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Seven Things To Know When You Receive A Notice Of Investigation From The Department Of Health

Doctor Acquitted in $85 Million Medicare Fraud Scheme Requests Reimbursement of Legal Expenses

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On August 12, 2022, a doctor acquitted in a $85 million Medicare fraud scheme filed a motion in the U.S. District Court for the Eastern District of New York requesting prosecutors cover the legal fees and expenses she incurred. Mayura Kanekar, a Brooklyn-based doctor, claims the government knew she was unaware of the scheme but arrested and prosecuted her anyway. In her motion, she said the Hyde Amendment allows a court to grant sanctions if the government’s position is found to be “vexatious, frivolous, or in bad faith.”

She added that if the U.S. Department of Justice (DOJ) had investigated correctly, it would have found that she did not know about kickbacks paid to patients. The Hyde Amendment is codified in federal statutes as a note following note following 18 U.S.C. Section 3006A.  It allows federal courts to award attorneys’ fees and court costs to criminal defendants when the court finds that the government’s position in the case was “vexatious, frivolous, or in bad faith.”

The Doctor‘s Arrest and Eventual Acquittal.

The Doctor was arrested on July 10, 2017, in the presence of her family, by armed federal agents. Prosecutors “proceeded to charge her with an extraordinary litany of crimes they either knew or had reason to know, lacked any legitimate basis,” according to the motion she filed. The DOJ charged her with paying kickbacks to shell companies and patients for the purpose of increasing her clinical services, which then allowed her to submit false claims to Medicare. Prosecutors alleged that she submitted $34 million in false claims and received $15 million between 2009 and 2016. Click here to read the DOJ’s press release to learn even more about the arrests and charges.

After a three week trial in June 2022, the defendant and two other health care providers, were acquitted of all federal charges. A Brooklyn jury reached not guilty verdicts on the nearly 20 counts which all three faced. Read more here.


Sanctions Under The Hyde Amendment.

The defendant’s motion did not deny that kickbacks were paid but stated that she had no knowledge they were coming from her office. According to the motion she filed, “the government’s witness testified [that] the practice of paying patient kickbacks was purposefully hidden from Ms. Kanekar [the doctor] and the other medical providers.” The doctor argued that the government shifted its strategy when it became apparent it couldn’t prove that she even knew about the kickback scheme.

The motion includes a Second Circuit Court of Appeal decision that states the criteria for such a finding under the Hyde Amendment. The defendant must show the charges were brought:  “a) to hector or intimidate the defendant on shaky factual or legal grounds;  b) without even a reasonably arguable factual and legal basis;  or c) with an element of intentional deceit or dishonesty.”

According to the motion, the defendant is requesting $845,750.70 for attorney‘s fees and expenses.  Click here to visit our website and view the motion to read more.

Contact Health Law Attorneys Experienced with Health Care Fraud, False Claims Act Violations, and Anti-Kickback Statute Violations.

The attorneys of The Health Law Firm represent healthcare providers in cases of accusations of medical billing fraud, health insurance audits, alleged overbilling, Medicare audits, ZPIC audits and RAC audits, False Claims Act cases, and whistleblower/qui tam cases throughout Florida and across the United States. Our attorneys also represent physicians, medical groups, nursing homes, home health agencies, pharmacieshospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from the Medicare or Medicaid Program.

To contact The Health Law Firm, please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Weld, Elliot. “Doc Cleared Of $85M Medicare Scam Wants Feds Sanctioned.” Law360. (August 15, 2022). Web.

Moreno, Ivan. “3 NY Doctors Acquitted Of $85M Medicare Fraud Scheme.” Law360. (June 14, 2022). Web.


About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

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By George F. Indest III, J.D., M.P.A., LL.M.

By George F. Indest III, J.D., M.P.A., LL.M.

Board Certified by The Florida Bar in Health Law

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