Intent is a critical element examined in both civil and criminal healthcare fraud investigated by the government. To determine whether a provider’s actions were conducted with bad intent, federal and state prosecutors will review both traditional sources of data (medical records, billing records, etc.) and a wide variety of evidential sources during their investigation, including emails, voicemails, social media, instant messages, purchasing and charge card records, and any systems data or metadata from any electronic device.
Because e-mails, text messages, and social media posts can be easily misconstrued or misinterpreted, this can present problems for providers should they ever find themselves the subject of an administrative, civil, or criminal investigation.
Join Regina G. Morano, J.D., and Robert W. Liles, J.D., M.B.A., M.S., as they review the compliance risks inherent in the daily activities of doing business in a modern world, and what proactive steps providers need to take to stay ahead of risk.
Paul Weidenfeld, J.D., is a former federal prosecutor and National Health Care Fraud Coordinator for the Department of Justice. His principle areas of practice are health care fraud and abuse and the Federal False Claims Act, and he has represented providers and individuals in health care matters since leaving government in 2006. Recognized for his efforts both as a prosecutor and as defense counsel, Paul has also trained extensively in the field of Alternative Dispute Resolution and mediation and is certified as a mediator in Louisiana and Virginia. In 2014, Paul co-founded Exclusion Screening, LLC in order to help healthcare providers navigate the difficulties and issues related to the screening for excluded individual and entities in all of the federal and state exclusion registries.
Robert W. Liles, J.D., M.B.A., M.S., of Liles Parker, PLLC holds both an M.B.A. and M.S. in Health Care Administration, in addition to a law degree. Robert has worked on the provider side as a federal prosecutor and now represents health care providers around the country in Medicare / Medicaid / Private Payor audits, state board of licensure actions, and False Claims Act cases. He currently serves as an IRO on Corporate Integrity Agreements for the Office of Inspector General. While working as a federal prosecutor, Robert was asked to serve as the country’s first National Health Care Fraud Coordinator for the Executive Office for U.S. Attorneys, advising federal prosecutors around the country regarding health care fraud statutes, schemes, investigative tools, privacy concerns, and compliance issues. Since entering private practice, Robert has continued to build on his health care background and experience. Robert has been rated “AV” by Martindale-Hubbell.