long average lengths of stay suggest patients who were not within six months of death. High live discharge rates suggest patients who were never eligible and were released once the benefit periods became difficult to justify. Heavy concentration of dementia and debility diagnoses is treated as corroboration.
The government understands that providers know they are being watched. In the $27.7 million case charged in the June 2026 Takedown, the owner allegedly bought information on recently deceased beneficiaries from a funeral home employee and billed brief hospice episodes for them, specifically to reduce his live discharge percentage.
These metrics are contestable. A hospice serving nursing facilities, a dementia-focused census, a rural referral base, or a program with strong physician relationships will diverge from national averages for reasons that have nothing to do with fraud. The defense tests the comparator group and supplies the operational explanation the model cannot see.
What Sentences Have Federal Courts Imposed in Hospice Fraud Cases?
Hospice sentences are among the most severe in healthcare fraud. The owner of a Texas hospice group that billed $150 million received 20 years, and the chief executive received 15. A Louisiana hospice owner convicted at trial on 23 counts received 20 years and was ordered to repay $42 million.
In the Central District of California, the lead defendant in a $16 million sham hospice scheme received 12 years, and co-defendants sentenced through late 2025 received terms from 15 to 57 months with restitution obligations from roughly $1.8 million to $4.7 million. Medical directors have received multi-year terms in these cases.
Guidelines exposure is driven by loss, role, the number of victims, and abuse of a position of trust. Loss in hospice cases is contested on the question of whether claims for patients who received real care from licensed clinicians should be counted at their full billed value.
Can a Hospice Owner Be Held Criminally Liable for Conduct by Employees?
Yes. Owners and executives are regularly charged for conduct within their organizations without having personally certified a patient or submitted a claim. The government proceeds under conspiracy and aiding and abetting theories, and on the principle that causing another person to submit a claim known to be false supports liability.
Prosecutors look for the decisions only an owner makes: census targets, compensation tied to admissions, pressure on clinicians to certify, selection and payment of marketers, and the response when staff raised eligibility concerns. Internal messages are usually the proof, not testimony.
The defense addresses what the owner actually knew and directed, documents the compliance structure and the independence of clinical decision-making, and distinguishes business growth from a scheme. An owner who relied on licensed physicians to make eligibility determinations occupies a different position than one who overrode them.
What Documentation and Electronic Records Does the Government Examine?
Investigators start with certifications and recertifications, then move to comprehensive assessments, individualized plans of care, physician and nurse visit notes, interdisciplinary group records, and documentation of symptoms and functional decline. Election statements and discharge records are reviewed to determine whether patients and families understood what hospice is and consented to it.
The EMR is examined as data rather than narrative. Metadata shows when an entry was created, when it was modified, who accessed the record, and whether a certification was backdated. Agents compare notes across patients to identify templated or copied language and argue the documentation was not individualized.
Those conclusions are testable. Charting systems auto-populate fields, permit late entries under policy, and record amendments in ways that resemble alteration. Forensic review of the system’s actual behavior frequently explains patterns the government presents as evidence of fabrication.
How Do Kickback Allegations Arise in Hospice Referrals and Medical Director Fees?
Two arrangements generate most of the exposure. The first is payment to marketers, community liaisons, assisted living operators, or families for referrals, particularly where compensation tracks admissions. The second is medical director compensation that functions as payment for certifications rather than for administrative and clinical services.
Under the Anti-Kickback Statute, remuneration offered to induce referrals for federally payable services is criminal when offered knowingly and willfully, with up to 10 years per violation. A tainted arrangement also converts every resulting claim into a false claim for civil purposes, which is how a kickback allegation multiplies into thousands of False Claims Act counts.
The defense examines whether compensation was fixed in advance, supported by fair market value analysis, and matched to services actually performed and documented. Failure to satisfy a safe harbor does not establish a violation, and documented effort to structure around one is affirmative evidence against willfulness.
How Do Parallel Civil, Criminal, and Administrative Hospice Proceedings Interact?
A hospice under scrutiny can face a payment suspension, a prepayment review, a revocation action, a sealed qui tam complaint, a civil investigative demand, and a grand jury investigation at the same time. They run on different clocks and different standards of proof but share one factual record.
Statements made in any of them are available in the others. A rebuttal statement, a corrective action plan, an audit response, or a reconsideration submission can be introduced in the criminal case, and an inaccuracy can generate independent false statement or obstruction exposure. The administrative deadlines are the shortest, which creates pressure to respond before the criminal picture is understood.
Sequencing is a defense decision: what to submit, when, in what forum, and with what privilege and Fifth Amendment protections in place for individuals whose interests may diverge from the company’s.
Does a Hospice Fraud Case End a Company or a Clinical Career?
Consequences frequently arrive before any conviction. A payment suspension can stop revenue on a credible allegation of fraud, and revocation under 42 C.F.R. § 424.535 removes billing privileges with a reenrollment bar. For a hospice drawing most of its census from Medicare, either action is existential well before an indictment.
A conviction for a program-related offense triggers mandatory exclusion for a minimum of five years, and an excluded individual cannot be employed by or furnish services reimbursed by any federal program. State medical and nursing boards act on their own schedules, often on the indictment.
Not every outcome is terminal. Suspensions are lifted, revocations are overturned on reconsideration, and matters resolve civilly with the enrollment intact. Which path a case takes is frequently determined in the first weeks, before anything is filed.
Why Does Federal Trial Experience Matter in a Hospice Fraud Defense?
Because the government tries these cases and wins them. DOJ’s Healthcare Fraud Unit completed nine jury trials through early June 2026, all resulting in convictions, after 17 trials in 2025, and pairs trial-designated prosecutors with data analysts.
Trial capability also determines the quality of the pretrial record. Counsel preparing for a jury retains hospice and palliative care experts before the government’s theory hardens, litigates the admissibility and construction of utilization summaries, develops impeachment of cooperating employees, and preserves the instruction issues that separate a wrong prognosis from a knowingly false certification.
Armstrong & Bradylyons PLLC brings 25 federal jury trials in complex fraud cases, including 17 healthcare fraud trials at DOJ involving more than $2.8 billion in alleged false claims, and defends hospice providers in every federal district and before CMS nationwide.