Many times I am hired when a person or company is under investigation for supposedly committing a crime, both in and near Atlanta and throughout the State of Georgia and in other parts of the United States (and sometimes even in foreign nations). Some of these investigations turn into criminal cases. Other times, no charges are brought. However, today I want to talk about a third type of result; when the criminal case turns into a civil settlement.
Many businesses operate in a highly regulated environment. For example, companies that provide services that are paid by Medicaid/Medicare or an insurance company almost always have to comply with lots of rules and regulations that in the end come out of the United States Department of Health and Human Services (“HHS”).
For a few years I’ve been working with some extremely honorable folks who operate several businesses that provided mental health and other services to poor people. Sometimes, they even give free housing, transportation and food to the poor. The payments for mental health services were provided from federal money that went to the State of Georgia. All this federal money comes with lots of federal regulations that must be complied with.
As many folks may know, I represent lots of companies and individuals who are investigated or prosecuted for health care violations. It turns out that someone (perhaps a whistleblower) claimed that these honorable people were improperly billing for these mental health services, and this claim resulted in a search warrant at their businesses. The owners came to me, and I discovered that state and federal authorities had an ongoing criminal investigation. Over the course of several years, I worked with these folks and finally got the prosecutors to see that my clients never intentionally did anything wrong. Instead, it was their employees who improperly billed and took most of the money. Additionally, I worked with the investigators and prosecutors to see if there was a way to fashion an overall civil settlement by which the companies would pay back to the State and HHS the improperly billed claims.
We are almost at the end. We negotiated an overall civil settlement amount that is large, but one that my clients feel they can pay back. In return for paying back, we got the criminal case to go away. It has cost my clients a lot of anguish, time and money, but in the end they get to return to what they do best: helping the poor among us. I have truly enjoyed representing these honorable people, and am glad to have helped.