Host Jonathan Porter welcomes back Jody Rudman, who heads up Husch Blackwell’s white collar practice group, to the podcast to discuss the intersection of criminal and civil healthcare fraud enforcement. With the Department of Justice announcing another massive healthcare fraud takedown last month, Jody provides critical insights into how criminal prosecutions and False Claims Act enforcement work in tandem—and what healthcare providers need to understand about both.
Host Jonathan Porter welcomes back Jody Rudman, who heads up Husch Blackwell’s white collar practice group, to the podcast to discuss the intersection of criminal and civil healthcare fraud enforcement. With the Department of Justice announcing another massive healthcare fraud takedown last month, Jody provides critical insights into how criminal prosecutions and False Claims Act enforcement work in tandem—and what healthcare providers need to understand about both.
We begin by examining why DOJ maintains two parallel enforcement mechanisms for healthcare fraud. Jody explains the fundamental differences between civil False Claims Act cases and criminal healthcare fraud prosecutions, including different burden of proof standards, the role of intent, and the types of conduct that trigger each pathway. We discuss how these two enforcement tools serve different purposes but often target the same underlying fraudulent schemes.
Next, we dive into last month’s major DOJ healthcare fraud takedown. While these enforcement actions are primarily criminal in nature, Jody explains the significant False Claims Act implications that follow. We explore the scope of the takedown, the types of schemes that are targeted, and how the takedown included more Medicaid Fraud Control Unit-initiated actions than ever before.
Our conversation then shifts to practical lessons for healthcare industry listeners. Jody identifies patterns and trends from recent enforcement activity that should serve as warning signs for providers. We discuss the types of conduct that elevate healthcare fraud from a civil matter to criminal prosecution, including the role of kickbacks, patient brokering, medically unnecessary services, and billing schemes that demonstrate clear intent to defraud.
We close by looking ahead to the future of healthcare fraud enforcement. Jody analyzes DOJ’s annual FCA statistics and the trajectory of these massive takedown operations. We examine whether enforcement numbers will continue climbing in coming years and what facts might influence the government’s enforcement strategy going forward.
Jonathan Porter | Full Biography
Jonathan focuses on white collar criminal defense, federal investigations brought under the False Claims Act, and litigation against the government and whistleblowers. He draws on his experience as a former federal prosecutor to guide clients in sensitive and enterprise-threatening litigation. At the Department of Justice, Jonathan earned a reputation as a top white-collar prosecutor and trial lawyer and was a key member of multiple international healthcare fraud takedowns and high-profile financial crime prosecution teams. He also teaches white collar crime as an adjunct professor of law at Mercer University School of Law.
Jody Rudman | Full Biography
Jody serves as the Office Managing Partner for Husch Blackwell’s Austin office and leads the firm’s White Collar, Internal Investigations & Compliance practice group. She also heads up the firm’s False Claims Act working group. Jody has assisted clients across a wide range of industries with investigations, negotiations, mediations, pretrial matters, grand jury proceedings, civil lawsuits, criminal indictments, jury trials, sentencings, and appeals. She has tried dozens of jury and bench trials in the federal and state courts, argued before the U.S. Court of Appeals for the Fifth Circuit, and appeared before the U.S. Supreme Court. Prior to entering private practice, Jody served as a federal prosecutor for the Northern District of Texas and was appointed by the Texas Attorney General to spearhead high-profile charitable trust and healthcare litigation matters for the State of Texas.