Attorney Andrew S. Feldman Addresses Uptick in Prosecutions of Physicians on Health Care Fraud and Abuse Panel at ABA’s 29th Annual National Institute on White Collar Crime in New Orleans
Earlier this month, Andrew S. Feldman from the Feldman Firm in Miami, Florida addressed the uptick in prosecutions of physicians at the ABA’s 29th Annual National Institute on White Collar Crime in New Orleans. The National Institute has been attended by leading federal and state judges and prosecutors, law enforcement officials, defense attorneys, corporate in-house counsel, and members of the academic community
During the panel discussion, Mr. Feldman stressed that the government is now, more than ever, prosecuting and investigating individual physicians, including cardiologists, dermatologists, ophthalmologists, and others for performing what they view as “medically unnecessary” procedures or tests.
Further, Mr. Feldman highlighted that, in these prosecutions, the “cover up is generally the crime.” Mr. Feldman also drew a key distinction between two experts battling over the necessity or reasonableness of a particular procedure and the scenario where the government unearths evidence that diagnosis codes or documentation supporting a particular procedure (e.g. a cardiac stent) was intentionally altered or falsified. “This is no longer a battle of the experts type of scenario and the issue is no longer whether or not the doctor should or should not have performed a particular procedure or even whether there was a substantial deviation from a medically accepted standard ..because in those situations, all you have is negligence.”
The esteemed panel also featured Walmart General Counsel, Karen Davila, and Chief Assistant of the Department of Justice’s Fraud Section, Gejaa Gojeeba. During the Health Care Fraud and Abuse panel, panelists addressed some of the following topics:
- Fraud and abuse related to hospice care, skilled nursing facilities, compounding pharmacies, ambulatory surgical centers, independent clinical laboratories, and managed care plans;
- Prosecution of pharmaceutical companies, medical device manufacturers, and sales representatives for off-label marketing;
- Enhanced communication between Civil and Criminal Divisions of the Department of Justice and the DOJ’s new procedure for reviewing qui tam actions;
- Impact of new publicly available information concerning physician payments via Centers for Medicare and Medicaid Services (CMS), including Open Payments and the Medicare Provider Utilization and Payment Data; and
- New “super cooperation” requirement for corporations seeking declinations of prosecution or Corporate Integrity Agreement.