EIDBI Autism Fraud: DOJ Charges Smart Therapy and Star Autism Owners in $46.6M Indictment
A federal grand jury indicted Shamso Ahmed Hassan and Hanaan Mursal Yusuf in the largest Medicaid autism fraud case ever charged by DOJ. The $46.6 million scheme allegedly defrauded Minnesota's EIDBI Program through hidden ownership, kickbacks to parents disguised with the code word "computer," and billing for services that were never provided.
Minnesota HSS Program Fraud: $15.7M Medicaid Takedown
The Justice Department charged eight defendants in the Minnesota Housing Stabilization Services Program Medicaid fraud takedown, alleging $15.7 million in false claims. The four cases reveal the federal charging theories now driving Medicaid waiver enforcement nationwide, including fraud tourism, conspiracy under 18 U.S.C. section 1349, and substitute asset forfeiture. Former DOJ Fraud Section prosecutors Scott Armstrong and Drew Bradylyons analyze the indictments.
Skin Substitute Fraud Defense: U.S. v. Ellsworth Analysis
Defense analysis of the May 2026 Ellsworth skin substitute fraud indictment. Analysis of the indictment, which includes No kickback counts, and medical necessity allegations.
DOJ Launches West Coast Health Care Fraud Strike Force: Federal Investigations in Arizona, Nevada, and Northern California
DOJ's Fraud Division announced the West Coast Health Care Fraud Strike Force on April 30, 2026, covering the District of Arizona, District of Nevada, and Northern District of California. Analysis of the $1.2 billion wound graft fraud prosecution, the $100 million Adderall telehealth fraud conviction, and the $650 million substance abuse Medicaid fraud indictment driving the expansion. How Strike Force investigations are built through data analytics, grand jury subpoenas, covert search warrants, and cooperating witnesses. Criminal statutes charged in Strike Force indictments including 18 U.S.C. 1347, the Anti-Kickback Statute, EKRA, and 21 U.S.C. 841. Defense considerations for individuals under investigation or facing indictment in Strike Force districts.
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.
Operation Never Say Die: Federal Hospice Fraud Arrests and CMS Payment Suspensions
Eight defendants arrested and 221 hospice providers suspended in Operation Never Say Die. Analysis of the federal charges, CMS payment suspension procedures under 42 C.F.R. 405.371, and the strategic risks of responding to a suspension notice while a parallel DOJ criminal investigation may be active.
Hospice Fraud: On the Law-Enforcement Horizon
Federal hospice fraud investigations are escalating in 2025 and 2026. Scott Armstrong and Drew Bradylyons, two former Assistant Chiefs at DOJ’s Fraud Section, explain the scrutiny, investigations, and charges that hospice executives and certifying physicians face in these cases.