Healthcare Fraud & Audit Defense Attorneys
Our Texas Healthcare Fraud Defense Attorneys Have Protected Providers for Nearly 40 Years
Blindsided by a billing audit, Medicare fraud allegation, licensing board inquiry, or patient complaint? When government auditors, Medicare contractors, or state licensing boards target your practice with administrative actions, the clock starts immediately. You need experienced healthcare audit defense attorneys who can resolve these matters efficiently, guide you through strict deadlines, and protect your professional standing.
At Hendershot Cowart P.C., our Texas-based healthcare audit defense lawyers have defended healthcare providers for nearly 40 years. We routinely handle Medicare audit responses, payor investigations, and professional board actions throughout Texas and nationwide – and we can step in immediately to help you.
Call (713) 783-3110 or contact us online to speak with a healthcare fraud defense lawyer in Houston today.
Health Care Investigations Practice Areas
- Anti-Kickback Statute
- Appealing a Medicare Enrollment Denial
- Billing for Services Not Rendered
- CIDs
- Compounding Pharmacy Fraud
- Corporate Practice of Medicine Doctrine
- Eliminating Kickbacks in Recovery Act (EKRA)
- False Claims Act
- FDA Investigations
- HHS-OIG Self-Disclosure
- Insurance Company SIU Audits
- Managed Care Organization Fraud Investigations
- Medical & Professional License Defense
- Medicare & Medicaid Recoupment
- Medicare Billing Privilege Revocations & Appeals
- Medicare Exclusions
- Medicare Fraud
- Medicare Payment Suspension
- Novitas Audits
- OIG Investigation
- OIG Self-Disclosure Protocol
- RAC (Cotiviti or Performant) Audits
- Stark Law
- Texas Health & Human Services Investigations
- Texas Medicaid Fraud Defense
- TRICARE Audits
- UPIC (Qlarant) Audits
What to Do When You Receive a Notice
If you've been contacted by a Medicare or Medicaid audit contractor, an insurance SIU investigator, or have received legal demands related to healthcare fraud, take these critical steps immediately:
1. Note Important Deadlines.
If you received a letter from Qlarant, CoventBridge, the TMB, or HHSC-OIG, you have days – not weeks – to respond. Note important deadlines and be ready to share that information with your legal counsel. Above all else, do not ignore or procrastinate a response. Most of these deadlines are non-negotiable, and a missed deadline can mean a missed opportunity to defend yourself and your practice.
2. Do Not Speak to Investigators Without Legal Counsel.
Even if agents say you're only a witness or "not the target," anything you say can and will be used against you.
What to say instead:
Healthcare Fraud Investigation Defense
At Hendershot Cowart P.C., our Texas-based healthcare fraud attorneys have defended healthcare providers against civil fraud allegations nationwide for nearly 40 years. We focus on resolving Medicare fraud investigations, False Claims Act cases, and regulatory enforcement actions before they become criminal matters.
The full roster of federal fraud defense matters we handle:
- False Claims Act investigations and qui tam whistleblower lawsuits
- Anti-Kickback Statute violations
- Stark Law (self-referral) violations
- OIG Civil Investigative Demands
- DME fraud
- EKRA (Eliminating Kickbacks in Recovery Act) investigations
- Telemedicine fraud
- FDA investigations (compounding pharmacies, medical devices, prescription drugs)
- Compounding pharmacy fraud
Common Investigation Triggers
Healthcare fraud investigations begin when red flags alert federal agencies, state programs, or private insurers to potential violations:
- Data analytics: Billing patterns deviating from peer benchmarks, unusually high service volumes, rapid increases in billing complexity, or aberrant coding
- Whistleblowers: Qui tam lawsuits, employee reports, competitor complaints, or patient allegations
- Audit escalations: RAC, UPIC, or other Medicare contractor audits uncovering systematic issues, significant extrapolated overpayments, or failure to repay within 60 days
- Law enforcement referrals: State Medicaid Fraud Control Units, FBI Healthcare Fraud Task Force, DEA prescription investigations, or medical board complaints
- Private insurance red flags: Special Investigation Unit (SIU) detection of unusual billing patterns, documentation deficiencies, or multi-payer scheme indicators
Our Defense Approach to Healthcare Fraud Investigations
When you contact us about a civil fraud investigation, we immediately:
- Assess criminal risk and implement strategies to keep the matter civil
- Analyze allegations for elements of intent vs. error
- Secure and preserve documentation showing good faith compliance efforts
- Proactively communicate with federal and state agencies
- Recommend voluntary disclosure when appropriate
- Negotiate civil resolutions, including repayment and corrective actions
- Protect your professional licenses and Medicare billing privileges
We work to demonstrate to investigators that issues stem from billing errors, compliance gaps, or misunderstandings – not criminal intent – keeping cases in the civil realm where they can be resolved through repayment, corrective action plans, and administrative remedies.
Medicare & Medicaid Audit Defense
When Medicare contractors audit your practice, immediate action is critical to protect your billing privileges and prevent overpayment demands.
To Us, Every Case is Personal
Real Stories, Real Results, Real Advocacy
-
I was provided with sage legal advice from Keith Lefkowitz, and then paralegal Rebecca Cepeda helped me set up my PLLC with the Secretary of State... I strongly recommend Keith and Rebecca to help with a medical practice set up. I look forward to working with them for my future legal needs.- B.
-
I have worked with Trey and the team there multiple times. They are attentive, great to work with, and I'm glad to know I always have top-notch legal representation- B.B.
-
Great people to work with! Keith helped us through our appeal step by step and was able to get our business up and running again.
-
Anton was my attorney for a ceases desist letter. He was absolutely amazing, responded extremely quickly and the response he wrote for me was phenomenal. Super happy with this law firm!
-
Highly recommend the firm and Philip in particular; I greatly appreciate the firm for the invaluable assistance with the legal matters we engaged it to address. Philip Racusin's expertise, attentiveness, responsiveness, and professionalism have been exceptional, and I don't believe we could have navigated this challenging situation without his support.
-
Outstanding firm. The team was efficient and provided good legal & business advice. Particular compliments to Trey Hendershot and Bryan Tehrani - I recommend them and will bring other matters to the firm for their assistance.
-
After many attempts at resolving my legal issue, Bryan and the team at Hendershot Cowart were able to resolve my problem. The team was kind and prompt in all aspects. Thank you!
-
Underground Service greatly appreciated the work and knowledge provided by Hendershot Cowart P.C. We were able to navigate legal processes very smoothly and in a timely manner to keep our company in good standing.
Why Choose Our Healthcare Audit Defense Lawyers
Proven Medicare Audit Defense Experience
Since 1987, our attorneys have represented thousands of healthcare providers in complex Medicare audits, RAC audits, and administrative proceedings at both the state and federal levels. We have successfully:
- Represented hundreds of healthcare practices through the rebuttal and appeals process in MAC or RAC overpayment and recoupment demands
- Challenged statistical sampling errors, misinterpretations of coverage policy, and demonstrated medical necessity in multi-million-dollar Medicare overpayment demands
- Prevented Medicare exclusions and restored billing privileges for numerous providers
- Defended Texas Medical Board and Texas Board of Nursing investigations resulting in dismissals or minimal sanctions
- Resolved UPIC investigations without referral to OIG or DOJ
Administrative Law Focus
Unlike criminal defense firms, we focus exclusively on administrative proceedings, audits, and civil matters. We understand:
- Medicare's five-level appeals process
- Administrative law judge (ALJ) hearings
- State medical board procedures
- CMS regulations and coverage policies
- Documentation requirements and medical necessity standards
Texas Medical Board Experience
Our attorneys have extensive experience with Texas Medical Board investigations and have successfully defended physicians against:
- Standard of care violations
- Unprofessional conduct allegations
- Nontherapeutic prescribing claims
- Failure to maintain adequate medical records
- Violations of TMB rules
- Peer review actions
Contact Our Healthcare Audit & License Defense Attorneys
From Records Request to Recoupment Defense – We Handle Every Stage
Healthcare audits and license investigations move quickly. The sooner we intervene, the better we can protect your practice, billing privileges, and professional license.
Our audit defense attorneys usually respond within 24 hours to schedule an initial consultation to assess your situation and decide on the next steps. We handle audit appeals, license defense matters, and administrative proceedings throughout Texas and nationwide for federal and Medicare matters.
We do not handle criminal defense but work aggressively to keep civil matters from becoming criminal cases. If your case has already been referred for criminal prosecution, we can refer you to qualified criminal defense counsel while continuing to handle the civil and administrative aspects.
Call (713) 783-3110 now or contact us online for immediate assistance.