LEG07: The New Era of Health Care Fraud: Recognizing Risky Arrangements and Navigating Law Enforcement Interactions
In June 2025, the U.S. Department of Justice announced the largest national health care fraud takedown in history—a sweeping enforcement action that significantly impacted DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) providers. This unprecedented initiative underscored the evolving and increasingly sophisticated nature of health care fraud, which often masquerades as legitimate business practices.
Gone are the days when overt illegal kickbacks to prescribers were the primary concern. Today, fraudulent schemes frequently involve complex and concealed relationships with technology vendors, telehealth platforms, subcontractors, lead generators, and call centers. These arrangements may appear permissible on the surface but can carry significant regulatory and criminal implications.
The legal landscape surrounding these issues is often intricate and counterintuitive. As a result, well-intentioned individuals may unknowingly engage in conduct that violates state or federal law—exposing themselves and their businesses to severe penalties. In many cases, transnational criminal organizations orchestrate these schemes by exploiting DMEPOS business owners and leveraging their Medicare billing privileges in exchange for a portion of the proceeds.
Join healthcare regulatory attorney Michael Silverman and criminal defense attorney Joseph Nascimento as they share real-world case studies from their joint representation of clients who became entangled in unlawful arrangements without understanding the legal boundaries.
This session will provide valuable insights into how certain practices by DMEPOS providers may inadvertently breach regulatory frameworks, the civil and criminal risks involved, strategies for identifying and avoiding questionable business relationships, and best practices for engaging with law enforcement should your organization come under scrutiny.
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