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What constitutes health care fraud in Texas?

by | Oct 30, 2023 | Fraud

Standing before a Texas criminal court judge with your freedom, career, finances, family life and personal reputation at stake is a stressful and, sometimes, frightening experience. Hearing a judge sentence you to 20 years in prison or hundreds of thousands of dollars in fines (or both) is like a nightmare come true. This is exactly what might happen, however, if you’re arrested and charged with health care fraud.

On the bright side, many cases involving health care fraud never even go to trial. If the judge overseeing your case determines that there is insufficient evidence, he or she might order a dismissal. Even if a case proceeds to court, there are often numerous defense options available to refute fraud charges. Understanding the charges against you and knowing where to seek support are the keys to a successful defense.

Health care fraud occurs on many levels of the industry

It’s possible to face health care fraud charges as a physician, insurance provider or even as a patient. In any case, the sooner you obtain legal support, the better able to craft a strong defense you’ll be. Here are several examples of issues that could land you in court for health care fraud:

  • Medical provider accused of billing multiple times for the same service
  • Billing for services not provided or not necessary
  • Intentionally miscoding a service to a higher fee bracket
  • A patient letting someone use his or her ID number
  • Using someone else’s ID number
  • Billing for equipment or medical services without proper license to serve
  • Forgery
  • Selling prescription drugs on the street

If you’re accused of health care fraud in connection with any of these issues, there is still good reason to be hopeful. With the right type of support, you may be able to achieve a positive, if not favorable, outcome in court.

Preserve your freedom and protect your career

If you’re a licensed professional in the medical industry, facing health care fraud charges places your career at risk. By exploring the defense options available, you can determine the best course of action to help mitigate your circumstances. If you believe that the process leading up to, during or following your arrest was flawed, meaning that law enforcement did not act in accordance with laws that govern their behavior, you can bring the matter to the court’s immediate attention.

The Fourth Amendment of the U.S. Constitution protects you against unlawful searches and seizures. If you can prove that an unlawful search or seizure took place in your case, you may be able to convince the judge to dismiss the case or at least rule specific evidence inadmissible in court. Exercising your rights to the fullest extent will produce the best possible outcome.