Other People’s Problems: Wiretaps in Health Care with Sarah Wirskye

October 26, 2022

In this episode, we share the story of a $300M health care fraud investigation. White collar criminal and civil fraud attorney Sarah Wirskye joins us to share her perspective on the investigation. We discuss wiretaps, paying for patient referrals, and kickbacks in health care.

Listen to the full episode using the player below, or by visiting one of the links below. Below is the episode’s transcript which has been edited for readability. If you have any questions or would like to learn more, email us at info@byrdadatto.com.


Intro: [00:00:00] Welcome to Legal 123s with ByrdAdatto. Legal issues, simplified through real client stories and real world experiences. Creating simplicity in 3, 2, 1.

Brad: Welcome back to another episode of Legal 123s with ByrdAdatto. I’m your host, Brad Adatto with my co-host and Michael Byrd.

Michael: Thanks Brad. As a business and healthcare law firm, we meet a lot of interesting people and learn their amazing stories. As you know, this season, we’re spicing things up a bit. We’re here to talk about OPP, other people’s problems.

Brad: Alright, Michael, for those listening for the first time this season, tell them, what are we doing with OPP?

Michael: Not start singing the song, right?

Brad: Right. No.

Michael: Okay.

Brad: That’s the first episode.

Michael: Yeah. So for those listening for the first time as you said, we’re going to, instead of doing client stories that are made anonymous so people don’t know who it is, we’re actually going out into the public and pulling [00:01:00] stories that many of y’all know about, taking those stories to then have some lessons to learn from.

Brad: Yeah. Well, before we get into today’s OPP story, Michael, did you ever play the game dominos?

Michael: Um, yes.

Brad: Okay.

Michael: I did. Yeah.

Brad: Good.

Michael: I was more of a card player though. Poker, Texas Hold em’ is my thing.

Brad: Yes. I knew that. Well, for those who’ve never played, dominos is a game where two to four people come together and you start off with seven domino pieces. You put the tiles together. You match your dominoes and eventually you try to get out and that’s kind of how the game goes. You’ve said you played it.

Michael: Yeah. Are you asking if I would beat you? Yes, I would. Yeah.

Brad: In college, any given night, you probably would find me with some friends, with some libations, some cold beverages, playing either dominoes or spade. So that was a big part of my college career.

Michael: If there’s a way to put an emphasis on the drinking part of that, then I think everyone will be able to buy it.

Brad: Yes, that’s true.

Michael: Yeah.

Brad: [00:02:00] However, before I went to college, I thought dominos were actually used for building, but mostly for destruction where you’d spend hours lining up a whole bunch of dominos, trying how to trick out, to see if one could fly across the room and knock down another domino and start all over again. Michael, in your youth, besides being a speed typewriter, typist, did you ever play with dominos in between typing

Michael: Typing champion. Well, if you mean in your youth as in current time then yes, actually last week, my daughter, Ellex had a science experiment where we had to line up dominos and I was an assistant and measure the speed by which they would fall at different distances. So yes, in my youth, I did play dominos.

Brad: Okay. Alright. Well, so that you don’t cheat, I want you to turn Siri off and since you seem to know…

Michael: I hate it when you do this.

Brad: Yes so since you know so much about dominos, I have some questions for you. Alright. Ready, Michael. Very first one. What is the most dominoes ever [00:03:00] stacked on one single piece of a domino?

Michael: Hmm, I’m going to go with 227.

Brad: You’re a little bit short. It was 1,120. It was a nice, Alexander…

Michael: can I change my answer?

Brad: No, not yet. Oh, Bendikov. It only took him eight hours to do that. Alright, Michael, you’ll like this one then, what is the most dominos you can stack on one domino in one minute?

Michael: Well, the lawyer in me has so many follow up questions. I don’t want to derail it. How are they stacked? All those kinds of things. I’m just going to give you a number. Okay. It’s probably going to be wrong again.

Brad: Yes. It will be.

Michael: You’re just making me look bad, which I know is part of the purpose.

Brad: It absolutely is.

Michael: Okay. I’m going to go with 550.

Brad: A little bit high this time. The most ever stacked in one minute is 73. Believe it or not two different Italians, two years apart were the ones who tried to stack it. Alright. So, this woman you’ll love, what was the fastest a domino has ever traveled? [00:04:00] What speed?

Michael: 25 miles an hour.

Brad: Wow. That’s actually not that bad. It’s actually 15 miles per hour and that was in the Netherlands.

Michael: I can make it go faster.

Brad: Fair enough.

Michael: Okay. Well, I’m going to reverse it on you a little bit now.

Brad: Okay.

Michael: Have you ever heard of the domino effect?

Brad: I have heard the domino effect. It’s when you drink a lot of beer. Wait, no, wait. That’s a different effect.

Michael: Yes.

Brad: Yes. It’s when you stack a domino and the domino effect is when one thing hits something bigger and then something bigger and just keeps falling that direction where a smaller object can propel a bigger object.

Michael: Apparently a domino can knock over something one and a half times its size so if you start with a regular size domino, it would take 29 progressively larger dominoes to knock over the empire state building.

Brad: Okay. Full disclosure, listeners out there, we of course do not recommend you attempt this.

Michael: Yeah, Brad, I think that’s impossible, but yes.

Brad: Okay.

Michael: I would agree. [00:05:00] Well, so we’ve Gotta stop the domino question.

Brad: Okay. Yeah.

Michael: We have a guest sitting here.

Brad: Yes. Patiently.

Michael: Patiently

Brad: Very, very patient.

Michael: We need to get on with the OPP.

Brad: Okay.

Michael: So why the domino talk?

Brad: Well, today’s OPP reminds me a lot of dominos. Today’s OPP story has to do with stacking, lining up one another and finally causing a big ripple effect of taking and knocking a whole bunch of people down. This is using wire tops and defendants flipping on each other and then again, eventually taking the big dog down.

Michael: Well, before we get into today’s OPP and for our audience members watching the show on our YouTube channel, hi out there. You’ll note that we have a guest in studio with us, however, we’re going to bring her on after we kind of introduce this OPP story. We’re very confident based on her training that she’s going to have a great perspective on this. [00:06:00]

Brad: Much better perspective than us. So, Michael today’s OPP story originally grabbed our attentions in April of 2022 when the department of justice of the Northern district of Texas announced 11 defendants pled guilty in a 300 million healthcare fraud case.

Michael: Yeah. Anytime we see people in healthcare, having orange jumpsuits in the equation it gets our attention quickly.

Brad: It certainly does and what was not in the headline, but was more jaw dropping that we learned later, was that these 11 defendants pleaded guilty to fraud just two months after being charged.

Michael: Yeah. That’s a pretty speedy process and definitely caught our attention outside the norm and I know when our guest joins us, she’ll have a perspective on that timeframe as well, but how did the 11 defendants plead guilty so fast?

Brad: Alright. I’ll give you some context to the story, because I know you love that. This OPP has the following professionals pleading guilty: an internal medicine physician, a family [00:07:00] doctor, or physician, a nurse practitioner, a marketing firm owner, a marketing employee, and two of the co-founders of a lab.

Michael: Kind of the usual suspects, especially the marketing people and the lab people.

Brad: Yes and for more context, the defendants plead to the follow felonies, so this is what they agreed to. Some of the non-medical providers, conspiracy to pay and receive healthcare kickbacks. The doctor and the NPS, conspiracy to solicit and receive kickbacks. The marketing company firm, conspiracy to pay and receive healthcare kickbacks and following the owners of the lab, conspiracy to pay and receive healthcare kickbacks and a whole bunch of other accounts of paying and receiving healthcare kickbacks to everyone, including the marketing company.

Michael: Why are you sweating so much? You look like you’re the one that did it. Is there something we need to talk about?

Brad: Not on the mic.

Michael: Okay. Okay. Yeah. Well, pleading guilty to these charges, what are the consequences?

Brad: Well for them, which is kind of [00:08:00] shocking. It’s only three to 15 years in those orange jumpsuits and it really will be depending on the person and the actual charges against them.

Michael: Well, I’m sure there’s a ripple effect as well so how do they go from practicing medicine, marketing and, providing lab services to being in orange jumpsuits.

Brad: Clearly, no or really bad legal.

Michael: Well, there’s a third possibility Brad, they could have gotten great legal advice and just chosen not to follow it.

Brad: Oh, that does happen.

Michael: We’ve had those lead a horse to water moments in the past.

Brad: True. This story represents what happens when people attempt to enter arrangement for one service, understanding that they ultimately are attempting to monetize the business, AKA patients that they’re seeking from the medical providers. In this case, there appeared to be some awareness that these pesky health laws existed and you couldn’t really pay people for referrals. So then these creative minds [00:09:00] started saying, oh, how can we just push these boundaries? And they started trying to find ways in which they could come up with marketing and advisory services, but everyone involved new is really disguised as kickbacks to the physicians and referring providers and the other potential and I’m going to use these air quotes, investment returns.

Michael: Mm. Okay. Well, so let’s get into some of the details.

Brad: Let me pause and take one step back and discuss the federal government, how we actually even learned about this cause a lot of times people are like, oh, they’ll never find out about it or how would they find out about it?

Michael: Alright.

Brad: So this origin story actually started four years even before the charges were brought. The nurse practitioner in this story was involved in another investigation, even a different part of the country where the federal authorities came along and the MP was like, well, you think this is bad? I’ve actually been doing something worse over here.

Michael: That part of it is kind of typical, right? I mean, using your [00:10:00] domino analogy, usually there’s the domino falls with something like that one person gets caught.

Brad: Yes and so then the in this case, the MP agreed to start dialing for defendants and, and start recording the calls with other people under this arrangement, which led to another confidential informant. I love the word. The CI had been steeped in this kind of culture before so it was natural for the CI to start calling these people and having conversations with them and these conversations brought probable cause for wire taps on the marketing company owner and at the marketing company owner’s employee who happened to be his sister.

Michael: Okay. That was a lot.

Brad: Yeah.

Michael: Let’s just pause for a moment to make sure I’m following you correctly. The NP gave us the CI? Who gave us the marketing company and its employee?

Brad: God, he’s doing great, Riley. He must have had enough caffeine today. Yes, you are correctly filing, but like any good late night commercial, just wait. There’s [00:11:00] more. After a few more months, they’re the wire taps. They started going up. They got another marketer wiretapping who confessed and agreed to cooperate and then this processed, they started recording other calls, which helped work their way up to the conspiracy chain and gather evidence of other players in this scheme, including the lab owners and physicians.

Michael: Man it’s getting messy.

Brad: Yes so this is where it’s getting really good and with all these calls and confessions, the federal government was able to establish an extremely strong case against these defendants. Alright, Michael, ready for this? I’ll detail, the mini elements they’re able to uncover, and I will ask both of you guys, both Sarah and you not to go revert back to season seven, where you start dinging me on the red flags, cause you’re going to hear a lot of things that you’re going to shout out why or no stop. Ready? The labs through marketers, paid doctors hundreds of thousands of dollars for advisory services, air quotes there, which were never performed in return for [00:12:00] lab test results. The labs paid portions of the doctor, staffs salaries and portions of their office leases contingent on the number of lab tests referred each month. In some instances, the lab marketers even made direct payments to the provider’s spouses. Then the labs threatened one provider that they would cease paying anything unless he immediately increased his lab referrals. And then finally they converted a lab into physician own lab where so the physicians could have ownership opportunities, but it was only based on if the physicians continued to refer adequate numbers to the labs. Finally, my favorite one is one of the doctors was going to probably leave the deal so they made an advanced distribution to him before he was an owner in order to appease him so that he would not leave their deals.

Michael: You’re saying these things are frowned upon?

Brad: Well, I don’t know. We might have to get some experts in here to help us with that.

Michael: It didn’t sound good.

Brad: No?

Michael: No it didn’t but why don’t we go [00:13:00] into commercial?

Brad: Okay.

Michael: On the other side, let’s bring on our guest to help kind of unpack this and unpack the results of the criminal investigation.

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Brad: Welcome back to Legal 123s with ByrdAdatto. I’m your host Brad Adatto with my co-host Michael Byrd. Now Michael, this season, our theme is OPP and we have our guest who patiently sat there and listened to us banter back and forth but really more importantly, we got into wiretapping and one person flipping on the next [00:14:00] one. Let’s please bring her in to figure out what has happened and how she sees it from her perspective.

Michael: Awesome. Our guest today is Sarah Wirskye. She is a practicing attorney for over 20 years, defending clients in white collar, criminal and civil fraud disputes with the government. Sarah received her law degree from Southern Methodist University with honors, unlike you and me, Brad.

Brad: That’s correct.

Michael: She has an MBA from the University of Texas at Dallas, masters of business administration, a bachelor of business administration from SMU, Southern Methodist University. Her business background is a former practicing CPA with a big six accounting firm and her MBA degree makes her uniquely suited to defend clients in financial fraud matters. Sarah is married to her husband, Bill, who’s also an attorney and has two children, Will and Katherine. For those of you who recognize Sarah’s name, she was on with us in [00:15:00] season three, dumpster fires and for those that don’t remember, Sarah is also my next door neighbor. So Brad, do not try to fish for any information about me like you tend to try to do with our guests.

Brad: I would never say Sarah, how bad of a neighbor is he? I would not ask her that question.

Michael: Do not ask that out loud.

Brad: I’m not

Michael: Okay.

Brad: Okay.

Michael: Alright, Sarah. Welcome.

Sarah: Thank you. Thanks for having me here.

Brad: Yes, Sarah. Welcome back and Michael, before I bring Sarah on with her first question, I assume I should not ask her for a bribe in our payola jar.

Michael: Yeah, Brad. I mean, that would be frowned upon, but mostly because it would be really embarrassing because she would say no.

Brad: Oh shhh okay. I won’t ask her that question either then. Alright, Sarah, before we start hitting you up with the questions from this OPP story, for our audience members who didn’t hear you the last time on our show, by the way, audience members go back and listen to it, please let them know what legal services does, and I’m using the term, white collar attorney provide.

Sarah: Sure. I [00:16:00] represent individuals and entities that have disputes or potential disputes with the government. So, because I do white collar and civil fraud work, I’m dealing with the federal government on the other side and so those services involve being engaged either, pre-filing of a case, which is really ideal because the goal in these cases is to try to convince the government not to move forward, whether it’s with an indictment or a civil fraud lawsuit and so we do an internal investigation, gather the facts and hopefully convince the government not to move forward. If they do move forward, then you really have two avenues. The cases are resolved via going to trial or some resolution short of that, which could be a plea to some lesser charges, which is what happened here in the case that Brad and Michael were talking about.

Michael: Yeah, well, let’s start from the top. Have you heard or seen investigations like this, where [00:17:00] it moves so fast from the charges to guilty plea?

Sarah: Never a case of this magnitude. I’ve seen small cases that have resolved quickly or less complex cases, but never, 15 defendant, 300 million healthcare fraud case so this moved really at lightning speed.

Brad: So, when you have multiple people indicted in this, is it always, when you watch the movie, so audience members, I don’t do this for a living, so that’s why I’m asking Sarah. This question is you have a CI and they flip, and then the first ones tend to go. Are they the ones typically to get the lowest sentencings in?

Sarah: You know, not necessarily. Cooperation is certainly a factor that comes into play for sentencing purposes and it’s a significant factor, but the other thing that the government considers or should really consider is somebody’s role in the offense. It really depends on where the [00:18:00] cooperative may fall in the culpability scale and usually the process works where you’ve got somebody that’s lower down that comes in and cooperates and gets the better sentence, the better resolution, but sometimes the process doesn’t really work the way it should. I mean, I’ve been involved in cases where the first person to come in to cut a deal, maybe the person at the top or near the top. What’s unfortunate about that is you may have somebody who orchestrated an egregious ski made tens, if not hundreds of millions of dollars and they end up with a really good deal, like you said, because they come in and cooperate. Sometimes the government takes that into account and their deal is not quite as good and then you have someone lower down the chain that depending on how their case is resolved may or may not get the same type of resolution, because they don’t have much to offer to the government. So to answer your question, there’s a lot that comes into play, but cooperation is definitely a significant [00:19:00] factor in that process.

Michael: It just occurred to me as I was listening to you and then thinking about the story, even with a game plan like they had in this a lot has to go right for it to fall like this, where everyone’s pleading guilty so fast cause it would just seemingly take like one person to stand up to the government and the whole thing would’ve gotten bogged down.

Sarah: Absolutely. I mean, obviously you have the evidence which we’ll talk about later in the wire taps and all that, which sounds like was pretty overwhelming, but on top of that, these resolutions were pretty reasonable compared to what you see in healthcare fraud cases.

Brad: Yeah.

Sarah: Because like you were talking about Brad, where you were talking about most of these individuals had five year caps. You had, I think one with three and then the couple of people at the top had 10 or 15 years. What that is, is that’s a statutory cap to a plea. That doesn’t mean that you’re going to serve that entire term in [00:20:00] prison.

Brad: Right.

Sarah: You know, there’s good time there. You get credit for under the first step act and oftentimes in plea deals, you have other factors that are negotiated and so they may have agreed to lesser loss amounts for some of these defendants. They may have agreed to other factors to where somebody’s statutory cap may have been five years and so that’s a ceiling, but their, actual exposure may have been closer to six months or possibly probation or even a year or two.

Brad: Well, and then the ramifications audience members is number one is you’re pleading guilty to a felony so bad, and you may have to wear a jumpsuit even if only for a couple of months bad, again.

Sarah: Bad. Very bad. Yeah.

Brad: I agree. I was kind of surprised when I saw how egregious it was and I’ve seen, obviously you’ve seen worse than I have, but as I was surprised to see how low the charges were, and maybe it was because the government didn’t have to spend that much money on prosecuting this [00:21:00] case. Maybe that was another reason why they’re only getting three to 15 years.

Sarah: Yeah, I mean, overall and almost everybody was at five years or less.

Brad: Yeah.

Sarah: Other than the two people at the top, those are reasonable offers and when your exposure going to trial could be 15 plus years and you plead to a five year cap and with various and the other negotiations and things like that, be looking at, like you said, it’s still prison and it’s still an orange jumpsuit, but you know, a year in prison is much better than15.

Brad: So yeah, no doubt.

Michael: It’s all context.

Sarah: Yeah.

Michael: Let’s talk about the wiretap process. Talk about what the government has to do to legally obtain a wiretap and kind of approaches that an attorney can make to deal with that.

Sarah: Sure and this is something that’s very unusual in a healthcare fraud case and so [00:22:00] I want to break that down a little bit because before they got the wire taps, they had the consent calls and so that is very common.

Brad: What does consent calls mean?

Sarah: So what that is, is basically under Texas law and a lot of states law, I can record a conversation that I’m a party to.

Brad: Gotcha.

Sarah: So if I call you, I can be recording it. If I’m sitting here, I can turn on my phone and record the conversation. What I can’t do is record a conversation between Brad and Michael, that I’m not a part of.

Brad: You don’t want to record it. Trust me. Those would be terrible.

Sarah: Yeah, we don’t want any evidence of that.

Michael: That’s why Brad was sweating earlier.

Brad: Yes.

Sarah: So consent calls or just recordings have become very, very common in white collar cases because the advances in technology. The chips have become small. You can record on a, I mean, the technology has made that very easy and so I always tell my clients that if you’re involved [00:23:00] in a federal criminal white collar investigation assume that at some point, someone’s going to try to get you on tape. The flip side of that, Michael, your question was, how do they get a wiretap? There’s more hurdles to that process. You actually have to make an application to the judge and you have to satisfy or show certain factors that you’re going to get evidence or you’re likely to get evidence of this crime and we need to do this. So there’s definitely a higher burden there.

Brad: On the government to prove that and so that’s where those affidavits come in, that you hear about, or witnesses coming to explain why they need to get a wiretap on somebody.

Sarah: Exactly, exactly and like I was saying, they’re unusual in white collar cases, most white collar cases. I mean, I’ll say probably over the last 25 years, I’ve had no more than 10 cases in which there have been true wire taps. You see ’em on [00:24:00] TV a lot more than you think and so clients always ask is my phone tapped and my answer is almost certainly no. I don’t know if this case changes things, but they are uncommon. In the cases where I’ve had ’em they’ve been public corruption cases so I haven’t seen them personally in a healthcare fraud case.

Brad: Gotcha.

Sarah: The reason why is there’s certain statutes that say you can use a wiretap to investigate certain crimes and healthcare fraud is not one of the listed statutes, but there’s a catchall that says, and this is under the federal criminal code, there’s a catchall that says that you can get a tap for any federal felony. Now that’s not commonly used.

Brad: Yeah.

Sarah: But I don’t know if we are going to see that change and this is an example of one of those cases.

Brad: It is the kitchen sink moment, but I guess because they had [00:25:00] so much good information from the MP and the CI in this particular one, they could probably have enough information to say, well, obviously some type of felony is occurring here. Let’s get ’em on a wire type. For audience members who didn’t catch on, Michael did say this earlier, all the things I described that was going on, where they’re paying people for their referrals, that’s bad.

Michael: It is actually frowned upon.

Brad: Very frowned upon. Orange jumpsuit, apparently frowned upon.

Michael: Yeah, it took all of my power and I’m sure Sarah’s as well not to audibly interrupt you as you were listing the actions.

Brad: Yeah and I think, and you probably know this too, Sarah, you probably see more, these weren’t allegations. I’m assuming this was a tape recording of them talking about these kind of conversations.

Sarah: My guess is they had quite a bit on the audio.

Brad: Yeah.

Sarah: That’s exactly right. Michael, one of the things that you had asked earlier on, how do you challenge those as an attorney? Well, the government gets these ex-parte and so you don’t know until after the fact and so [00:26:00] later remedy is to file a motion to suppress regarding that evidence, but it’s already out there so, and motion to suppresses, they’re challenging.

Brad: Yeah.

Sarah: I mean, it’s difficult to prevail.

Brad: Going back to something very, maybe 25 years, have you ever even heard of a thing moving this fast where a charge is filed and two months later, everyone up and down the chain has pled guilty.

Sarah: Not a case of this complexity or of this magnitude with this many defendants. Now, in this case, it sounds like some of these defendants had their deals done and cut before they actually made the indictment public, that it was unsealed because some of those plead papers were filed within a week or so after. My guess is some of those people had already resolved the case and that does happen, but where everyone resolves the case? No, I mean, that’s really unusual.

Brad: Well, in our little [00:27:00] bit of time left Sarah, do you have any final thoughts for our listeners and when you heard the stories, anything else? Any good takeaways you want to give them besides don’t wear orange jumpsuits.

Sarah: Well, yeah, that’s a big one. That’s a big one. Right? Don’t pay for referrals, but really this case hit a lot of what the government is focusing on in their white collar cases. I mean, healthcare fraud continues to be a huge priority.

Brad: Yeah.

Sarah: These arrangements. The kickback cases. Probably 95% of my healthcare crisis involves some sort of arrangement where there are payments to referral sources and in this case, from what you were saying, Brad, it sounded particularly egregious where they were tying those payments to the volume or the value of those referrals.

Brad: Yes.

Sarah: Big no-no.

Brad: Listeners, if you ever pull up and bore yourself to death and reading the stark or anti-kickback laws, the word volume and value is the biggest [00:28:00] no-no of all. Yes, completely agree with you on that.

Sarah: The last thing is, this lab focus, that’s something that we are continuing to see as well. So this case, like I said, had a lot of the big areas the government’s focused on. The big unknown, I think is, are we going to start seeing more wire taps used in these types of healthcare investigations and I think that’s to be determined.

Brad: Yeah and you nailed it early on, but I mean, we always talk to our clients about this and or anyone who’s our listener will have heard her say so many times they might pass out, but the form substance is what matters in all these deals and Michael, you may have said this, they may have had a great counsel that put together the best looking document of all time and said, this is how you have to do things. If you just blow past it and you don’t even follow whatever the doc written document says is irrelevant. The government cares about the substance behind it, which is, oh, I have a marketing agreement or I have a [00:29:00] lease with them, but I don’t pay the lease unless they refer to me. That’s problematic audience or I pay ’em above fair market value. There’s so many different ways that people think they’re getting creative. We, in this firm, we jokingly talk about when someone calls us and asks, how do I give a legal kickback? Fast forward audience members. There is no such thing as a legal kickback. That’s either legal or it’s illegal. There’s nothing in between.

Michael: Kickback has a pretty negative implication to it.

Brad: Yes. Except if you have a pay level. If they had this, this would be fine.

Michael: That’s a payola jar, not a kickback jar.

Brad: Yes. That’s totally different. Michael, what about you? You have some final thoughts?

Michael: Well, the audience probably have figured this out by now, my practice is more focused on the business structuring side and Brad does a lot of the regulatory and obviously Sarah is knee deep in this. My perspective is a little bit more probably in tune with some of the audience as far as just a layman’s view. That’s number one. [00:30:00] Patient referrals cannot be used as a currency in an arrangement.

Brad: Correct.

Michael: It is often, the desire. I mean, someone wants to form a lab and they need labs to be referred to, to be a successful business and doctors refer the labs so how do I incentivize the doctors to send more labs. It’s allowed in many other business industries to have models like that, where you incentivize sales. It’s a no-no in this industry and Brad spends a lot of time trying to figure out how arrangements can be done correctly. As Brad said, even after you do ’em correctly, or it’s set up correctly, you gotta actually follow it and then you’re carrying risks and so it’s so important early on, if you are coming under the view of the government and they’re investigating you to get counsel someone like Sarah quickly so that [00:31:00] you can start preparing to defend yourself.

Brad: Yeah. Well, Sarah, thank you for joining us in studio and next time bring more cash with you.

Sarah: Well, thanks for having me.

Brad: Awesome. Well, Michael, believe it or not, that’s it for today’s show. It was another amazing show. So happy to have Sarah in studio. Next week, audience members, we have a guest joining us in studio. Another attorney. This attorney was one of the first to report, the physician best known for the podcast, Doctor Death, to the Texas medical board. We’ll be joined by our friend and trial attorney, Mike Lyons to tell us his side of the Doctor Death story.

Outro: Thanks again for joining us today and remember if you like this episode, please subscribe. Make sure to give us a five star rating and share with your friends. You can also sign up for the ByrdAdatto newsletter by going to our website at ByrdAdatto.com. ByrdAdatto providing this podcast as a public service. This podcast is for educational purposes only. This podcast does not constitute legal advice, nor [00:32:00] does it establish an attorney, client relationship. Reference to any specific product or entity does not constitute an endorsement or recommendation by ByrdAdatto. The views expressed by guests are their own and their appearance on the program does not imply an endorsement of them or any entity they represent. Please consult with an attorney on your legal issues.

ByrdAdatto founding partner Michael Byrd

Michael S. Byrd

ByrdAdatto Founding Partner Bradford E. Adatto

Bradford E. Adatto

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