Win Your Case With CCG Healthcare Litigation Support
CCG provides healthcare litigation support to health care practices facing healthcare fraud and false claims act investigations and litigation. CCG was founded by Ronald W. Chapman II, a career federal criminal defense attorney who has achieved high profile defense verdicts in healthcare fraud and false claims act cases including the recent acquittal of four physicians in what the federal government called the “largest healthcare fraud case in the nation”. Our team of healthcare experts includes data analytics experts, medical experts, document reviewers, and investigators and can provide an off the shelf investigation team to interview witnesses, review claims, prepare statistical modeling of the practice to give you an edge in your healthcare fraud investigation.
How Can CCG Help With Your Healthcare Fraud and False Claims Act Defense?
When the federal government comes knocking you better be ready with a well-designed compliance plan that includes auditing and monitoring. By contacting CCG prior to the initiation of an investigation or audit we can assess your practice and determine compliance shortfalls quickly and get you on the right track. But many practices do not have a compliance plan or auditing and monitoring capabilities and if you find yourself in the middle of an audit or investigation we can still help! At the first sign of an audit, investigation, or criminal charges our team is ready to determine the nature of the federal government’s issue and conduct an internal investigation to develop evidence in your defense.
It starts with interviews of employee witnesses to determine the ground truth before the federal government begins gathering witnesses and locking in their case. We then pull relevant claims data and medical records to determine the billing, coding, and documentation issues in the case and the potential overpayment, if any. Our experts will prepare graphs and charts rebutting the Government’s often skewed picture of the facts that your counsel can utilize in pre-trial discussions to minimize exposure. If the case is headed to trial, don’t worry, our experts are able to take the stand in your defense and expertly rebut government allegations of fraud.
A Case Study: CCG Secures Acquittals in the Largest Healthcare Fraud Case in the Nation
In 2018 the Pain Center USA was raided by federal agents who alleged that the practice engaged in a $500 million fraud scheme to over-utilize interventional pain management treatments. The government claimed that the clinic was rife with fraud and utilized opioid pain medications to “hook” patients on opioids in order to unlawfully induce patients into receiving back injections. CCG was retained to rebut the government’s claims at trial and generate statistical evidence that would show the jury that the Government’s claims were false.
CCG experts began by securing the Medicare claims data for the practice and determining the scope of claims at issue. We pulled all claims from 2016 to the data of the raid. Next we analyzed claims data using statistical experts to determine if the government’s theory was true. If true, patients would have received significant amounts of facet, epidural, and caudal injections over their course of treatment. The claims data would have also shown that patients at the practice received high doses of opioid medications.
After determining the parameters of our analysis we took a deep dive into the data and created graphs and charts depicting the prominent findings. We were able to determine that the average patient was only a patient at the practice for 108 days. Further, patients received only an average of 30 morphine milligram equivalents of pain medication – a relatively low dose. Moreover, when the claims data for each individual doctors was analyzed, we were able to determine that most patients only received two injections from the practice – which was hardly the long series of treatments the government claimed in the indictment. Further, we were able to show that the range of therapies for each patient varied widely.
After determining that the Government’s claims were not supported by the data, we were able to provide vital statistical charts to the defense that drove the defense case-in-chief and its theory at trial. The graphs were admitted into evidence by our statistician who testified at trial and our Medicare expert. After seven weeks of trial testimony, the jury deliberated for just 10 hours and returned a defense acquittal on all 54 counts of the indictment including a count of healthcare fraud conspiracy, unlawful distribution conspiracy. Dr. Bothra, the owner of the clinic was freed that day after 42 months in custody due to the vital trial support that CCG provided to the defense.
For a free assessment of your case and to determine how our CCG healthcare experts can help you win your healthcare fraud or false claims act case contact CCG today. Our healthcare fraud experts investigators are ready to provide you and your counsel the vital trial support necessary.