Criminal Investigations and Prosecutions

Dwyer & Collora, LLP has represented physicians, dentists, psychiatrists, pharmacists, chiropractors, medical clinics, medical device suppliers, clinical laboratories, hospitals and nursing homes in state and federal grand jury investigations and prosecutions. Allegations included Medicare and Medicaid fraud, such as billing for services not rendered, upcoding, performing unnecessary services, and kickback violations. Despite the seriousness of the allegations, the firm's attorneys have frequently negotiated resolutions that avoided the filing of criminal charges, and more important, did so without disruption to the client's practice and without loss of the client's license.

Representative cases include:

• Defending health care corporations and high-level executives against charges of federal health care fraud brought by the United States Attorney's Office, including one of the first cases in the country predicated upon the criminal enforcement of the Food & Drug Administration's medical device laws and cases. Spawned by national enforcement initiatives such as Operation Labscam and the investigation of renal dialysis centers, often these cases have involved coordinating joint defense teams, conducting internal investigations, collecting and analyzing hundreds of thousands of documents, and mounting challenges to novel theories of liability posed by federal prosecutors.
• Representing a North Carolina psychiatrist and his incorporated mental health clinic through two years of investigation conducted jointly by the U.S. Department of Justice and the North Carolina Medicaid Fraud Control Unit. While the investigation was pending before a federal grand jury, Dwyer & Collora, LLP's attorneys were able to fully resolve the matter through a civil settlement involving the corporation, the U.S. Department of Justice, the Department of Health and Human Services, and the North Carolina Medicaid program.
• Defending a dental clinic and its dentist-owner against criminal charges brought by the Public Protection Bureau of the Office of the Attorney General alleging the submission of false, inflated and unnecessary claims. These charges were brought under the Massachusetts False Claims Act, which, unlike its federal counterpart, is not limited to claims submitted to federal health care programs, and the allegations arose exclusively from claims submitted to a private health insurance company. The charges were resolved upon a joint recommendation of the defendants, the Attorney General and the Board of Registration in Dentistry.
• Resolved  criminal indictments pending in two counties against a psychiatrist charged with writing prescriptions for controlled substances without a legitimate medical purpose. The charges stemmed from a series of undercover operations in which State Police posed as patients to obtain prescriptions.
• Representing the Vice President of Marketing for a New England independent clinical laboratory who was indicted for violations of the anti-kickback statute. The charges against her were ultimately dismissed when the corporation for which she worked tendered a plea to a misdemeanor.
• Representing a corporate pharmacy and its sole proprietor who were indicted for violations of Medicaid's usual and customary charge rules, billing for services not rendered, and submitting false claims to Medicaid. The case was resolved when the corporation offered a guilty plea, accepting liability for the acts of its various employees. The charges against the pharmacist/owner were dismissed after a short period of pre-trial probation, preserving his ability to continue practicing his profession. Dwyer & Collora, LLP has negotiated similar dispositions in a number of other cases, enabling an individual owner’s ability to practice his/her trade was preserved through the tender of a corporate guilty plea.
• Representing top managers of one of the state's largest mental health clinics during the course of an ongoing grand jury investigation into allegations of billing for services not rendered and submitting claims to Medicaid for services rendered by a non-program provider. Following an internal investigation, the lawyers successfully persuaded the Medicaid Fraud Control Unit of the Office of the Attorney General to discontinue the grand jury proceedings without seeking an indictment, and to settle all allegations through a civil settlement with the clinic, without any admission of liability by any party.
• Representing a chiropractor who was indicted for insurance fraud for allegedly failing to disclose to a motor vehicle insurer that his patient had been involved in a previous motor vehicle accident. The Insurance Fraud Division of the Office of the Attorney General entered a nolle pros after Dwyer & Collora, LLP filed a substantial motion to dismiss alleging insufficient evidence before the grand jury and grand jury impairment, and raised a constitutional challenge to the inter-relationship between the privately-funded Insurance Fraud Bureau and the Attorney General's Office.
• Dwyer & Collora, LLP has successfully represented numerous other health care providers, including durable medical equipment suppliers, ambulance services, dentists, psychiatrists, nursing homes, and podiatrists in criminal investigations by the Medicaid Fraud Control Unit of the Office of the Attorney General. 

These cases illustrate why we are known as wise warriors. The attorneys of Dwyer & Collora, LLP fight to win in court, and are respected and feared for their prowess there. But first, we always try to achieve a favorable outcome for our clients without the expense and time of a trial. By often resolving cases like these through civil settlements, with no admission of liability, we work to prevent collateral consequences such as program exclusion or disciplinary action by professional licensing authorities.

Attorneys at Dwyer & Collora, LLP have frequently represented licensed professionals charged with possession of controlled substances, issuing unauthorized prescriptions, and self-prescribing. By working jointly with the Drug Enforcement Agency, State Police, and licensing authorities, the firm's attorneys have frequently been able to guide clients to substance abuse programs and peer counseling to assist in their recovery, to resolve criminal charges without a conviction, and to negotiate probation agreements with licensing authorities which permit them to continue practicing.

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