Recent Blog Posts
Top 10 Red Flags Prosecutors Look for in Healthcare Billing Audits
Healthcare billing audits are often viewed as administrative matters focused on reimbursement, documentation, and compliance. However, some audits evolve into something far more serious. When auditors uncover findings that suggest intentional misconduct rather than simple mistakes, those findings may be referred to federal or state prosecutors for criminal investigation. For healthcare providers, physicians, clinic… Read More »
The Impact of Making False Statements to Federal Officers in Healthcare or Financial Fraud Cases
The Law Offices of Stanley L. Friedman represents individuals and businesses in Los Angeles facing serious white-collar criminal investigations, including healthcare fraud and financial fraud matters. One of the most overlooked but highly consequential charges that can arise in these investigations involves making false statements to federal agents or agencies. While the underlying fraud… Read More »
How Coding Errors Can Lead to Fraud Investigations — and Defenses
Healthcare billing is one of the most complex administrative systems in the United States. Physicians, clinics, hospitals, and other healthcare providers must navigate thousands of diagnostic and procedural codes while complying with constantly evolving Medicare, Medi-Cal, and private insurance regulations. In this environment, coding mistakes are not uncommon. But when regulators or prosecutors believe… Read More »
Why Whistleblower Retaliation Claims Can Complicate Fraud Defense
Healthcare fraud investigations are rarely straightforward. In many cases, they are driven not only by data analytics and audits, but also by insiders such as employees, former employees, or business partners who come forward with allegations of wrongdoing. These individuals are often referred to as whistleblowers, and when they claim they were retaliated against… Read More »
What to Expect When Facing an OIG Investigation
Healthcare providers who participate in Medicare, Medi-Cal, or other federally funded programs operate under constant regulatory oversight. Among the most powerful enforcement bodies in this space is the Office of Inspector General, commonly referred to as the OIG. When the OIG initiates an investigation, it is rarely routine, and it is never something to… Read More »
Do Miranda Rights Apply to Healthcare Fraud Investigations?
Healthcare fraud prosecutions rarely begin with flashing lights or dramatic arrests. More often, they start quietly, with audit letters, document requests, or phone calls from investigators. By the time a healthcare provider realizes the seriousness of the situation, federal agents may already have spent months or even years building a case. One of the… Read More »
Los Angeles Healthcare Fraud Defense Attorney Quoted in Politico Article
Stanley L. Friedman was interviewed for an article recently published by the politics and policy news publication Politico. The article concerns the increased scrutiny and potential rise in prosecutions of Medicaid fraud coming from the federal government, primarily regarding reimbursement claims for home and community-based services. As a former Assistant U.S. Attorney in the… Read More »
Understanding “Upcoding”: What It Is and Why It’s Prosecuted
Healthcare providers operate in a complex billing environment where thousands of services must be coded accurately in order to receive reimbursement from government healthcare programs such as Medicare and Medi-Cal. While coding errors sometimes occur unintentionally, federal and state authorities take a particularly aggressive stance toward a practice known as upcoding. When investigators believe… Read More »
Data Analytics and Billing Spikes Lead to Federal Healthcare Fraud Investigations in California
Dr. Mehmet Oz’s recent letter to Governor Newsom in January has put the state in the position where it must now step up investigations and prosecutions of healthcare fraud. In the letter, Dr. Oz emphasized explosive growth in certain Medi-Cal billing categories. Behind that language lies a critical reality for healthcare providers: modern healthcare… Read More »
CMS Puts California on Notice
What Dr. Oz’s Letter to Governor Newsom Means for Healthcare Providers In a highly publicized letter to Governor Gavin Newsom, the Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz signaled intensified federal scrutiny of California’s Medi-Cal system. The letter, directed to state leadership but clearly intended for a broader audience, alleges… Read More »