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Medical Necessity Conflicts Can Lead to a Medicare Abuse Investigation

White Collar Criminal Defense By Harvey Binnall PLLC - 2018/05/24 at 08:46am

Healthcare professionals and organizations often struggle with adhering to the rather complicated, multi-pronged regulatory schemes that — together — establish Medicare fraud and abuse liability under the law.  Medicare abuse (in particular) has been a unique challenge for various healthcare professionals and entities, as the government is increasingly taking advantage of the “subjective” nature of Medicare abuse determinations and imposing civil and criminal penalties at their discretion. What is Medicare Abuse, Exactly? Medicare abuse is any practice — systemic or irregular — that imposes unnecessary and unjustified costs on the Medicare Program.  Though Medicare abuse is generally less severe of […]

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Bank Fraud Requires an Intent to Defraud

White Collar Criminal Defense By Harvey Binnall PLLC - 2018/05/17 at 08:40am

If you have been charged with bank fraud, you may be feeling somewhat overwhelmed — after all, despite the fact that bank fraud is defined as a white collar crime, conviction carries significant criminal and civil penalties.  In fact, the federal bank fraud statute outlines penalties of up to $1M in fines and up to 30 years imprisonment.  Given the high-stakes nature of such litigation, it’s important that you get in touch with a team of qualified criminal defense attorneys as soon as possible. Here at Harvey & Binnall, PLLC, our attorneys understand the unique texture of white collar criminal […]

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When is an Unjust Enrichment Claim Relevant to a Commercial Dispute?

Business and Commercial Disputes By Harvey Binnall PLLC - 2018/05/10 at 08:35am

If you’re involved in a commercial dispute with one or more parties, you may be wondering about the potential damages recoverable for “unjust enrichment” and what it actually means for your case. What is unjust enrichment? Stated simply, unjust enrichment is a claim that is based on the idea that the defendant — the breaching party — has somehow gained an advantage by virtue of their conduct, and that this has led to a fundamentally unfair situation.  If the court were to allow the defendant to keep this advantage (usually in the form of obtained assets, financial or otherwise), then […]

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DOJ Intensifies Focus on Healthcare Fraud

White Collar Criminal Defense By Harvey Binnall PLLC - 2018/05/08 at 07:34pm

If anyone wondered which white-collar crime issues would attract special Department of Justice interest during the Trump administration, they now have a tentative answer. In July 2017, 412 individuals in 41 different parts of the country were charged with $1.3-billion worth of health care fraud schemes involving false billings to Medicare and Medicaid, as well as overprescribing opioids and other dangerous narcotics. In a parallel action undertaken at the same time, the Department of Health and Human Services (HHS) launched suspension actions against 295 individual providers including doctors, nurses and pharmacists. The medical profession, hospitals and pharmacies, and the pharmaceutical […]

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