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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


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 Medicare Fraud


What Is Medicare Fraud?

Medicare fraud refers to intentionally deceiving Medicare in order to receive unauthorized payments or benefits. It is a serious crime that costs taxpayers billions of dollars each year and can put beneficiaries’ health at risk[1]. Some common examples of Medicare fraud include[1][2]:

  • Billing for services or medical equipment that were never provided
  • Billing for unnecessary services that are not medically needed
  • Misrepresenting non-covered treatments as medically necessary
  • “Upcoding” – billing for more expensive services than were actually performed
  • Accepting kickbacks for patient referrals
  • Waiving patient co-pays and overbilling Medicare
  • Using a Medicare beneficiary’s identity to submit false claims
  • Prescribing unnecessary medication to profit from reimbursements

Medicare fraud can be committed by doctors, hospitals, pharmaceutical companies, medical equipment suppliers, and even by beneficiaries themselves. Healthcare providers and organizations involved in fraud may face criminal charges, civil monetary penalties, exclusion from Medicare, and loss of medical license[1].

Major Types of Medicare Fraud

Some of the most common types of Medicare fraud include[1][2][3]:

Billing for Services Not Performed

This basic scam involves billing Medicare for services, tests, or equipment that were never actually provided. Examples include billing for phantom patients, fake diagnoses, fictitious appointments, and unnecessary ambulance rides.

Misrepresenting Non-Covered Treatments

Providers disguise treatments that Medicare does not cover, such as cosmetic procedures, as medically necessary covered services.

Upcoding Services

Billing for more complex and expensive services than were actually performed. For example, billing a basic doctor visit as an extensive medical evaluation.

Unbundling Charges

Breaking apart a procedure into multiple billable components instead of billing as a single service. This leads to higher reimbursements.

Kickbacks for Referrals

Doctors or clinics receive illegal kickbacks in exchange for referring patients to a particular hospital, pharmacy, or medical equipment supplier. This drives up unnecessary costs.

Identity Theft

Fraudsters steal Medicare beneficiaries’ personal information to illegally bill services or file fake claims under their names and numbers.

Prescription Drug Schemes

Doctors overprescribe medications for kickbacks from pharmaceutical companies, or prescribe unnecessary drugs and bill Medicare.

Home Health Care Fraud

Home health agencies bill for services that patients didn’t qualify for or never received. Agencies recruit patients for unnecessary care.

Major Medicare Fraud Laws

The government has passed strict laws to combat rampant Medicare fraud and abuse[4]:

False Claims Act (FCA)

This civil law imposes penalties on any person or company that knowingly submits false claims to the government for reimbursement. Violators face fines of $11,000 – $22,000 per false claim.

Anti-Kickback Statute (AKS)

AKS prohibits knowingly paying or receiving bribes, kickbacks, or other “remuneration” to induce referrals for federal healthcare program business. Violations are felonies punishable by fines up to $25,000 and five years in prison.

Physician Self-Referral Law (Stark Law)

This prohibits doctors from referring Medicare patients to facilities in which they or their family have a financial interest, unless an exception applies. Penalties include denial of payment, refunds of claims, and civil monetary penalties.

Exclusion Statute

This requires the exclusion of healthcare providers convicted of Medicare fraud from participating in federal health programs. Providers may be excluded permanently or for a period of years based on the offense.

Civil Monetary Penalties Law (CMPL)

The CMPL authorizes civil penalties for different fraudulent and abusive acts, such as paying kickbacks, violating the Stark Law, and billing for unnecessary services. Fines range from $15,000 – $70,000 per violation.

How to Prevent Medicare Fraud

Doctors, healthcare organizations, and beneficiaries can take steps to prevent fraud[1][5]:

  • Carefully review Explanation of Benefits statements and Medicare Summary Notices for errors.
  • Avoid using providers who offer free services, waive copays, or guarantee specific medical equipment in exchange for Medicare numbers.
  • Protect Medicare card and number. Treat card like a credit card.
  • Report suspicious claims or activities to 1-800-MEDICARE or Medicare’s fraud hotline.
  • Exercise caution providing identifying info over phone, email, or door-to-door.
  • Verify provider credentials and check for disciplinary actions.
  • Implement compliance programs to ensure billing procedures adhere to regulations.
  • Conduct internal audits to identify improper billing and claims.

Penalties for Medicare Fraud

Medicare fraud can lead to severe criminal, civil, and administrative punishments[1]:

Criminal Penalties:

  • Felony conviction
  • Imprisonment – sentences typically 1 to 10 years
  • Fines from $10,000 to $250,000 per offense

Civil Penalties:

  • False Claims Act – triple damages, fines of $11,000 – $22,000 per false claim
  • Civil Monetary Penalties – fines from $15,000 – $70,000 per violation

Administrative Sanctions:

  • Exclusion from Medicare and other federal health programs
  • Loss of medical license
  • Repayment of fraudulent claims

Recovering improperly paid funds is a top priority. Providers may have payments suspended pending fraud investigations.

The Costs of Medicare Fraud

Medicare fraud drains critical resources from taxpayers and the healthcare system[2]:

  • The Centers for Medicare and Medicaid Services (CMS) estimates that fraud accounts for 10% of total healthcare expenditures, around $163 billion per year.
  • Between $31 and $59 billion is lost specifically due to Medicare fraud annually.
  • Fraudulent activities lead to higher healthcare costs and insurance premiums for consumers.
  • Funds lost to fraud result in reduced access to care for beneficiaries.
  • Patient health is put at risk when subjected to unnecessary treatments, services, and medications.
  • Tax dollars lost to fraud could be used for other essential government healthcare programs and services.

How the Government Combats Medicare Fraud

Federal and state agencies are employing new technologies and increased collaboration to combat Medicare fraud[2][5]:

  • CMS uses data analysis to identify and stop fraudulent billing patterns.
  • The Department of Justice (DOJ) has increased prosecution of fraud cases.
  • The Health Care Fraud Prevention and Enforcement Action Team (HEAT) allows agencies to share data to detect and prevent fraud.
  • Medicare Fraud Strike Forces allow rapid response to fraud using data analysis and multi-agency collaboration.
  • The Center for Program Integrity coordinates efforts to screen providers, monitor billing, and build fraud cases.
  • Increasing use of screening technology, like fingerprinting, helps verify provider identities and credentials.
  • Whistleblower rewards encourage insiders to report fraud.
  • The Senior Medicare Patrol recruits retired professionals to educate beneficiaries on protecting themselves from fraud.

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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...

~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

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