Overview
Health care fraud is one of the DOJ's highest enforcement priorities, and the Southern District of Florida is among the most active healthcare fraud enforcement districts in the country. Our attorneys have defended individuals and entities across the full spectrum of healthcare fraud allegations, from billing irregularities to large-scale Medicare and Medicaid fraud conspiracies.
Adam Fels's June 2025 full acquittal of Kenia Valle Boza, charged in a $12 million Medicare fraud conspiracy the DOJ had publicly promoted at healthcare conferences as a landmark enforcement precedent, is the defining example of this practice. The jury acquitted on all counts after four hours of deliberation, rejecting the DOJ's theory that billing supervisors bear personal criminal responsibility for coders' decisions. Franklin Monsour, lead trial counsel for Ms. Valle Boza and now a partner at Dechert LLP (formerly of McDermott Will & Emery), brought Mr. Fels onto the trial team to try the case with him to verdict, a pairing that has become one of the firm's niche practices: national firms retaining FFS for trial-specific reinforcement rather than replacing their own counsel.
Our healthcare fraud defense spans physician, hospital, pharmacy, laboratory, DME, home health, and mental health settings. We represent executives, billing departments, medical professionals, and corporations facing grand jury subpoenas, search warrants, federal indictments, and parallel False Claims Act investigations.
Our Approach
Healthcare fraud cases are won through expert command of the regulatory frameworks governing billing and documentation. The line between a billing error, a regulatory violation, and criminal fraud requires deep knowledge of Medicare and Medicaid rules, and a defense that can demonstrate good faith reliance on those rules. We engage medical and billing experts early to evaluate the government's coding theories and build the defense narrative for trial or pre-indictment resolution.
