.png)
Our client, a Doctor of Dental Surgery, was the subject of a multi-state investigation that spanned nearly three years. The time and operational drag on the business arising from these investigations was significant, but the Prosecution Division of the Pennsylvania Department of State's Office of Chief Counsel recently closed their file on this matter with no further action or licensing implications.
Telemedicine is an Enforcement Risk Factor
Using our background as former prosecutors, federal investigators, and government regulators, HLA advises a wide spectrum of clients across the healthcare delivery chain on how to take risk in a safe and compliant manner.
Although there a number of factors that potentially increase risk in the highly regulated healthcare industry, the Department of Justice and supporting agencies, such as HHS-OIG and the FBI, have prioritized civil and criminal investigations relating to telemedicine in recent years.
Telemedicine is often the subject of federal focus because it typically crosses state lines and involves relatively high claim volume.
HLA's Defense Strategy
In this case, we helped the investigative agencies to understand the telemedicine space in great detail, which provided context for our arguments that the client's business model was fully compliant with all applicable laws and regulations.
In the healthcare industry, there is a lot of "grey," which provides for innovation and business opportunities. At the same time, if you or your business are seeking to capitalize on those opportunities, it is critical to have a compelling narrative that will address any regulatory concerns in the event of scrutiny. Reliance on experienced defense counsel often helps to support that narrative.
State Officials Declined to Prosecute
Based on our factual and legal arguments, multiple state licensing boards, including the Pennsylvania Department most recently, declined to take further action and closed their file. Now our satisfied client can refocus his energy where it should be, on running his business.
MORE ARTICLES BY CATEGORY
DOJ Targets Florida Dermatology Practices’ Wound Care Coding: Don’t Let Your Practice Go It Alone
Earlier this year, the DOJ announced a settlement with Florida dermatology practices over allegations of false wound care claims submitted to Medicare. Learn more about the settlement and how Health Law Alliance can protect your wound care practice before regulators come knocking.
Read More >>When a Wound Care Audit Hits, Call Counsel First: How Specialized Attorneys Protect Your Practice
Medicare is intensifying scrutiny of wound care, OIG’s work plan spotlights skin-substitutes and related services, while CMS’s CERT program still finds sizable fee-for-service improper payments - so a targeted audit can escalate quickly to payment suspensions and referrals if mishandled.
Read More >>When Inventory Discrepancies Become Audit Nightmares: Understanding One of the Most Common and Costly Audit Findings
Inventory reconciliation is one of the most scrutinized areas in PBM and payer audits and even small discrepancies can trigger major financial, reputational, and regulatory fallout.
Read More >>Collateral Consequences of PBM Audits: What Pharmacies Need to Know
PBM audits can quickly escalate from routine reviews into high-stakes enforcement actions with lasting financial, reputational, and regulatory consequences for pharmacies.
Read More >>







