Zealous, Professional Defense Against Health Care Fraud Charges
Under Title 18 U.S.C. §1347, health care fraud is a federal offense in the United States. In some instances, health care fraud may be related to medical providers defrauding health care benefit programs by submitting inaccurate claims for products or services. In other cases, medical providers may be accused of health care fraud for defrauding patients through services that were not medically necessary. It is not uncommon for federal and state agencies to work together to investigate fraudulent health care claims, meaning that accused parties may face state and federal charges in health care fraud cases. In cases related to fraudulent claim submissions, accused parties often face allegations related to Medicare and Medicaid.
Doctors, ambulance companies, pharmacists, hospitals, clinics and various other parties may all face health care fraud charges. If you’ve been charged or are under investigation, your freedom and your career may be on the line. That’s why you need to contact Peter Barrett: Dallas Criminal Defense Attorney. Our attorney has more than 25 years of criminal defense experience in both state and federal court, and he zealously fights for the rights of his clients.
What Is Involved In A Health Care Fraud Case?
Because individuals and institutions can be accused of health care fraud, it is extremely important for anyone in the medical profession to have an experienced lawyer on hand in case they face charges related to this crime. Common health care fraud charges include:
- Billing for services that were not provided or not medically necessary
- Falsifying claims that a patient is home-bound
- Attempting to secure patients or services through bribes
- Upcoding/unbundling (improperly applying codes to receive higher reimbursements for medical diagnoses and procedures)
- Misrepresenting when services were provided
- Misrepresenting what service providers were used
- Waiving deductibles and co-payments without a justifiable reason
- Billing for drug prescriptions the pharmacy never filled
- Reporting diagnoses and procedures incorrectly
- Utilizing unnecessary services
- Unnecessarily or falsely issuing prescription drugs
- Engaging in unlawful prescription drug buy-backs
- Unlawfully prescribing and distributing medication
- Medicaid/Medicare fraud
In addition to single individuals being charged with health care fraud, two or more people may be charred with health care fraud conspiracy under Title 18 U.S.C. §1349. This statute stipulates that it is illegal for a group of people to attempt to defraud health care benefit programs or patients, whether they are successful in that attempt or not. Under, U.S. Code §3729, the False Claims Act, individuals or groups may also face civil action for health care fraud, depending on the circumstances of the case. These charges are usually brought by the government in cases where accused parties have attempted to commit Medicare/Medicaid fraud.
How Our Firm Can Help You
Health care fraud can result in a maximum prison sentence of 10-20 years, or a fine of $10,000 for each false claim. Under the False Claims Act, you can also be sentenced to up to five years in prison and a fine of $250,000.
Fortunately, there are multiple defenses for healthcare fraud that an experienced attorney will be able to apply. In many cases, the accused party may not have even been aware they were filing an inaccurate claim. If an accused’s business has a valid compliance program, it is possible to argue that compliance errors may have been inadvertent. Errors in billing or compliance do not inherently demonstrate that the accused party had intent to commit health care fraud, and the burden of proof is on the government to convince a judge otherwise.
Attorney Barrett is known for providing compassionate and energetic legal aid, and supported by our seasoned legal team, he has successfully argued cases in state and federal courts, the Supreme Court of Texas, as well as appellate and district courts. Remember, just because you have been accused of a crime does not mean you should give up hope.