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When you’re facing a federal issue, you need an attorney whose going to be available 24/7 to help you get the results and outcome you need. The value of working with the Spodek Law Group is that we treat each and every client like a member of our family.
Client Testimonials
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THE BEST LAWYER ANYONE COULD ASK FOR.
The BEST LAWYER ANYONE COULD ASK FOR!!! Todd changed our lives! He’s not JUST a lawyer representing us for a case. Todd and his office have become Family. When we entered his office in August of 2022, we entered with such anxiety, uncertainty, and so much stress. Honestly we were very lost. My husband and I felt alone. How could a lawyer who didn’t know us, know our family, know our background represents us, When this could change our lives for the next 5-7years that my husband was facing in Federal jail. By the time our free consultation was over with Todd, we left his office at ease. All our questions were answered and we had a sense of relief.
Understanding the Differences: Kickbacks vs. Physician Self-Referrals
When dealing with Medicare, Tricare, Medicaid, or any other government benefit program, medical providers must navigate regulatory and statutory billing restrictions. Every healthcare provider must adhere to specific compliance laws, such as the Anti-Kickback Statute and Physician Self-Referral Law. Both of those laws have limitations, requirements, and penalties.
It is vital to know the difference between these laws so that medical providers can avoid federal prosecution and reduce the potential for civil liabilities. If you are the center of a healthcare fraud investigation, make sure to consult with an experienced defense attorney.
Kickbacks and Physician Self-Referrals: Differences
Applicability Scope
Physician self-referral is often known as “Stark Law.” These statutes and laws have different applicability scopes. Stark Law only applies to doctors and their family members. Any healthcare entity that shares a “financial relationship” with the medical provider is covered under the law.
Stark Law applies to services billed to Medicaid and Medicare from a “designated health provider.” On the other hand, the Anti-Kickback Statute concerns all medical providers and their personnel. This statute also applies to all federal programs. The federal government can prosecute providers for soliciting, receiving, or paying improper monetary compensation.
If you are looking for a lawyer that listens, is aggressive where needed, and holds his word above all else, Todd is the best pick. I had hired multiple attorneys prior to hiring the Spodek Group for a white collar case. The first thing that stood out to me was the cost, as anyone going through the process and dealing with the system, money was tight at that time - especially after hiring and firing multiple lawyers. The cost was not as high as others which was definitely a plus. Todd's intake process was also unlike other attorneys. He took the time to actually listen. He cared. He was trying to put himself in my shoes while I was explaining the situation to him and he really took the time to understand the whole situation. Other lawyers will give you 15 mins and send you a retainer agreement. Not Todd, I think he spent almost two hours with me as I was explaining everything.Not only was he great during the onboarding process, he was supportive and very informative through the entire plea process and eventually sentencing. After hiring him, I asked if I should hire a prison consultant, he told me to save my money as he would do everything they would. He was right and held up to his word. Later on I would hear from others that went with the prison consultants that they were a waste of money - I am glad I listened to Todd!When it came time for sentencing, two days prior to sentencing, the prosecutor tried increasing my proposed prison time by almost double - apparently a normal move. Todd and his team worked with me non-stop through the weekend prior to sentencing to ensure that I was not given additional prison time. Again, he took the time to listen and came up with a strategy to explain the case with great detail.Unfortunately, I did plead guilty as that was my best option. Todd and his whole team wrote up nearly 300 pages of a summary of what happened and why I should not be given prison time. If I breakdown the amount I spent with Todd versus the amount of work that I saw being done, I am shocked I was not charged four times as much. The other benefit was, a lot of criminal defense lawyers were just a single attorney with a paralegal or two. Todd had a team of people that I dealt with (5-7 people that I interacted with), but he was ALWAYS accessible. It would never take him more than an hour to reply unless he was in court.I was sentenced to prison and I was emotionally distraught. Todd and his team did whatever they could even after sentencing to make sure I was alright. He personally stayed in touch with my family to ensure I was doing alright and offered support to them. Most lawyers would consider the job complete at sentencing, not Todd.After prison, Todd still spent time with me to make sure I was on the right track and avoiding any potential risks in the future. He has also been giving advice on how to navigate probation etc and has not been looking at the clock for billing.Although I wish I had never been arrested in the first place, I am glad I had Todd and his team in my corner. Without them I likely would have had to spend a lot more time in prison than I did.Thank you, Todd, and the entire Spodek Law team, for helping turn what was a nightmare into a manageable situation!
I am immensely grateful to the entire team at Spodek Law Group for their unwavering dedication and exceptional expertise throughout my case. From our initial consultation to the final resolution, their professionalism and tireless advocacy made all the difference. Their strategic approach and attention to detail instilled confidence in me every step of the way.Thanks to their hard work and commitment, we achieved a truly favorable outcome that exceeded my expectations. Not only did they navigate the complexities of my case with precision, but they also provided invaluable support and guidance during what was undoubtedly a challenging time. I cannot recommend Spodek Law Group highly enough, especially attorneys Todd Spodek and Claire Banks; they are beacons of excellence in the legal profession.YSP.
Todd, Ralph and Alex are amazing. Helped my husband get from a double digit number with multiple charges to a single digit, by the time I blink he will be out. They very professional and help with all your needs. They dealt with my anxiety and worry very well and they understand that your family member needs to get home as soon as possible.
Believe every single review here about Alex Z!! From our initial consultation, it was evident that Alex possessed a profound understanding of criminal law and a fierce dedication to his clients rights. Throughout the entirety of my case, Alex exhibited unparalleled professionalism and unwavering commitment. What sets Alex apart is not only his legal expertise but also his genuine compassion for his clients. He took the time to thoroughly explain my case, alleviating any concerns I had along the way. His exact words were “I’m not worried about it”. His unwavering support and guidance were invaluable throughout the entire process. I am immensely grateful for Alex's exceptional legal representation and wholeheartedly recommend his services to anyone in need of a skilled criminal defense attorney. Alex Z is not just a lawyer; he is a beacon of hope for those navigating the complexities of the legal system. If you find yourself in need of a dedicated and competent legal advocate, look no further than Alex Z.
I don’t know where to start, I can write a novel about this firm, but one thing I will say is that having my best interest was their main priority since the beginning of my case which was back in Winter 2019. Miss Claire Banks, one of the best Attorneys in the firm represented me very well and was very professional, respectful, and truthful. Not once did she leave me in the dark, in fact she presented all options and routes that could possibly be considered for my case and she reinsured me that no matter what I decided to do, her and the team will have my back and that’s exactly what happened. Not only will I be liberated from this case, also, I will enjoy my freedom and continue to be a mother to my first born son and will have no restrictions with accomplishing my goals in life. Now that’s what I call victory!! I thank the Lord, My mother, Claire, and the Spodek team for standing by me and fighting with me. Words can’t describe how grateful I am to have the opportunity to work with this team. I’m very satisfied, very pleased with their performance, their hard work, and their diligence.Thank you team!
I recently had Spodek Law Group represent me for a legal matter in NYC and I am thoroughly impressed with their services.Alex Zhik secured the best possible outcome for my case.It was a seamless journey from the initial consultation to the resolution of my legal matter. From the moment I spoke to Todd about my case, his enthusiasm to help was evident, setting a positive tone for the entire experience. The efficiency and professionalism displayed by the team is commendable.A particularly noteworthy aspect of their service is their user-friendly portal to upload your documents/evidence. This not only simplified the process, but showcases their commitment to streamline the client experience.Lastly, in an industry where legal fees can often be a concern, I found their pricing to be very reasonable, making needing legal assistance feel accessible and stress-free.I am grateful for their support and wouldn't hesitate to turn to them again in the future.
Criminal and Civil Liability
Stark Law is a civil statute. These unlawful self-referrals are punished with financial penalties and exclusion from specific programs. Some penalties under Stark Law include:
Civil monetary penalties
Restitution for the improper amounts billed to Medicaid and Medicare
False Claims Act liabilities
Medicaid and Medicare program exclusions
While Stark Law solely focuses on civil penalties, the Anti-Kickback Statute includes both criminal and civil enforcement provisions. These civil penalties have higher monetary fines. In criminal cases, the medical providers and their personnel often face stricter penalties per violation. These consequences include five years in federal prison and a $25,000 fine.
Exceptions
Stark Law and the Anti-Kickback Statute offer exemptions to protect medical providers from any legal liabilities. There are several exceptions under Stark Law. Many of these exceptions have been expanded under federal regulations, and they include:
Safe harbors and exemption provisions are provided in the Anti-Kickback Statute. Some of the exceptions are similar to Stark Law, and they include:
Specified risk-sharing arrangements
Legitimate payments to W-2 employees
Payments to purchasing agents
Safe harbor transactions
Intent and Strict Liability
Stark Law is known as a “strict liability” statute. With that, the prosecution does not have to prove an intentional action on the provider’s behalf. However, federal prosecutors must show that the provider improperly billed Medicaid or Medicare for unlawful-referred services. In some cases, the provider provided an illegal self-referral as a medical doctor. These two actions are enough for a civil liability violation.
Under the strict liability provision of Stark Law, federal prosecutors can pursue financial fines. However, the prosecutors must establish intent to seek program exclusion of the healthcare provider.
Proof of intent is necessary for criminal or civil offenses under the Anti-Kickback Statute. The violations must be “willfully and knowingly” committed by a healthcare provider or their employees. Constructive knowledge is enough to provide an Anti-Kickback Statute violation.
Different Types of Transactions
In many cases, the Anti-Kickback Statute and Stark Law are discussed together. Remember that kickback and self-referrals are two distinct types of transactions according to federal law.
With a self-referral, the designated health service has referred a patient to an entity that has a financial relationship with the referring physician. An illegal kickback is often paid in exchange for a payment to a healthcare benefit program from the federal government. Only improper claim submissions and referrals can trigger liability. If there is an attempt to solicit a referral fee, that action is enough for criminal prosecution with the Anti-Kickback Statute.
If you have been accused of these civil or criminal crimes, you need to speak to an experienced federal fraud defense lawyer. With the right legal advice, you can find a favorable outcome for your case.
