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.
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.