Top 10 Things to Do When You are Under a Healthcare Fraud Investigation

When you are given notice that you are being investigated for healthcare fraud, especially if you did not commit the crime, it can be one of the most unsettling and terrifying moments of your life. It can be even more distressing when you don’t have any access to legal advice. Depending on the state, a healthcare fraud is a crime that is a felony or serious misdemeanor, depending on the severity of the case. It can land you in jail for years, and you may have to pay a fine up to $250,000.

Healthcare fraud includes health insurance fraud like Medicaid fraud, drug fraud, and medical fraud. These schemes can come in the form of billing for services not rendered, upcoding of services, upcoding of items, billing duplicate items, excessive services fees, kickbacks, and more. The last thing you want is to be convicted of a crime you didn’t commit. If you, your practice, or your healthcare organization are slapped with healthcare fraud allegations, the prosecutors will gather as much evidence as they can to pin the crime on you. Here are the top 10 things you must do when you are under a healthcare fraud investigation:

Stay Calm and Don’t Panic

When you find out you are being investigated for a healthcare fraud charge, the first instinct is to panic. Some people in the past have resorted to rushing to the police to explain their case, others attempt to destroy evidence, and some have threatened others who they feel may testify against them.

Remember to keep calm because if you react out of sheer desperation, you may say something or do something that you end up regretting. When dealing with the police or any other government agency, it is best to err on the side of caution. It is critical to keep a calm so you won’t lose your ability to think clearly.

You can put off interacting with the police by telling them that you need time to consult your legal counsel for advice. If they do come to you with a search warrant or subpoena, you must allow them access. However, be sure that their search is limited to the locations stated in the document. No matter how angry you are, remember to remain respectful. Reign in your temper because you don’t want to do anything that will exacerbate the situation.

Know Your Rights

It is your constitutional right to remain silent. Anything you say can be used against you. If the police or any government agency question you and put you under investigation before reading you your rights, anything that you say to them during that period can be used as evidence against you in court .

Before you answer any questions during an investigation, whether formal or informal, everything that you say must be communicated through your attorney or with your attorney present. This is for your own protection.

The police or any government agency may attempt to invite you in for a pre-interview. Take note: the maximum period the police can keep you for their investigative questioning without any formal charge is only 24 hours.

Hire a Reputable Lawyer

Having a lawyer present is essential. It is not an admission of your guilt. Hiring someone you trust means you should choose the best person for the job, especially when you are being investigated for an offense as serious as healthcare fraud. Your lawyer will sit with you through police investigations. Sometimes, the police have even been known to drop the investigation when there is very little evidence and they know that you have obtained legal counsel. You also need to make sure that you hire someone that specializes in healthcare fraud.

Our team of lawyers at Bell P.C., also known as the Healthcare Fraud Group, specializes in serving clients who are subject to investigations involving fraud within the federal health system. We have made it our mission to clarify everything in a government investigation, from finding out reasons for the accusations, dealing with possible penalties, and working hard to defend our clients’ interests. Our network of highly-experienced lawyers and legal professionals collaborate with each other to keep you protected.

You must hire someone that you trust and feel comfortable with. As the investigation progresses, you will have to discuss personal issues with your lawyer. You will have to be honest even if the details are potentially embarrassing. Thus, it is critical to find a legal team that you feel at ease with.

Learn As Much as You Can

If you are under investigation for a healthcare fraud allegation, you will naturally be curious to find out more about the issues levied against you. It is human nature to want to know everything, especially why you are being investigated, what prompted the investigation, and whether there is probable cause for suspecting you.

Your lawyer can help answer these questions. They can also talk to the police and get information from them on your behalf. Most of all, any statements made by your legal counsel will not be imputed against you. Once you know what you’re being charged with and what evidence they have, your legal team can begin planning a solid defense strategy.

Cooperate if They Have Documentation

If they have a subpoena to bring you to the police station for questioning, or if they have a warrant to search your residence or place of business, you have no choice but to cooperate. To resist would be futile and seen as an obstruction of justice.

It may be easier said than done, but try to assuage your fears, especially if you are not guilty. The truth shall always prevail. If you are detained, you are entitled to make a phone call. Be sure to contact your lawyer right away so that your legal team can plan the next course of action to take. Staying one step ahead of things is critical to your success.

Be Careful of What You Say

When medical insurance fraud investigative agents come knocking on your door, you are already guilty in their minds. Their mission is to gather as much information as they can so that they can officially charge you with a crime.

If they approach you without a warrant or subpoena, politely decline the interaction. Instead, redirect them to the contact number of your lawyer and tell them you are aware of your rights.

Be Wary of Police or Other Government Agency Tactics

Investigators may contact your in order to invite you over for an informal discussion. This approach is specially crafted to put you at ease in the hopes that you will incriminate yourself. Everything you say to the police, whether over the phone or in person, can be used against you when charges are filed. This is why everything must be passed through or communicated by your attorney.

Collect the Necessary Documents

After you and your attorney are informed of why you are being investigated, gather all the necessary documents that may pertain to the case. Make several copies and go over the details with your lawyer.

This way, in case the prosecution or defense comes up with something critical, you have these resources within easy reach. It is critical to remember not to turn over any of your documents to the police, no matter how much they insist, unless you get the advice to proceed from your lawyer. You will never be required to turn over documents unless the investigators come with a warrant or subpoena.

Gather Exculpatory Evidence

It is your lawyer’s job to begin gathering evidence to exonerate you. This includes gathering documents that display good intentions and finding witnesses who will speak on your behalf.

It is important for you to know that you must never talk to a potential witness yourself because you could be charged with witness tampering, which carries stiff penalties and even jail time. If you feel as if there is something to be gained from speaking to a witness, push the information through your attorney.

Take Care Not to Destroy Any Evidence, Even Inadvertently

No matter how tempting it may be, never tamper with any evidence. Do not destroy anything, even documents that may incriminate you. Tampering with evidence is a very serious offense that could land you in jail on its own.

Remember, it is important to document where all your sources of information are coming from and how you obtained them so that you can credibly provide the evidence in court.

Bottom Line

Being under investigation for an alleged crime you did not commit is unnerving and frightening. You may be tempted to act foolishly because you want to get the investigation over with as quickly as possible. Again, always remain calm. Your best bet for a positive outcome is if you think rationally and make calculated decisions. Most importantly, hire an experienced attorney like the Bell P.C. Health Care Fraud Group to assist you through the entire investigation process.

With a lawyer’s guidance, you increase your chances of emerging from an investigation unscathed.

If you, your healthcare business, practice, or organization is currently under investigation, do not hesitate to call the Healthcare Fraud Group for assistance. Schedule an initial consultation with our highly skilled and experienced healthcare fraud attorneys. Our entire legal team will be at your service to help you mount an aggressive defense or to come up with some form of a compliance program to clear your name.