Spotlight on Healthcare Fraud Defense: Responding to a Civil Investigative Demand

In many instances, the first indication that a healthcare provider may be under government investigation is when it receives a request for documents and records.  Although an investigative agency my use informal requests, most often the Department of Justice or the local United States Attorney’s Office formally issues the request as a Civil Investigative Demand, or “CID.”

Government’s Authority to Issue CID

The False Claims Act, 31 U.S.C. § 3729 et seq., empowers the Justice Department to issue a CID where there exists “reason to believe that any person may be in possession, custody, or control of any documentary material or information relevant to a false claims law investigation ….”  Much like other avenues of government-compelled production, such as grand jury subpoenas, a CID obligates the recipient to produce the requested documents or to make a valid claim of privilege.

Considerations for Responding to CID

  1. Immediately Consult with Experienced Counsel – A CID could trigger many concerns for a healthcare provider, including the nature and scope of the investigation, potential costs to respond to the CID and defend the matter, and the possibility that individual providers may be targeted by the government. An experienced healthcare fraud defense attorney can work with the provider to assess the scope of the information sought, formulate a response plan, and avoid taking any actions which might negatively impact the company’s status in the government’s eyes.
  2. Carefully Review the CID to Make Sure the Request is Specific – A CID must contain a sufficiently detailed description of the documents it seeks and a deadline for the production of those documents. The CID recipient can negotiate to narrow the scope of the CID request and to extend the deadline to respond to the CID.
  3. Place a Document Hold on Potentially Responsive Documents – The best way to credibly negotiate with the government is to show a good-faith plan of document retention, collection, and production.
  4. Have the Attorney Open Dialogue with the Government – Once the defense attorney and the CID recipient have an understanding of the scope of the CID’s request, the potential pool of responsive documents, and the burden of responding, the defense attorney should contact the Department of Justice to begin negotiating and coordinating a response. Although the initial receipt of a CID may be cause for alarm, retaining an experienced healthcare fraud defense attorney can help you navigate the complications of the CID response.

Contact Georgia and South Carolina Healthcare Fraud Defense Attorneys

The attorneys at Crowder Stewart LLP, who are former federal prosecutors and members of the Department of Justice Healthcare Fraud Task Force, have extensive experience defending healthcare providers in connection with government investigations and prosecutions.  If we can assist you or your healthcare practice in connection with a government investigation, either civil or criminal, please do not hesitate to contact us at (706) 434-8799 or crowderstewart.com.