If you may be involved
Stop unlawful conduct.
Preserve the record.
If you believe you have participated in, assisted with, or been directed to submit knowingly false Medicare or Medicaid claims, stop participating in unlawful billing conduct and promptly seek advice from a qualified federal criminal-defense attorney. Do not wait for charges before seeking advice.
- Preserve relevant informationDo not destroy, alter, backdate, fabricate, or conceal records, emails, messages, or billing information.
- Respect lawful accessDo not access or remove records without authorization or send patient information through this site.
- Take legal process seriouslySeek advice promptly, but do not ignore subpoenas, court orders, deadlines, or required reports.
These are general safeguards, not instructions to discontinue legitimate patient care or individualized advice about correcting or reporting a particular claim.
Federal enforcement
Data-driven investigations.
Individual consequences.
In June 2026, DOJ announced an agreement enabling deployment of advanced data analytics algorithms and artificial intelligence tools in CMS’s Integrated Data Repository environment, alongside work by its healthcare-fraud Data Fusion Center. DOJ announcement, June 23, 2026 (opens a new tab)
DOJ’s Health Care Fraud Section describes a multi-agency Strike Force Model and use of advanced analytics to identify, investigate, and prosecute healthcare-fraud schemes. DOJ Health Care Fraud Section (opens a new tab)
Those announcements describe investigative tools. They do not establish that a particular billing anomaly proves a crime, and this site does not describe a formally named “AI audit protocol.”
The role of defense counsel
Understand the situation
before deciding how to respond.
A criminal-defense attorney can evaluate your circumstances, explain rights and obligations, and advise about interviews, subpoenas, document preservation, and available responses. Seek advice before making voluntary statements or disclosures, without ignoring lawful process or required reporting.
No promise of immunity or outcome.
Hiring counsel does not guarantee immunity, prevent prosecution in every case, or ensure that imprisonment will be avoided. Seeking whistleblower status also does not automatically protect a participant from liability; the statute expressly addresses specified involvement in the underlying conduct. 31 U.S.C. § 3730(d)(3) (opens a new tab)
Common questions
A careful start.
What if an investigator has already called?
Promptly seek advice from a qualified attorney about your situation and any deadlines or requests. Do not make false statements or destroy records. A website cannot determine whether you are a witness, subject, or target.
Should I explain everything in a contact message?
No. Start with your name, a safe contact method, and the identities requested for conflict review. Do not put detailed admissions, patient information, or records into ordinary email or voicemail.
Can you represent everyone involved?
Do not assume so. The firm must evaluate conflicts and the interests of each potential client before discussing representation. This website’s separate paths are not an offer of joint representation.
What if I also have information about someone else’s fraud?
Both issues may need evaluation, but reporting does not automatically protect you from liability. Start with independent advice about your own position rather than assuming that a potential award resolves criminal-exposure concerns.
Read the separate whistleblower information