A Guide to Healthcare Fraud

A Guide to Healthcare Fraud

Although medical professions are around to provide assistance and treatment for those in need, there are a handful of professionals who choose to engage in careless and criminal behaviors. Unfortunately, these select few have a negative impact on others and their ability to practice medical worry-free.

Given the increase in fraudulent activities within the healthcare field, we are seeing an equal attempt of organizations within the government working to combat their actions. For this reason, we are seeing a drastic increase in doctors, surgeons, and other medical professionals being charged with health care fraud. These charges can have a devastating impact on a professional and their ability to practice. For this reason, it is crucial for those accused to reach out to a reputable criminal defense attorney as soon as possible.

What is Healthcare Fraud?

An action is considered to be health care fraud when the perpetrator acts to willfully and knowingly execute, or attempt to execute, schemes that are designed to defraud any health care benefits programs.

Some examples of these actions include:

  • Billing for services, items, or treatment that was not performed or not medically necessary
  • Up-coding or unbundling to maximize billed amounts
  • Falsely certifying that a patient needs home care services
  • Providing false dates of services on billing records
  • Providing false providers of services on billing records
  • Billing for medications not received
  • Waiving co-payments or deductibles
  • Not correctly reporting procedures or diagnoses
  • The unlawful dispensing or prescribing of medications or treatment
  • Engaging in Medicaid fraud
  • Buying back prescription drugs
  • Issuing medications under false or unnecessary pretenses

These activities can result in overbilling for services or treatment that was never rendered. Unfortunately, health care fraud costs companies over $68 billion annually across the United States.

The Impact of Health Care Fraud Charges

Health care fraud charges are extremely serious. Those charged with these crimes can face up to twenty years in prison, depending on the charges they face. In cases where the actions resulted in the death of a patient, medical professionals can face life in prison.

On top of prison sentences, those found guilty of health care fraud charges can face hefty fines up to $500,000 per offense. These could add up to millions of dollars in cases involving numerous charges.

Finally, those found guilty of health care fraud can also be forced to pay restitution. It is extremely common for judges to require those found guilty of health care fraud to require them to pay back all of the money they overbilled for services and treatments.

Get Help with Your Case

Being charged with health care fraud is unlike any other criminal charges an individual or corporation can face. Unfortunately, those accused can have a difficult time finding adequate representation due to the fact that the regulatory scheme for health care is extremely complex.

Thankfully, our team at Healthcare Fraud Group is well-versed in the laws surrounding these devastating charges. Our team is dedicated to providing effective and competent legal representation to those in need. If you were accused of healthcare fraud, contact our criminal defense attorneys today at 888-402-4054 to schedule a free case review to discuss defense options surrounding your case.

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