The Company Got a Declination. The Founder Got Indicted the Same Day. What DOJ's New Corporate Enforcement Policy Means for Florida Executives

On July 29, 2026, the Justice Department did two things in one announcement. It declined to prosecute a health care management services organization that had reported its own kickback and billing problems. And it unsealed a seven count indictment against the man who built the practice that company managed, and who went on to serve as its chief executive. Same conduct. Same investigation. Two very different mornings. If you run a physician practice, a surgery center, or a management company in Florida, that pairing is the enforcement development of the summer.

One announcement, two outcomes. The company's path to a declination ran straight through the executive who built the practice.

Key Takeaways

• This was DOJ's first health care declination under the department wide Corporate Enforcement and Voluntary Self-Disclosure Policy announced March 10, 2026.
• The company paid one million dollars in victim compensation and was not charged. Its founder and former CEO was indicted the same day on seven counts.
• Charges include health care fraud under 18 U.S.C. § 1347 and payment of illegal remuneration under 42 U.S.C. § 1320a-7b, each carrying up to ten years per count.
• Corporate cooperation credit is paid for with evidence about individuals. Assume the company's disclosure package describes you by name.
• Florida practices, surgery centers, and management companies use the same compensation structures the government just charged as kickbacks.

What Actually Happened

The Justice Department's National Fraud Enforcement Division resolved a criminal health care fraud investigation into a New Jersey based management services organization under Part I of the Corporate Enforcement and Voluntary Self-Disclosure Policy. The company billed for an optometry practice and a surgery center. It self-disclosed, cooperated, rewrote its billing and compensation policies, hired compliance personnel, and compensated victims. The Department declined to prosecute it for health care fraud, illegal kickbacks, and conspiracy. It paid one million dollars back and walked away without a charge.

The same day, the Department announced a seven count indictment against the founder of that practice and surgery center, who became the management company's CEO after outside investors came in at the end of 2021. It alleges that from at least 2015 through March 2023 he conspired to bill Medicare for unnecessary and duplicative diagnostic eye tests, and paid ophthalmologists for referrals of surgical patients. The payments were allegedly papered as consulting fees and structured as monthly flat fees that tracked a percentage of the prior year's Medicare reimbursement on tests for referred patients. Roughly 3.4 million dollars in claims went in. He then allegedly sold the business to private equity on the strength of those reimbursements. An indictment is an allegation. He is presumed innocent.

A monthly flat fee that tracks a percentage of last year's Medicare reimbursement on tests for referred patients is not an accounting detail. It is the government's whole theory, and it lives in the documents.

The Department was explicit about how the two pieces fit. The Assistant Attorney General said corporate enforcement aids the Department's prosecutions of individuals. Read that from the executive's chair. The company's path to a declination ran through him.

What the Government Is Actually Building

The policy that produced this declination is new. Announced March 10, 2026, it is the first of its kind applied across all criminal cases rather than one enforcement program. Part I gives a company that self-discloses promptly, cooperates fully, remediates, and compensates victims a defined route to no charges at all. Companies are going to take it.

Understand what a company hands over to earn it. Full cooperation means the internal investigation report, the interview memoranda, the emails, the valuation files or the absence of them, and an agreement to keep cooperating with prosecutions of individuals. The policy does not make conduct disappear. It converts a corporate case into an individual case, faster and cheaper than agents could build one from subpoenas.

The Health Care Fraud Strike Force Program now runs nine strike forces, including in South Florida. The pattern repeats: percentage based compensation, testing volume that does not match clinical need, and a management company between the physicians and the billing.

The Health Care Fraud Strike Force Program now runs nine strike forces, including in South Florida. A Southern District of Florida defense attorney sees the same pattern in practice after practice: percentage based marketing or consulting compensation, testing volume that does not match clinical need, and a management company sitting between the physicians and the billing.

Exposure and Charges

The seven counts break into two theories. The fraud theory is conspiracy plus two substantive counts under 18 U.S.C. § 1347, each carrying up to ten years. The kickback theory is one conspiracy count carrying five years and three substantive counts of paying illegal remuneration under 42 U.S.C. § 1320a-7b, ten years each.

The Anti-Kickback Statute is what makes ordinary business arrangements dangerous. Remuneration means anything of value. The government does not have to prove a patient was harmed. It has to prove remuneration, intent, and a nexus to a federal health care program. In the Eleventh Circuit an arrangement violates the statute even if it had legitimate business purposes, so long as one purpose was inducing referrals. Anti-Kickback Statute defense starts from that unforgiving premise.

Sentencing is driven by loss, not count structure. Intended loss, victim count, role, abuse of a position of trust, and sophisticated means all push the guideline range up before anyone argues a variance. Add the sale of the business and the government has a personal gain narrative to argue alongside loss. Comparing a corporate victim payment to an individual's exposure is comparing a check to a prison term.

"Corporate enforcement aids our prosecutions of individuals."— Assistant Attorney General, U.S. Department of Justice

Critical Mistakes Executives Make Early

The most expensive mistake is assuming that because the company hired counsel, you are represented. You are not. Company counsel represents the company. When the board authorizes an internal review, the warning you get before your interview is not a formality. What you say in that room can go to the government inside the cooperation package that earns the company its declination.

The second mistake is helping. Executives who believe the conduct was lawful volunteer the most, because they think a full explanation ends the inquiry. Those memoranda become the government's roadmap on intent. The same instinct shows up when HHS-OIG or FBI agents appear at an office or a home.

The third is unilateral cleanup. Cancelling a consulting agreement or rewriting a compensation formula after an inquiry lands, with no privileged record, reads as consciousness of guilt.

The fourth is waiting. This matter ran from conduct ending in March 2023 to an indictment in July 2026. The executive who engaged counsel in year one had options the executive who waited no longer has. Pre-indictment defense work is where these cases are decided.

Strategic Defense Approach

Establish independent representation before the internal investigation interview, not after. Separate counsel, a joint defense or common interest agreement where appropriate, and a clear picture of what the company has already told the government. Corporate officer federal investigation work is a different discipline from company side compliance work, and the two should never share a lawyer.

Reconstruct the record before the government finishes doing it. Contemporaneous fair market value opinions, board minutes, and the commercial rationale for a compensation structure are worth far more produced in a defense presentation than extracted in discovery. Percentage based compensation is not automatically criminal. It becomes criminal when the government can show it was designed to buy referrals and dressed up as something else. That difference lives in documents.

Why Timing Matters Right Now

Every company in this space just watched a competitor self-disclose and walk away from a criminal case. Expect more voluntary disclosures over the next twelve months, each arriving with an individual attached.

That changes the clock. The first sign of trouble used to be a subpoena or an agent at the door. Now it may be a board resolution authorizing an internal review, or an outside firm asking for your calendar and your email. By the time a federal grand jury subpoena arrives, the disclosure may already be with the Fraud Section. If a target letter arrives, the charging decision is largely made.

The window opens the moment you learn the company is looking, and it closes when the disclosure goes in. Often that is a matter of weeks. Federal investigation defense in this posture is not about litigating a case that exists. It is about shaping one that has not been charged.

Common Questions

Facing a Federal Health Care Investigation in Florida?

If your company has retained outside counsel to run an internal review, if you have been asked to sit for an interview, or if a federal grand jury subpoena or target letter has arrived, the next few weeks will shape everything that follows. Aaron M. Cohen has spent more than 30 years defending physicians, executives, and businesses in federal investigations and prosecutions, from pre-indictment defense through trial and sentencing. As a Boca Raton federal criminal defense and Southern District of Florida defense attorney with a national practice, he handles these matters with discretion. Consultations are confidential.

Corporate officer federal investigation work is a different discipline from company side compliance work. The two should never share a lawyer.

If you or your loved ones have been arrested or are under federal investigation, call Aaron M. Cohen, 24 hours a day to get help.

This article is for informational purposes only and does not constitute legal advice. Reading this article does not create an attorney-client relationship. An indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt. The government's claims in the matters discussed are allegations only, and there has been no determination of liability. Every case is different. If you are facing a federal investigation or charges, consult a qualified attorney about your specific situation.