Understanding Aggravated Identity Theft in Health Care Fraud

We’ve explored identity theft in this blog before and we are seeing increasing investigations into health care fraud, so I want to take the opportunity to examine the intersection of these two topics. 

Recently, the Fifth Circuit issued an opinion in United States v. Dubin, 982 F.3d 318. In this case, the defendant and his son were convicted of defrauding Texas’s Medicaid program. Mr. Dubin (senior) was a licensed psychologist who owned his own practice, and his son provided business services. The practice began providing Medicaid-covered services to a youth shelter and Mr. Dubin ...

Prosecutors Continue Aggressive Pursuit of Physicians

Federal prosecutors continue to crack down on doctors who unlawfully distribute controlled substances. While typically exempt from prosecution for the distribution of drugs, doctors can find themselves on the wrong side of the law when their actions are not for legitimate medical purposes and within the usual course of their medical practice.

Courts typically engage in a case-by-case analysis to determine whether a doctor’s prescribing has crossed the line. Questionable practices can include patients traveling long distances while bypassing numerous other physicians; ...

Target Letters: Let Your Lawyer RSVP

A target letter is a letter from the U.S. Attorneys Office informing you that you are a target of an ongoing investigation. If you are a target, then the government has reason to believe you have participated in a federal crime. Being a target is different than being a subject or a witness. A subject of an investigation is a person whose conduct is within the scope of a grand jury investigation. This is a level of accusation below target, but nonetheless must be taken seriously. If you have been identified as a witness, then the government believes you may have information relating to an ...

Virginia Lawyer Convicted in Extortion Plot

Lawyers in white collar cases typically fill the role of either prosecutor or defense attorney. Occasionally, they also play the part of the criminal defendant, which is what happened last week in federal court in Virginia in a highly unusual case.

Attorney Timothy Litzenburg, age 38, of Charlottesville, admitted to attempting to extort hundreds of millions of dollars from a U.S. chemicals manufacturer. Prosecutors charged Mr. Litzenburg with threatening financial and reputational harm to the company unless it paid him $200 million. Mr. Litzenburg had previously helped to ...

Tax Season is Year-Round for IRS Criminal Investigators

Tax season in America has a different schedule in 2020, with the deadline for filing having been pushed back until July due to COVID-19. This means that we all have a little more time to get our returns submitted to the Internal Revenue Service. However, for IRS criminal investigators, tax season is a year-round affair during which they relentlessly pursue those who fail to follow the law.

When I was a federal prosecutor, I relished working on tax cases and always gave them top priority. It was my duty to enforce the tax laws in order to preserve the integrity of the tax system and to deter ...

Tags: IRS, Tax Fraud
Cyber Criminals Target Medical Providers with COVID-19 Email Attacks

Criminals continue to exploit the fear and uncertainty created by the COVID-19 crisis by engaging in targeted cyber attacks upon businesses in the United States.

According to the FBI’s Cyber Division, network security tools of health care providers recently identified a series of email phishing attacks. The subjects of these emails contained topics related to COVID-19 and had malicious files attached to them which, if opened, could have deployed ransomware or implanted malware to steal personal and financial data.

The attachments were Microsoft Word documents, 7-zip ...

Price Gouging in a State of Emergency

Large-scale crises yield large-scale humanitarian responses — from international volunteer efforts and mobilization of national aid organizations to very local and mostly unrecognized community actions.  Every day, I hear of people checking in on elderly neighbors, offering to help each other with errands, and giving away highly-sought-after sanitation products.  Unfortunately, just as sure as most people respond to a crisis with good intentions, there are those who see opportunity and will seize this moment to try to profit from the collective fears and chaos.

“Price ...

Coronavirus Causes Surge in Cybercrime

The COVID-19 crisis has created a great deal of anxiety among the public and cybercriminals are hoping to profit as a result. The FBI recently issued a warning to be on the lookout for scammers due to a major uptick in Coronavirus-related cybercrime. While it's unfortunate that we have to be on guard at a time like this, the good news is that there are steps that you and your business can take to avoid becoming a victim.

Phishing emails

Be wary of emails that claim to have a treatment or cure for the disease. The U.S. Food & Drug Administration (FDA) has not approved a vaccine or pill to treat the ...

Identity Theft – Dead or Alive

In January, the Fourth Circuit became the sixth Circuit Court in the country to hold that the crime of identity theft does not require the use of a living person’s identity.  In United States v. George, No. 19-4125 (Jan. 9, 2020), the United States appealed a district court’s dismissal of an aggravated identity theft charge where the defendant had used the identification of a deceased individual to purchase a home. 

Unlike regular identity theft, which punishes the unlawful use of another’s means of identification with a sliding scale of maximum potential terms of imprisonment ...

Justice Department Takes Data-Driven Approach to Health Care Fraud

The United States Justice Department takes health care fraud seriously and has for many years. Several years ago, when I was still a federal prosecutor, I attended a conference on the topic at the National Advocacy Center in Columbia, South Carolina. There, I heard about the biggest cases coming out of Detroit and South Florida and the analytical tools that were being used in what were the hotspots for health care fraud in America. I brought those strategies back with me to West Virginia and began using them to identify outliers, or those doctors who were billing in amounts that were ...