Last week, I read a lengthy article about a new DOJ indictment involving nearly 200 individuals, including doctors, nurses, and other medical professionals, charged with participating in various health care fraud schemes. The scope of the indictment is staggering, with accusations of around $2.7 billion in intended losses and $1.6 billion in actual losses. Reading the DOJ’s statement, I was immediately taken back to my time as a defendant, dealing with the shock and confusion of being under investigation.

When you see your name against the United States of America, the initial shock is profound. I understand this feeling deeply because I’ve been there myself. It’s a moment filled with disbelief, fear, and confusion. In those initial stages, many people react poorly (to proof this point, read Lessons From Prison)—they feign ignorance, blame others, and in so doing, miss opportunities to get the best outcome possible.

The truth is, once someone someone becomes a target the government views you not as a professional or a community leader, but as a criminal. This harsh reality is difficult to accept, but recognizing it early can help you navigate the investigation more effectively.

The Origins of Government Investigations

Government investigations often begin long before you are aware of them. They can be triggered by various factors, such as whistleblowers, audits, or data analysis. Understanding this can help you grasp why and how you became a target.

In the recent DOJ case, it’s clear that extensive investigations were conducted before charges were brought. The indictment highlights schemes involving unnecessary medical procedures, fraudulent billing to Medicare, and distribution of controlled substances. The government’s goal is to protect public funds and ensure that medical professionals adhere to ethical standards.

Without effective mitigation, some of the sentences in this case will be very long.

Key Points:

  • Investigations are thorough and detailed (some defendants have been cooperating in this case for a while now).
  • They are driven by data and evidence collected over time.
  • The government’s goal is to build a strong case before making their move.
  • The government has endless resources to prove its case and will punish those who exercise their right to go to trial. As I told Dr. Phil in April 2019, “Once you are in the criminal justice system, it is hard to emerge unscathed.”

Preparing for Charges and Sentencing

Given the gravity of the situation, it’s essential to prepare for the inevitability of more charges, a plea, a conviction at trial, and an eventual sentencing hearing. Early preparation can significantly affect the outcome. Those who take proactive steps are often better positioned to achieve favorable results. Yet you can expect some defendants to wait and do nothing. Others will act and work to demonstrate why they are different than the DOJ’s scathing indictment.

In the case of the recent indictment, those charged must understand that the DOJ views health care fraud as its biggest white collar crime priority, especially when it involves Medicare fraud and the mistreatment of patients.

“It does not matter if you are a trafficker in a drug cartel or a corporate executive or medical professional employed by a health care company, if you profit from the unlawful distribution of controlled substances, you will be held accountable,” Attorney General Merrick B. Garland said in the news release. “The Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.”

Preparing now can make a significant difference in the final outcome.

Key Points:

  • Start preparing immediately for the charges and sentencing.
  • Understand the government’s perspective and build your strategy accordingly.
  • Use this time to gather evidence, find support, and plan your response.

Discussion Question

If you are a target or under indictment, how are you responding?

Justin Paperny

P.S. Our next blog will discuss the importance of hiring the right lawyer to help you guide you.