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nyc criminal lawyers over 30 years of experienceWe Know How To Win Cases

Spodek Law Group handles tough cases
nationwide, that demand excellence.

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Faced 5+ Years in Prison

People Vs Joseph Amico

Covered by NYDaily News. Las Vegas man accused of threatening a prominent attorney and making vile remarks.

Faced 10+ Years in Prison

People Vs. Anna Sorokin

Covered by New York Times, and other outlets. Fake heiress accused of conning the city’s wealthy, and has an HBO special being made about her.

Faced 3+ Years in Prison

People Vs. Genevieve Sabourin

Accused of stalking Alec Baldwin. The case garnered nationwide attention, with USAToday, NYPost, and other media outlets following it closely.

Faced Potential Charges

Ghislaine Maxwell Juror

Juror who prompted calls for new Ghislaine Maxwell trial turns to lawyer who defended Anna Sorokin.

Why Choose Us

Clients can use our portal to track the status of their case, stay in touch with us, upload documents, and more.

Regardless of the type of situation you're facing, our attorneys are here to help you get quality representation.

We can setup consultations in person, over Zoom, or over the phone to help you. Bottom line, we're here to help you win your case.

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Meet Todd Spodek

WE PROVIDE WHITE GLOVE SERVICE TO CLIENTS
WHO WANT MORE FROM THEIR ATTORNEY

The Spodek Law Group understands how delicate high-profile cases can be, and has a strong track record of getting positive outcomes. Our lawyers service a clientele that is nationwide. With offices in both LA and NYC, and cases all across the country - Spodek Law Group is a top tier law firm.

Todd Spodek is a second generation attorney with immense experience. He has many years of experience handling 100’s of tough and hard to win trials. He’s been featured on major news outlets, such as New York Post, Newsweek, Fox 5 New York, South China Morning Post, Insider.com, and many others.

In 2022, Netflix released a series about one of Todd’s clients: Anna Delvey/Anna Sorokin.

Why Clients Choose Spodek Law Group

The reason is simple: clients want white glove service, and lawyers who can win. Every single client who works with the Spodek Law Group is aware that the attorney they hire could drastically change the outcome of their case. Hiring the Spodek Law Group means you’re taking your future seriously. Our lawyers handle cases nationwide, ranging from NYC to LA. Our philosophy is fair and simple: our nyc criminal lawyers only take on clients who we know will benefit from our services.

We’re selective about the clients we work with, and only take on cases we know align with our experience – and where we can make a difference. This is different from other law firms who are not invested in your success nor care about your outcome.

If you have a legal issue, call us for a consultation.
We are available 24/7, to help you with any – and all, challenges you face.

What Is Healthcare Billing Compliance?

The Importance of Proper Billing and Coding in Healthcare

Billing and coding are two of the primary ways healthcare providers such as doctors or hospitals can get in trouble. With the complexity of healthcare billing codes, mistakes are inevitable, which can cause problems such as under-billing, increased administrative costs to correct errors, and damaged professional relationships.

The Ramifications of Errors

A more serious problem occurs, however, when these errors trigger investigations of fraud. Whether the accusations come from private insurance carriers or from governmental programs like the Centers for Medicare & Medicaid (CMS), these simple mistakes could lead to severe penalties under the False Claims Act. Increasingly, these investigations can lead to criminal investigations and arrests for federal healthcare fraud.

The good news is that many of these mistakes are preventable. If a mistake still inevitably happens, it isn’t part of a larger pattern of abuse, so insurers are more likely to let you correct an error instead of filing charges.

The Scale of Healthcare Fraud

Medical billing is too complex, and too important, to take any chances. Each year, there is an estimated $400 billion of healthcare fraud. For this reason, there are a number of agencies aggressively pursuing and prosecuting these cases, including federal prosecutors, the Office of the Inspector General (OIG), the Department of Health and Human Services (HHS), the Medicare Fraud Strike Force, the Federal Bureau of Investigation (FBI), the Medicaid Fraud Control Unit, just to name a few.

These groups have specially trained federal investigators, outside investigative companies, and computer programs written to look for any “outliers.” These outliers show providers who have levels of billing outside the norm for their region and specialty, a high number of incorrect coding errors, or other red flags for fraud. For example, when comparing all doctors who perform hip replacement surgeries in Miami in a given year, are there a few doctors who consistently bill additional treatment outside the norm? Is there a pattern that could indicate bills are being padded, patients are receiving unnecessary treatment, or billing for work not even completed?

Types of Fraudulent Billing Charges

A few examples of fraudulent billing charges include:

  • Billing for Services Not Provided – Billing for a procedure that wasn’t provided, or charging for a more expensive piece of equipment than was actually used.
  • Billing for Medically Unnecessary Services – Performing services on patients that don’t meet the treatment criteria.
  • Billing for Mutually Exclusive Services – Billing for two different procedures that can’t be performed simultaneously, or services that are medically impossible such as gender-exclusive procedures.
  • Billing Unreasonably High Levels of Care (Upcoding) – Charging for more serious and expensive treatments than necessary.
  • Billing for Services Not Covered – Billing insurer for services that are excluded under the policy.
  • Failing to Collect Copays – Routinely waiving copays is considered fraud because it creates a false image of the actual service charges. For example, if your patient has a $20 copay, the insurance company pays $80 on a $100 charge. If you waive the copay, then the bill was actually only $80, not $100, and the insurance company should only pay $60.
  • Billing for Out-of-Network Services – Submitting bills that aren’t qualified because the treatment is considered out-of-network.

For the healthcare provider, this high level of scrutiny means that you can’t make mistakes. You have to ensure that your business is organized and keeps accurate records to prevent violating the False Claims Act. Or at least that any small mistakes don’t end up looking like criminal fraudulent activity.

Call us today to learn how we can implement your billing and compliance protocols to protect you from mistakes that could lead to criminal investigations and prosecutions. Keep in mind that criminal and civil investigations of healthcare fraud carry significant penalties, including lengthy prison terms, loss of your medical license, CMS exclusion, and large monetary penalties, all meaning the end of your career at the very least. You need an experienced attorney to help you navigate the complicated world of medical billing so you can rest easy.

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Testimonials

I was searching for a law firm with some power to help me deal with a warrant in New York . After 6 days I decided to go with Spodek Law Group. It helped that This law firm is well respected by not only the top law firms in New York , but the DA , Judge as well. I...

~Fonder Brandon

5 Stars
It was my good fortune to retain Spodek Law Group for representation for my legal needs. From the beginning, communication was prompt and thorough. Todd, Kenneth and Alex were the first people I worked with and they all made me, and my company Qumana skincare feel comfortable and confident that the team was going to work hard for me. Everything...

~A G

5 Stars
After meeting with several law firms, I chose the Spodek Law Group not only for their professionalism and experience, but for the personal attention given to me right from the initial consultation. It is important to recognize how crucial having the right legal team is when faced with potentially life altering events that impact families and the lives of loved...

~George Cherubini

Spodek Law Group

White Glove Service

We Provide Superior Service, Excellent Results, At A Level Superior To Other Criminal Defense Law Firms. Regardless Of Where Your Case Is, Nationwide, We Can Help You.
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