Last week, one of my clients got a letter from a state Attorney General. The letter requested information about two of the organization’s former employees. When the client forwarded me the letter, I suggested that I would call the author and confirm that my client wasn’t a target of the investigation. My client was nervous. “Won’t having a lawyer call on my behalf make me look guilty?” the client asked, continuing “Don’t only guilty people need lawyers?”
There is much to unpack there. I’ll start with a common adage: when a lawyer represents themselves, they have a fool for a client. Experience has taught that even lawyers benefit by bringing in another pair of eyes to handle problems. If lawyers shouldn’t represent themselves, it is extra clear that a non-lawyer shouldn’t.
There are many reasons for this. First, you don’t know what you don’t know. Again, a fresh pair of eyes can be helpful. But there are other benefits to having a lawyer make contact.
If you call an investigator, nothing will stop them from starting to interrogate you. They can ask anything they want. If you’re worried about how it will look having a lawyer call on your behalf, imagine how it will look if you try to shut down an agent’s questions – when, mid-call, you regret not engaging counsel. Worse yet, let’s say that you make some factual mistake during the call. You’re now on the hook for making a false statement during an investigation. Having a lawyer make the call on your behalf provides an inherent buffer, lowering the risk that the call takes an unexpected turn.
Second, I wouldn’t tie yourself in knots trying to determine whether a particular course of action looks guilty or not. After all, agents are well-aware of the fact that people think it makes them look bad to get a lawyer. The result could be some sort of psychological Catch-22: guilty people don’t retain counsel for fear of looking guilty. You may arouse suspicion by NOT engaging counsel. Don’t get trapped by mind games about appearances. Focus on substance.
But I really want to emphasize the strongest argument for engaging counsel. If you’ve ever watched a cop show or read a newspaper article about investigations, you know the length to which a government agent will go to try to keep someone from engaging counsel.
There is a reason for that.
People who have counsel are less likely to get convicted. Agents don’t want people to get counsel, because it makes their work more difficult. And that should tell you all you need to know. This point is illustrated brilliantly by a Gary Larson cartoon. The cartoon features a man talking to a shark in a boat, as other sharks circle hopefully. The shark says “I’ll tell my people you’re going to stay in the boat, but I warn you, they’re not gonna like it.”
It’s absolutely true that government agents will be annoyed at you for getting counsel. But the reason for their displeasure is that their job will be harder.
Larson’s The Far Side offers the perfect analogy. Would you rather jump in the water and have happy sharks (government agents), or stay in the boat – that is, engage counsel and refuse to talk, and annoy them? Personally, I am staying in the boat. Finally, the letter ends with the statement “Please note that the data regarding investigations is confidential, and I request that you treat this information accordingly.” Just a reminder that while the STATE may be required to keep the information confidential, YOU are not. The government’s request is just that: a request. That’s importantly distinguishable from a requirement.
In March, the U.S. Supreme Court issued a decision in the case of Chiles v. Salazar. The decision raises many questions and fuels speculation. But
The 30th Annual Compliance Institute for the Health Care Compliance Association (HCCA) is scheduled to take place in Orlando next week. If you are there,
Please log in to your account to comment on this article.
Breast biopsy procedures may be clinically straightforward but accurately translating them into compliant billing can be anything but. In this focused webcast, Shawn Blackburn, CPC, CPMA, CIC, CRC, CCS-P breaks down how imaging guidance, lesion count, laterality, and payer expectations all impact how these procedures should be reported. Through clear explanations and real-world scenarios, you’ll gain practical insight into aligning clinical workflows with billing requirements, avoiding common pitfalls, and ensuring your documentation supports accurate reimbursement and compliance.
Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Sherri L. Clayton, RHIT, CSS. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.
Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Traditional utilization management models can no longer keep pace with regulatory shifts, payer scrutiny, and operational pressures. In this webcast, Tiffany Ferguson, LMSW, CMAC, ACM, ACPA-C, introduces an Adaptive Model strategy that modernizes UM through role specialization, technology-driven workflows, and proactive, team-based processes. Attendees will learn how to restructure programs to improve efficiency, strengthen clinical collaboration, and enhance financial performance in a rapidly changing healthcare environment.
Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.
In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
Celebrate Lab Week with MedLearn! Sign up to win one year of our Laboratory All Access Pass! Click here to learn more →
Have a Medicare regulation question you’d love Dr. Hirsch to answer? Now is your chance! CLICK HERE to learn more→
Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
