18 U.S.C. § 1347 Healthcare Fraud: Elements, Defenses, and Federal Enforcement
18 U.S.C. § 1347 is the lead charge in nearly every federal healthcare fraud case. Former DOJ Fraud Section prosecutors Scott Armstrong and Drew Bradylyons break down the four elements the government must prove, why a Medicare rule violation is not a crime, why good faith is a complete defense, and how prosecutors pair the statute with 18 U.S.C. § 1035 and the Anti-Kickback Statute.
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.