If you’ve been contacted by a federal agency or received a target letter related to healthcare fraud, Seek legal advice promptly for charges to be filed. Early legal intervention can often protect your career, your business, and your freedom. Healthcare fraud is one of the most aggressively prosecuted white-collar crimes in Miami and across Florida.
These investigations often involve Medicare or Medicaid billing audits, whistleblower complaints, or undercover operations. You could be accused of false claims, upcoding, unbundling, or kickback violations—even if you weren’t directly involved in the billing process. Once the DOJ or OIG is involved, you need an attorney familiar with both healthcare law and federal criminal procedure.
At Beaton Law Firm, we represent doctors, nurses, practice owners, and healthcare executives. Our goal is to intervene early, reduce exposure, and resolve the matter before it reaches indictment. If charges are filed, we build an aggressive, trial-ready defense strategy to protect your license and reputation.
What to Do After Receiving a Target Letter or Request
Preserve billing records, patient files, compliance policies, employee communications, audit materials, and electronic data in their original form. Do not delete records, alter a chart, or provide an unprepared interview. Counsel can review the request, identify deadlines, and coordinate a response with compliance professionals without sacrificing the legal analysis.
Issues a Defense Review May Examine
The review may address who created or approved a claim, what information was available at the time, whether a coding decision was supported, and how the government obtained the records. A person’s role in a practice does not answer those questions by itself. The DOJ Health Care Fraud Section and HHS-OIG fraud resources explain the agencies’ enforcement roles, but neither source determines the facts of a particular investigation.
Protecting Professional and Business Interests
An investigation may create parallel licensing, employment, payer, or business concerns. A coordinated plan should identify which communications are urgent, which records need preservation, and whether separate counsel or compliance advice is needed. The response should remain accurate and based on the evidence rather than assumptions about what investigators want to hear.
Separate a Records Request From a Criminal Charge
Healthcare matters can involve audits, overpayment questions, document requests, administrative action, civil proceedings, or criminal investigations. Preserve the notice, clinical records, billing data, coding support, communications, and available audit trails in their original form. A collection log should identify where each record came from, the date it was obtained, and whether it was produced. Do not amend historic records after receiving an inquiry; keep any later explanation separate from the contemporaneous file.
Review the Scope of the Request
The Justice Department’s Health Care Fraud Section describes its work generally. An individual matter still depends on its specific notice, statute, and evidence. Confirm the patient, service period, provider, format, and deadline named in the request, and retain a copy of what is submitted with proof of delivery.
Where another entity holds a record, retain the request for the source copy and its response. Note the custodian and the date of every production.