Federal Healthcare Fraud and Illegal Prescribing Charges: Intent, Medical Necessity, and Defense Strategies
Missouri physician indicted on 38 federal counts combining healthcare fraud with illegal prescribing of Adderall, benzodiazepines, and hydrocodone. Analysis of the government's burden on intent after Ruan v. United States, medical necessity defenses for non-opioid controlled substances, supervision fraud theories under 18 U.S.C. § 1347, and why trial readiness matters in dual-theory prosecutions. By former DOJ ARPO Strike Force director.
Home Health Certification in Federal Fraud Cases: OASIS, Homebound Status, Face-to-Face Encounter
Analysis of the Medicare home health certification process in federal criminal fraud cases. Covers the face-to-face encounter under 42 C.F.R. 424.22, OASIS assessment scoring under PDGM, homebound status certification, CMS-485 physician certification, LCD compliance, and defense strategies including cross-examination of beneficiary witnesses who received undisclosed kickback payments. By former DOJ Fraud Section prosecutors.