A Guide on Picking the Best Health Care Fraud Law Firm for Your Case

Health care fraud was not as popular as it’s today – the fight against drug abuse was the leading prosecutorial movement before from nowhere; banking and savings loan violations became the center of attention.

Now, fraudulent acts relating to medical treatments are at the uproar and law enforcement is trying its possible best in putting a stop to these unethical doings but they need to keep working efficiently to curb health care fraud because it is the greatest current source of economic losses and at the same time the greatest source of economic recovery – which it indirectly means that not doing anything about it or taking necessary measures against these illegal acts will result into eating up the government’s revenue but prosecuting it is very worthwhile. The prosecution being profitable makes it one of the very good reasons why the government should not relent in thinking and developing new ideals daily to win it in all ramifications.

The Best Health Care Fraud Law Firm

A lot of law firms engaged themselves in dealing with cases of this great magnitude, but getting the Best Health Care Fraud Law Firm for Your Case is not always easy to do. An individual including doctors, physicians, health care administrators, health care entrepreneurs, and also businesses like hospitals, clinics, etc. can hire for themselves an expert attorney in health care fraud matters from one of the Best Health Care Fraud Law Firms.

Is Your Health Care Fraud Case Substantial Enough?

A good lawyer from one of the best law firms in the country will look into your case and examine if it is good enough. Any health care fraud accusation you are bringing up must have a well-documented evidence in relation to Medicare fraud, Tricare fraud and Medicaid fraud. To say your health care fraud case is substantial it must have a whistleblower that has good knowledge of the fraudulent act you are bringing up as a case.

A whistleblower could be any individual such as an agent, industrial expert, contractor or an employee. The lists below give you the categories of health care fraud whistleblowers.

Health Care Professionals: they include anybody like hospital administrators, health care administrators, and many other certified health care professionals.
Medical professionals: health care personnel like a physician, nurse, pharmacist and others like researchers and sales representatives.
Financial Professionals: officers with respect to financial sector, accountants, coding specialists, benefit coordinators and many more under this category.

The above categories of whistleblowers stated above are the ones you should always sort after to add to your health care fraud case so it can be good enough. Anyone aside from these brackets is not advisable and not helpful in making a good case. We do understand there are actually not many people willing to stand as a whistleblower because of the personal risk and professional risks attached to it but getting the right one is only the best option and the right path to winning your case.

Before we proceed to the guilds you need in choosing the Best Health Care Fraud Law Firm for Your Case, you need to have an idea about some important terms and things like:

The False Claims Act
The False Statements Act,
Anti-Kickback Statutes
Whistleblower Incentives
Schemes Health Care Businesses Use in illegally Receiving Federal Benefit Programs’ Imbursements

The False Claims Act

The False Claims Act tackles situations that relates to a doctor billing for treatments that are neither needed nor performed to a patient in the first place. The most known health care fraudulent acts like Overbilling, Phantom billing, fabricating patient accounts, Medical laboratory testing fraud, etc. are covered under the False Claims Act.

The following elements stated below must have been met before you can think of hiring an experienced lawyer in one of the Best Health Care Fraud Law Firms for Your Case:

False, fictitious or fraudulent acts must have been submitted by the defendant to one of the departments of the United States
The defendant is fully aware of the crime he/she has committed before involving themselves in such unethical acts.
There is must be a sense of intent in the illegal act done by the defendant; otherwise, it doesn’t stand.

The False Statements Act

This has to do with using fabricated statements, representations, writings, etc. to communicate to the government, which in most cases is considered with the state and health condition of a patient.

The False Statements Act is very related to the False Claims Act, but they are not the same. Two instances differentiating the two terms are given: under the False Claims Act, the health care practitioner can be said to have presented a bill for an eyes test that never happened while the False Statements Act, on the other hand, can be triggered when a doctor claimed a diagnosis of an illness the patient did not truly have.

The listed elements stated below for the False Statements Act must have been met before you can think of hiring an experienced lawyer in one of the Best Health Care Fraud Law Firms for Your Case:

The statement that was directly or indirectly submitted to the federal government is labeled fabricated, untrue or lies
The defendant prior to submitting the false statement had the intention of fabricating the lies
The statement was sent to trigger or influence the action of the government

Anti-Kickback Statutes

It is unacceptable to collect reimbursement for the recommendation of products or services in places that has to do with the health of the people even though it involves you, an orthopedist, collecting compensation from the physical therapy center you have referred to any of your patients or a psychiatrist accepting gig tickets from a pharmaceutical company in exchange for giving out samples of its new product. The anti-Kickback statutes are said to be easily wronged by the health care practitioners because many of them knowingly engaged in the acts against it without them fully aware of how illegal the acts are.

Schemes Health Care Businesses Use in illegally Receiving Federal Benefit Programs’ Imbursements

To be frank, if you do really want to successfully win your health care fraud case you must be ready to pinpoint and carefully understand the several schemes the people including doctors, physicians, health care administrators, health care entrepreneurs, and also businesses like hospitals, clinics, etc. use in defrauding the federal health care programs like the Medicare, Medicaid and Tricare established by the government. A good and the Best Health Care Fraud Law Firm for Your Case should have immense knowledge and experience about this.

There are many of these fraudulent schemes but our focus will only be on the most common ones which are off-label marketing and health care Kickbacks.

Off-label Marketing: this fraudulent act is related to pharmaceutical companies. This act occurs when a pharmaceutical company without the endorsement from the Food and Drug Administration (FDA) decides to promote or market a particular drug for use. The False Claims Act is fully against any pharmaceutical company from encouraging a physician to use a drug billed to the government in an off-label manner.
Health care Kickbacks: this scheme is all about persuading the referral of patients or health care products allocated by a federal-funded health care program just for the sake of generating improper incomes. We will proceed by explaining the two laws used to prohibit this act having concerns with medical matters.

The Anti-Kickback Statute (AKS): this federal criminal statute bans pharmaceutical businesses and individuals from creating payments or using other incentives for inducing the referral of patients or services held by a federal or state health care program.
The Stark Law: this is also known as Stark Statute. This law prohibits a medical practitioner from sending a patient under the coverage of federal benefit programs like Medicare and others to a private entity because the medical personnel or one member of the family of the health practitioner got a direct or an indirect financial connection with the entity.

A lot of complications can be involved while dealing with these laws mentioned above, and the things needed for filling a lawsuit can be so discouraging. This is among the reasons why you need to discover and locate Best Health Care Fraud Law Firm for Your Case and win it efficiently for you.

The Effect and Detection of these Fraudulent Acts

This article has stated earlier that these unacceptable doings by individuals, including doctors, physicians, health care administrators, health care entrepreneurs, and also businesses like hospitals, clinics, etc. concerning health matters cost the federal government a great amount of money every year now. A measure to put a total end to it or reducing it to the lowest minimal is seriously needed. Although, we quite know that the detection efforts required to put this to a thing of the past are not stress-free but extensive and multi-faceted.

The Reward for Whistleblowers

The government has done greatly well in giving incentives to the whistleblowers that risk their professional and personal securities to report and expose people and organizations that engage in fraudulent acts against the federal benefit programs. The whistleblower would be entitled to a portion of the money recovered if the lawsuit is successful, it can stretch into millions of dollars depending on the subject of the fraudulent act and the impact of the whistleblower in the process of winning it.

The Necessary Things to Do in Getting the Best Health Care Fraud Law Firm for Your Case

The most important thing I feel is necessary is to walk up to one of the Best Health Care Fraud Law Firms and consult a professional lawyer that deals with criminal defense cases on health care before attempting to involve yourself in such fraudulent acts. This experienced attorney you might have met should be willing to assist you by explaining in details the things to do in avoiding fraudulent deeds concerning health care programs like Medicare on both federal and state levels.

The health care fraud firm, through one of their lawyers, should also be free to let you understand how you can build, on your own, compliance program around your organization to avoid being held responsible for actions you know nothing about that was done by one of your colleagues at work.

Let us assume you have already gone against the rule by committing crimes against the government through one of their federal benefit programs and you are currently being investigated or you have been charged, the only option left for you is to go straight to one of the most creditable and secured law organizations in the country to consult a very good attorney. You should not just stand to do nothing or mess up the whole thing by providing false statements to the investigator in which, by doing this, you have worsen the case.

Knowing fully well that health care fraudulent acts are currently being checked on both federal and state levels to try to eradicate and prosecute whoever is found guilty of such dealings against the sanity of the economy, health care practitioners should endeavor to do all that is needed to be done to protect themselves, businesses and professional futures from the devastating implication of violation.

The professional criminal defense lawyer you are getting from one of these reputable Health Care Fraud Law Firms for Your Case should have experience in representing health care providers against fraud accusations on both state and federal levels. The Best Health Care Fraud Law Firms for Your Case is the one that is ready to provide risk-free consultations to help you determine if they are the best to stand on your behalf. I will advise you don’t use them at all if they can’t offer you this. Many people have suffered in the hand of incompetent attorneys from law organizations that can’t be reckon with.

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