John G. Martin
Of Counsel
516-393-2214
White Collar Criminal Defense
- Overview
- Attorneys
- Insights
- News
Criminal investigations and prosecutions are the most serious and potentially life-changing matters we handle at Garfunkel Wild. Simply receiving a grand jury subpoena or an inquiry from law enforcement immediately brings with it a flood of concerns about where the investigation is headed, and who might be in legal jeopardy. Garfunkel Wild’s White Collar Criminal Defense Practice Group is comprised of attorneys with extraordinary levels of experience on the government side of these matters, who can aggressively defend our clients to the exclusion of all other concerns.
Investigations and prosecutions of members of the health care community are different from other criminal prosecutions in many ways. Garfunkel Wild’s attorneys are a far better option for individuals in need of a strong criminal defense than standard criminal defense lawyers because:
- We understand that, in terms of collateral consequences alone, no other profession is at the same risk of investigation and prosecution as the health care community
- The laws governing the health care industry are a complex and arcane web of statutes, regulations, manuals, alerts and “guidance,” making the risks even higher. Garfunkel Wild’s well-earned reputation as a preeminent health care firm, and our mastery of these laws, is an asset that no standard criminal defense practitioners can offer
- Our team is steeped in the world of health care, giving us a deep understanding of our clients’ businesses and a unique appreciation of the differences and difficulties these cases present
- Most importantly, we are able to combine our expertise and experience in the general area of criminal practice with our command of health care law and compliance to be effective in the only way that matters: getting to the right result for the client
Garfunkel Wild has represented Doctors, Dentists, Nurses, Hospital Executives, Pharmacists, Physical Therapists, Physician Assistants, Businesspeople and others in federal and state investigations and prosecutions brought by the Department of Justice, the Attorney General, and local District Attorneys. Regardless of who the client is or what the allegation is, our mission is always the same: do what needs to be done to protect our clients from harm, while remaining acutely aware that we are often all that stands between them and an outcome that can destroy their lives.
Practice Group Contacts
Team
New DOJ Report: Providers Beware
Last week, the U.S. Department of Justice (DOJ) and the U.S. Department of Health and Human Services (HHS) released its annual, jointly authored Health Care Fraud and Abuse Control Program Report (the Report) for Fiscal Year 2023.
New OIG Priorities Emerge in Report
The U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG) released its Semiannual Report (SAR) to Congress on December 4, 2024.
OIG Highlights New Concerns
This week, the U.S. Department of Health and Human Services (“HHS”), Office of Inspector General (“OIG”) fulfilled its annual statutory obligation by releasing its 2024 Top Management and Performance Challenges Report (the “Report”). Historically, the Report has not attracted widespread interest in the provider community because it largely focuses on HHS operational challenges. Importantly for providers and other stakeholders, however, the Report reveals crucial insights about compliance priorities for the year ahead.
OIG Report Highlights Enforcement Priorities
The U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG) released its revamped Semiannual Report (SAR) on June 3, 2024. The SAR’s new format focuses on the oversight work OIG completed during the reporting period, and emphasizes how this work directly addresses the Top Management Challenges Facing HHS.
Telehealth Update: NY Proposes Controlled Substance Prescribing, Waiting on DEA
On May 15, 2024, the New York State Department of Health (DOH) announced a pivotal change in its regulations, as it intends to permit health care providers to use telemedicine to conduct patient evaluations before prescribing controlled substances. Prior to the COVID-19 pandemic, DOH required health care providers to perform an initial in-person physical evaluation of patients before prescribing controlled substances.
Be Prepared! NYS OMIG’s 2024 Work Plan Provides an Audit Roadmap for Health Care Providers of All Types
Garfunkel’s Compliance Webinar Series rolls on with an examination of the 2024 Work Plan published by the New York State Office of Medicaid Inspector General (OMIG).
FTC Bans Non-Competes Across the Nation
On Tuesday, April 23, 2024, the Federal Trade Commission (FTC) promulgated a final rule banning most non-compete agreements, in any industry, and is set to become effective 120 days after its publication in the Federal Register (the “Final Rule”).
OIG Allows Patient Assistance Programs Funded by Drug Manufacturers
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (24-02) permitting a non-profit organization (Non-Profit) to provide financial support to eligible patients with specific rare diseases through assistance programs (Programs) it operates.
American Health Law Association – Telemedicine Series Part II: Enforcement Trends in Telehealth
In this webinar, the John G. Martin will explore current trends in criminal and civil telehealth enforcement to better understand provider risks and mitigation strategies.
OIG Issues New Resource for Single Audits
The United States Department of Health and Human Services (HHS), Office of Inspector General (OIG) recently posted a new educational resource on its website about Single Audits. HHS is the largest grant-making agency in the Federal government, and OIG’s new resource is designed to help key stakeholders understand the scope of Single Audits, as well as improve the overall quality of such audits.
New York OMIG Updates Self-Disclosure Guidance
The New York State Office of the Medicaid Inspector General (OMIG) recently updated its Self-Disclosure Guidance and Frequently Asked Questions (collectively, “Updates”). These Updates give participating providers and entities additional insight into how to report overpayments involving unresponsive Medicaid Managed Care Organizations (MMCOs) or multiple entities, as well as those that are untimely, have adjusted or voided claims, or lost or damaged records.
OMIG’s 2024 Work Plan Gives Critical Insights into Program Integrity Initiatives
The New York State Office of the Medicaid Inspector General (OMIG) released its 2024 work plan in furtherance of its mission to coordinate and conduct activities to prevent, detect and investigate medical assistance program fraud, waste and abuse, and to recover improperly expended Medicaid funds.
OIG’s Newest Strategic Plan Prioritizes Managed Care Oversight
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) recently designated oversight of managed care as a “priority area”, and developed a coordinated strategic plan (the Plan) to better align its audits, evaluations, investigations, and enforcement of managed care.
OIG Issues Toolkit for Medicare Advantage Organizations
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) released a new toolkit to help Medicare Advantage (MA) organizations replicate OIG audit methodologies to detect and correct inaccurate diagnosis codes in their own systems.
OIG Approves Use of Gift Cards for Referrals in Certification-Heavy Advisory Opinion
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (23-15) permitting a consulting company’s (Consultant) proposal to offer gift cards to its current physician practice customers for referring potential new physician practice customers to Consultant. Notably, OIG determined that the proposed arrangement did not implicate the Anti-Kickback Statute (AKS).
OIG Approves Creative Approach to Restructuring Medical Practice Partnerships
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (23-12) that allows a limited liability partnership (the Partnership) consisting of two classes of physician partners to make a one-time, voluntary redemption offer (offer) to individual partners when they reach age 67.
Favorable OIG Advisory Opinion Allows Subsidies for FDA-Approved Clinical Studies
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (23-11) that allows a medical device manufacturer (Manufacturer) to subsidize Medicare cost-sharing obligations as part of a U.S. Food & Drug Administration (FDA)-approved clinical study involving a Category B Investigational Device Exemption.
OIG’s Favorable Advisory Opinions Allow Incentives to Medigap Plan Policyholders
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted two favorable Advisory Opinions (23-09 and 23-10) to allow a licensed offeror of Medicare Supplemental Health Insurance (Medigap Plan) policies and a preferred health organization (PHO) (collectively, “the requestors”) to incentivize Medigap Plan policyholders to seek inpatient care from a hospital within the PHO’s network. Notably, OIG issued these favorable opinions even though the proposed incentives implicated the Anti-Kickback Statute (AKS) and the Beneficiary Inducement Civil Money Penalty (CMP), and there was no applicable exception or safe harbor.
More Provider “Nuggets” From OIG’s Year-End Reporting Blitz
Continuing its year-end reporting blitz, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its Semiannual Report (SAR) to Congress on December 1, 2023.
DOJ/HHS Jointly Release “Highlight Reel” Report
This week, the United States Department of Justice (DOJ) and the United States Department of Health and Human Services (HHS) fulfilled its annual statutory obligation by releasing its jointly-authored Health Care Fraud and Abuse Control Program (HCFAC) Report for Fiscal Year 2022.
OIG Provides Roadmap to Hot-Button Issues
The OIG fulfilled its annual statutory obligation by releasing its Top Management and Performance Challenges (TMC) document. Providers should take note because the document provides important insight into the specific areas over which HHS (and the OIG) will remain focused.
OIG Releases New General Compliance Program Reference Guide
On November 6, 2023, the OIG released its General Compliance Program Guidance, the first in a series of new, non-binding reference guides designed to share information with health care compliance professionals and other health care industry stakeholders
Fraud and Abuse – Lessons from Esformes Case
John Martin will present the “Fraud and Abuse – Lessons From Esformes Case” Webinar on September 18, 2019.
Nassau County Bar Association (NCBA) Hospital and Health Law Committee CLE – Recent Trends in Health Care Fraud Investigations
John G. Martin and Robert A. Del Giorno will present at the Nassau County Bar Association’s CLE – Recent Trends in Health Care Fraud Investigations on September 17, 2019.
John Martin Quoted In Newsday Article Entitled “Former CFO From LI Pleads Guilty To Stealing From Manhasset Real Estate Firm” On September 10, 2019
John Martin Quoted In Newsday Article Entitled “Former CFO From LI Pleads Guilty To Stealing From Manhasset Real Estate Firm” On September 10, 2019.
John Martin Quoted in New York Law Journal on Appellate Reversal of Charges Against His Client, a Suffolk County Pharmacist, in HIV Drug Scheme
John Martin Quoted in New York Law Journal on Appellate Reversal of Charges Against His Client, A Suffolk County Pharmacist, In HIV Drug Scheme
Criminal investigations and prosecutions are the most serious and potentially life-changing matters we handle at Garfunkel Wild. Simply receiving a grand jury subpoena or an inquiry from law enforcement immediately brings with it a flood of concerns about where the investigation is headed, and who might be in legal jeopardy. Garfunkel Wild’s White Collar Criminal Defense Practice Group is comprised of attorneys with extraordinary levels of experience on the government side of these matters, who can aggressively defend our clients to the exclusion of all other concerns.
Investigations and prosecutions of members of the health care community are different from other criminal prosecutions in many ways. Garfunkel Wild’s attorneys are a far better option for individuals in need of a strong criminal defense than standard criminal defense lawyers because:
- We understand that, in terms of collateral consequences alone, no other profession is at the same risk of investigation and prosecution as the health care community
- The laws governing the health care industry are a complex and arcane web of statutes, regulations, manuals, alerts and “guidance,” making the risks even higher. Garfunkel Wild’s well-earned reputation as a preeminent health care firm, and our mastery of these laws, is an asset that no standard criminal defense practitioners can offer
- Our team is steeped in the world of health care, giving us a deep understanding of our clients’ businesses and a unique appreciation of the differences and difficulties these cases present
- Most importantly, we are able to combine our expertise and experience in the general area of criminal practice with our command of health care law and compliance to be effective in the only way that matters: getting to the right result for the client
Garfunkel Wild has represented Doctors, Dentists, Nurses, Hospital Executives, Pharmacists, Physical Therapists, Physician Assistants, Businesspeople and others in federal and state investigations and prosecutions brought by the Department of Justice, the Attorney General, and local District Attorneys. Regardless of who the client is or what the allegation is, our mission is always the same: do what needs to be done to protect our clients from harm, while remaining acutely aware that we are often all that stands between them and an outcome that can destroy their lives.
Practice Group Contacts
Team
New DOJ Report: Providers Beware
Last week, the U.S. Department of Justice (DOJ) and the U.S. Department of Health and Human Services (HHS) released its annual, jointly authored Health Care Fraud and Abuse Control Program Report (the Report) for Fiscal Year 2023.
New OIG Priorities Emerge in Report
The U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG) released its Semiannual Report (SAR) to Congress on December 4, 2024.
OIG Highlights New Concerns
This week, the U.S. Department of Health and Human Services (“HHS”), Office of Inspector General (“OIG”) fulfilled its annual statutory obligation by releasing its 2024 Top Management and Performance Challenges Report (the “Report”). Historically, the Report has not attracted widespread interest in the provider community because it largely focuses on HHS operational challenges. Importantly for providers and other stakeholders, however, the Report reveals crucial insights about compliance priorities for the year ahead.
OIG Report Highlights Enforcement Priorities
The U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG) released its revamped Semiannual Report (SAR) on June 3, 2024. The SAR’s new format focuses on the oversight work OIG completed during the reporting period, and emphasizes how this work directly addresses the Top Management Challenges Facing HHS.
Telehealth Update: NY Proposes Controlled Substance Prescribing, Waiting on DEA
On May 15, 2024, the New York State Department of Health (DOH) announced a pivotal change in its regulations, as it intends to permit health care providers to use telemedicine to conduct patient evaluations before prescribing controlled substances. Prior to the COVID-19 pandemic, DOH required health care providers to perform an initial in-person physical evaluation of patients before prescribing controlled substances.
Be Prepared! NYS OMIG’s 2024 Work Plan Provides an Audit Roadmap for Health Care Providers of All Types
Garfunkel’s Compliance Webinar Series rolls on with an examination of the 2024 Work Plan published by the New York State Office of Medicaid Inspector General (OMIG).
FTC Bans Non-Competes Across the Nation
On Tuesday, April 23, 2024, the Federal Trade Commission (FTC) promulgated a final rule banning most non-compete agreements, in any industry, and is set to become effective 120 days after its publication in the Federal Register (the “Final Rule”).
OIG Allows Patient Assistance Programs Funded by Drug Manufacturers
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (24-02) permitting a non-profit organization (Non-Profit) to provide financial support to eligible patients with specific rare diseases through assistance programs (Programs) it operates.
American Health Law Association – Telemedicine Series Part II: Enforcement Trends in Telehealth
In this webinar, the John G. Martin will explore current trends in criminal and civil telehealth enforcement to better understand provider risks and mitigation strategies.
OIG Issues New Resource for Single Audits
The United States Department of Health and Human Services (HHS), Office of Inspector General (OIG) recently posted a new educational resource on its website about Single Audits. HHS is the largest grant-making agency in the Federal government, and OIG’s new resource is designed to help key stakeholders understand the scope of Single Audits, as well as improve the overall quality of such audits.
New York OMIG Updates Self-Disclosure Guidance
The New York State Office of the Medicaid Inspector General (OMIG) recently updated its Self-Disclosure Guidance and Frequently Asked Questions (collectively, “Updates”). These Updates give participating providers and entities additional insight into how to report overpayments involving unresponsive Medicaid Managed Care Organizations (MMCOs) or multiple entities, as well as those that are untimely, have adjusted or voided claims, or lost or damaged records.
OMIG’s 2024 Work Plan Gives Critical Insights into Program Integrity Initiatives
The New York State Office of the Medicaid Inspector General (OMIG) released its 2024 work plan in furtherance of its mission to coordinate and conduct activities to prevent, detect and investigate medical assistance program fraud, waste and abuse, and to recover improperly expended Medicaid funds.
OIG’s Newest Strategic Plan Prioritizes Managed Care Oversight
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) recently designated oversight of managed care as a “priority area”, and developed a coordinated strategic plan (the Plan) to better align its audits, evaluations, investigations, and enforcement of managed care.
OIG Issues Toolkit for Medicare Advantage Organizations
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) released a new toolkit to help Medicare Advantage (MA) organizations replicate OIG audit methodologies to detect and correct inaccurate diagnosis codes in their own systems.
OIG Approves Use of Gift Cards for Referrals in Certification-Heavy Advisory Opinion
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (23-15) permitting a consulting company’s (Consultant) proposal to offer gift cards to its current physician practice customers for referring potential new physician practice customers to Consultant. Notably, OIG determined that the proposed arrangement did not implicate the Anti-Kickback Statute (AKS).
OIG Approves Creative Approach to Restructuring Medical Practice Partnerships
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (23-12) that allows a limited liability partnership (the Partnership) consisting of two classes of physician partners to make a one-time, voluntary redemption offer (offer) to individual partners when they reach age 67.
Favorable OIG Advisory Opinion Allows Subsidies for FDA-Approved Clinical Studies
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (23-11) that allows a medical device manufacturer (Manufacturer) to subsidize Medicare cost-sharing obligations as part of a U.S. Food & Drug Administration (FDA)-approved clinical study involving a Category B Investigational Device Exemption.
OIG’s Favorable Advisory Opinions Allow Incentives to Medigap Plan Policyholders
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted two favorable Advisory Opinions (23-09 and 23-10) to allow a licensed offeror of Medicare Supplemental Health Insurance (Medigap Plan) policies and a preferred health organization (PHO) (collectively, “the requestors”) to incentivize Medigap Plan policyholders to seek inpatient care from a hospital within the PHO’s network. Notably, OIG issued these favorable opinions even though the proposed incentives implicated the Anti-Kickback Statute (AKS) and the Beneficiary Inducement Civil Money Penalty (CMP), and there was no applicable exception or safe harbor.
More Provider “Nuggets” From OIG’s Year-End Reporting Blitz
Continuing its year-end reporting blitz, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its Semiannual Report (SAR) to Congress on December 1, 2023.
DOJ/HHS Jointly Release “Highlight Reel” Report
This week, the United States Department of Justice (DOJ) and the United States Department of Health and Human Services (HHS) fulfilled its annual statutory obligation by releasing its jointly-authored Health Care Fraud and Abuse Control Program (HCFAC) Report for Fiscal Year 2022.
OIG Provides Roadmap to Hot-Button Issues
The OIG fulfilled its annual statutory obligation by releasing its Top Management and Performance Challenges (TMC) document. Providers should take note because the document provides important insight into the specific areas over which HHS (and the OIG) will remain focused.
OIG Releases New General Compliance Program Reference Guide
On November 6, 2023, the OIG released its General Compliance Program Guidance, the first in a series of new, non-binding reference guides designed to share information with health care compliance professionals and other health care industry stakeholders
Fraud and Abuse – Lessons from Esformes Case
John Martin will present the “Fraud and Abuse – Lessons From Esformes Case” Webinar on September 18, 2019.
Nassau County Bar Association (NCBA) Hospital and Health Law Committee CLE – Recent Trends in Health Care Fraud Investigations
John G. Martin and Robert A. Del Giorno will present at the Nassau County Bar Association’s CLE – Recent Trends in Health Care Fraud Investigations on September 17, 2019.
John Martin Quoted In Newsday Article Entitled “Former CFO From LI Pleads Guilty To Stealing From Manhasset Real Estate Firm” On September 10, 2019
John Martin Quoted In Newsday Article Entitled “Former CFO From LI Pleads Guilty To Stealing From Manhasset Real Estate Firm” On September 10, 2019.
John Martin Quoted in New York Law Journal on Appellate Reversal of Charges Against His Client, a Suffolk County Pharmacist, in HIV Drug Scheme
John Martin Quoted in New York Law Journal on Appellate Reversal of Charges Against His Client, A Suffolk County Pharmacist, In HIV Drug Scheme