Our team at Weaver Johnston & Nelson, PLLC has handled white collar matters including indictments and allegations of fraud, violations of the Anti-Kickback Statute, False Claims Act violations, money laundering, tampering with governmental records, drug offenses, and various other matters. In particular, attorney Jason Knutson has extensive experience in white collar cases, beginning with his work in Austin with the Travis County District Attorney’s White Collar Division and then with the United States’ Department of Justice’s Fraud Section where he focused on healthcare fraud.

 

Areas of Focus

One of the statutes most commonly used by the federal government in criminal prosecutions of medical providers and related entities is the healthcare fraud statute. This statute makes it a violation to devise a “scheme or artifice to defraud” a government healthcare program, including Medicare, Medicaid, and Tricare. Because of the broadness and ambiguity of the language “scheme or artifice to defraud,” government investigators and prosecutors can mistakenly interpret a legitimate business plan as a “scheme” so it is important to hire a law firm experienced in all facets of healthcare law. Various agencies of the federal government investigate healthcare fraud—primarily the Federal Bureau of Investigation (FBI), the U.S. Department of Health and Human Services, and the Office of Inspector General (HHS-OIG).  A person convicted of healthcare fraud can serve up to ten years in prison, and be fined up to $250,000, and can be excluded from the Medicare program. 

Any person who knowingly presents a false or fraudulent claim to the U.S. government for payment is liable for substantial penalties, plus three times the amount of damages sustained by the government because of that claim. The U.S. Department of Health and Human Services, the Office of Inspector General (HHS-OIG), the Centers for Medicare and Medicaid Services (CMS), and the FBI commonly investigate alleged violations of the False Claims Act. They do so in conjunction with local United States Attorney’s Offices and the Department of Justice in Washington, D.C. Because of the heavy penalties involved, it is it is important for medical providers to have knowledgeable and experienced representation to defend against False Claim Act allegations.

The federal Anti-Kickback Statute is also commonly used by the federal government in criminal prosecutions against medical providers and entities. It prohibits the exchange of remuneration, or anything of value, in return for referring an individual or providing items or services for which payment may be made under a federal healthcare program. The penalties are very stiff for medical providers who violate this statute. Violators can be fined up to $25,000.00 and excluded from the Medicare and Medicaid programs, as well as face prison time. Medical providers have to tread very carefully in conducting their daily business to be sure they comply with this statute. We assist providers in responding to violations of the Anti-Kickback statute and ensuring that they comply with the requirements of this statute.

Often a company is not aware someone within the company is committing acts in violation of criminal or civil statutes.  In many instances, it is prudent for a company to get ahead of government investigations by having a law firm conduct an internal investigation.  Weaver, Johnston, and Nelson has a team of attorneys that are experienced and proficient in criminal, civil, and transactional law.  Accordingly, our firm can conduct internal investigations—protected by the attorney-client privilege—to ensure that everyone in the company is complying with federal and state rules and regulations, and to advise the company on the best course of action should they discover areas of concern.     

Both the State of Texas and the federal government investigate corruption by government officials and employees. Those investigations may include allegations of obstruction of justice, making false statements, elections crimes, fraud, theft, criminal civil rights violations, tax crimes, firearms offenses, and drug charges. 

Money laundering involves disguising the criminal nature of financial assets to make those assets appear legitimate. The federal government uses a multitude of agencies to enforce various money laundering statutes. Money laundering charges often accompany various other white collar charges such as healthcare fraud, bank fraud, and wire fraud.  The penalty for federal money laundering carries a sentence of up to twenty years in prison and a $500,000 fine.

Wire fraud is any scheme to defraud another person that uses electronic communications, either across state lines or internationally. It is closely related to the federal offense of mail fraud, which involves any fraud offense committed with the use of the U.S. mail or other interstate carriers.  Wire fraud is commonly charged along with other fraud-related offenses and carries the penalties of up to twenty years in prison, and a $250,000 fine. 

Although it is lawful for a physician to issue prescriptions, and a pharmacist to fill prescriptions for legal controlled substances, federal law deems the writing or filling of prescriptions that are “outside the usual course of professional conduct, or without a legitimate medical purpose” as criminal.  The punishment for doing so is based upon the weight of the controlled substance, and a person can receive up to a life sentence if the government can prove that a certain amount of controlled substances were distributed.  Because of the opioid crisis, the federal government has emphasized these prosecutions during the last few years.  In particular, the government has ramped up the prosecution of physicians and pharmacists, clinics and pharmacies, and related individuals and entities, for the prescribing of various opioids, including the Schedule IV controlled substances oxycodone, hydrocodone, oxymorphone, and hydromorphone.  In fact, the DEA has several “Tactical Diversion Squads” across the country that are tasked specifically with investigating the illegal distribution of pharmaceutical drugs. Recently, the FBI has also tasked special agents with investigating these crimes. Weaver, Johnston, and Nelson attorney Jason Knutson has had extensive experience working on these cases, and can assist clients in handling these serious charges. 

The State of Texas tasks various government agencies to investigate white-collar crime. Among those are the Texas State Auditor’s Office, the Texas State Comptroller’s Office, the Texas Attorney Generals Medicaid Fraud Control Unit (MFCU), and the Texas Rangers. Those agencies investigate various criminal offenses, including fraud, healthcare fraud, tax fraud, bribery, conspiracy, securing the execution of a document by deception, and tampering with a governmental record. Our firm has extensive experience dealing with these agencies and can help clients defend against investigations by the State of Texas.