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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.

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

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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.

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New York Healthcare Fraud Lawyers

By Spodek Law Group | July 27, 2023
(Last Updated On: October 13, 2023)

Last Updated on: 13th October 2023, 01:54 pm

What Constitutes Healthcare Fraud in New York?

Healthcare fraud involves intentionally deceiving or misrepresenting information to obtain reimbursement or payments from government healthcare programs like Medicare and Medicaid. There are several degrees of healthcare fraud charges in New York:

  • 1st Degree – Defrauding over $1 million in one year – Felony with 1 to 25 years in prison
  • 2nd Degree – Defrauding up to $50,000 in one year – Felony with up to 15 years in prison
  • 3rd Degree – Defrauding over $10,000 in one year – Felony with up to 7 years in prison
  • 4th Degree – Defrauding over $3,000 in one year – Felony with up to 4 years in prison
  • 5th Degree – Any amount defrauded – Misdemeanor with up to 1 year in jail

Common Healthcare Fraud Allegations

Some of the most common allegations of healthcare fraud include:

  • Billing for services not performed – This involves billing for medical services, tests, or procedures that were never actually done.
  • Upcoding – Billing for more expensive services than were actually performed to obtain higher reimbursements.
  • Billing for unnecessary services – Performing and billing tests, services or procedures that are not medically needed.
  • Identity theft – Using a patient or provider’s insurance information to submit fraudulent claims.
  • Prescription fraud – Writing unnecessary prescriptions, altering prescriptions, or self-prescribing controlled substances.

Gathering Evidence and Building a Defense

The key to defending healthcare fraud charges is gathering evidence to show you did not intentionally commit fraud. An experienced attorney can help collect:

  • Medical records – These show what services were actually provided and if they were medically necessary.
  • Billing records – Review records for errors that led to incorrect billing.
  • Witness statements – Interview staff to show billing was done properly per protocol.
  • Expert opinions – Have other doctors review records to assess medical necessity.
  • Compliance program – Demonstrate you had a program to prevent fraud and errors.

Common Defenses in Healthcare Fraud Cases

Some potential defenses your attorney may use include:

  • Lack of intent – If errors were unintentional, it was not fraud.
  • Billing mistakes – Show the wrong code was used or other clerical errors caused overbilling.
  • Medical necessity – Have doctors testify services were necessary for proper care.
  • Lack of knowledge – You were unaware of improper billing by staff members.
  • Compliance program – Demonstrate efforts were made to comply with regulations.

Tips for Finding the Right New York Healthcare Fraud Lawyer

Finding an attorney experienced in healthcare law is crucial for building a strong defense. Consider these tips:

  • Specialization – Find lawyers focused specifically on healthcare fraud, not general fraud.
  • Experience – Look for extensive experience defending healthcare fraud cases.
  • Resources – Choose a law firm with the resources to do a full investigation.
  • Reputation – Select an attorney with a solid reputation and proven results.
  • Communication – Find a lawyer who is responsive and explains things clearly.
  • Strategy – Pick a lawyer who develops creative defense strategies tailored to your case.
  • Fees – Discuss fee structures to find one that fits your budget.

What to Do If You Are Under Investigation

If you receive a subpoena or learn you are under investigation for healthcare fraud, be sure to:

  • Consult an attorney – Do not speak to investigators without an attorney present.
  • Preserve records – Do not destroy any records requested in the subpoena.
  • Remain silent – Do not try to explain anything or make statements about the case.
  • Review billing – Work with your lawyer to proactively review billing for errors.
  • Cooperate – While asserting your rights, cooperate respectfully with the investigation.

Take Your Defense Seriously

Healthcare fraud convictions can result in enormous fines and years in prison, as well as loss of licensure and exclusion from government programs. Building an strong defense requires working diligently with an experienced attorney. Thoroughly investigate the facts of your case and understand the relevant healthcare regulations. With the right legal strategy and advocacy, many healthcare providers can resolve these cases favorably. Do not leave the fate of your practice and reputation to chance – consult a dedicated New York healthcare fraud lawyer.

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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...

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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...

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