Healthcare Fraud Investigation: Preparation for Individuals and Counsel

Begin with the actual contact

A practice audit, subpoena, agent contact and criminal charge are different events. Record what was received, by whom, on what date and with which stated deadline. Retain qualified federal defense counsel to interpret the contact and direct the response. The first preparation product is a factual intake summary, not a conclusion that a particular person committed an offense.

Build a map of the practice

Identify the legal entities, locations, owners, managers, clinical services, billing vendors and periods involved. A physician may have worked through several entities under different contracts. An owner may have acquired a business after particular claims were submitted. Put changes on a timeline and attach the records supporting the dates. Distinguish personal recollection from a document that confirms it.

Separate patient records from personal preparation

Your personal-history file and a practice production are different workstreams. Do not send patient charts, identifiers or privileged advice through SAG’s inquiry form. Counsel should identify authorized record custodians and an appropriate handling process. Preserve original documents and metadata. A working chronology should point to source material rather than overwrite or reinterpret the underlying chart.

Define the assignment before exchanging files

An engagement can focus on professional history, employment duties, family responsibilities, documented corrective work and practical preparation. Agree with counsel on recipients, review points and the boundary between personal preparation and investigative response. Financial or clinical questions may require qualified specialists. SAG does not decide whether a claim was medically necessary or legally payable.

Choose the next guide by the problem

Use the investigation guides for contact and document questions, the financial guides for reconciling different amounts, and the sentencing chapters when a plea or conviction makes the presentence process the next priority. The same person may need several of these workstreams, but each should have a defined owner and deadline.

Continue your preparation

• Civil and Criminal Healthcare Matters
• HHS OIG Subpoena Preparation
• Healthcare Fraud Restitution
• Healthcare Fraud: Individual Role Records

Sources and professional scope

Official context: HHS OIG’s overview of healthcare fraud and abuse authorities. Its overview is educational and includes historical penalty figures; consult current authorities with counsel. U.S. Sentencing Commission guidelines resources support counsel’s sentencing review. Sources checked November 6, 2026.

SAG provides personal and professional chronology, source indexing, interview preparation and practical planning within a written scope. Retain qualified federal defense counsel for investigation-stage legal decisions. SAG is not a law firm and does not provide legal advice, clinical opinions or forensic accounting. An engagement does not automatically establish privilege.

Clients work directly with Joseph. SAG serves clients nationwide from New Jersey, with travel arranged for cases. No charging decision, sentence, placement or release date is guaranteed.

Request a Private Case Review

Already have defense counsel? Discuss Support for Your Client. Share your stage and next deadline in the inquiry, not patient records or privileged material.