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Health Care Fraud

Healthcare Fraud Law - 18 U.S. Code § 1347

Healthcare fraud entails knowingly and willfully executing or attempting to execute a scheme or means of defrauding any healthcare benefit program, or, by fraud, false pretenses, representations or promises obtain any money or property owned by or controlled by any healthcare benefit program.

Federal crimes such as Medicare fraud carry severe penalties. Under federal sentencing guidelines, if you are convicted of of the white collar crime of Medicare fraud, you could be facing thousands of dollars in fines and years in a federal prison.

The defendant may also be ordered to to pay restitution and placed on probation for many years. Federal prosecutor's aggressively pursue a conviction in a Medicare fraud case.

Contacting a practiced criminal defense attorney is essential if you are facing a healthcare fraud investigation. You can face severe fines and up to 10 years imprisonment or both if convicted.

Some types of healthcare fraud include:

  • Billing personal expenses
  • Billing for services/products not delivered
  • Billing for more expensive services/products than were delivered
  • Arranging for and paying or receiving kickbacks
  • Overpricing of services/products
  • Unnecessary treatment
  • Billing items separately that should be billed together
  • Falsifying claims in order to receive payment

Healthcare fraud has recently been covered widely by the media and is on the mind of many Americans. Many health care providers are finding themselves having to justify items and services billed to insurance companies and healthcare benefit programs like Medicare .

Additionally, more and more providers are finding they have to defend against accusations of health care fraud.

Investigators and prosecutors from the federal government will thoroughly research allegations of health care fraud.

If you are undergoing an investigation you need the help of a savvy and resourceful criminal defense lawyer from Cron, Israels & Stark.

Different Types of Medicare Fraud

Indictments for Medicare fraud can include over-billing, or billing for medical services or medical devices not provided or not needed in the first place. Normally, medical clinics and doctors are the most commonly charged in Medicare fraud and healthcare fraud cases.

Medicare fraud occurs when healthcare providers submit false or padded bills to Medicare for payment and cost the federal government millions of dollars every year.

There can be many reasons for errors in Medicare billings, which were the result of intentional deception of the Medicare system. These can include clerical errors, inadequate billing supervision and also improper supervision on the treatment area. There have also been cases where the errors in the government documentation or processing itself.

The government has ramped up a task force to go people involved in any type of Medicare fraud. This can take many different types of  frauds — doctors or patients can be involved.

In basic terms, it deals with getting money from the government for health insurance in the form of Medicare and then using the money improperly.

There are a wide range of scams and the government is paying out millions of dollars related to Medicare fraud claims. If they have proof you are ising the money unlawfully, they will file criminal charges.

They will first start with their investigative body which is more of a bureaucracy. If they have reasonable belief some type criminal activity is occurring, the case will be moved to the criminal task force. 

Once it's moved to there, you can expect to be approached and interviewed. They are attempting to question you about why they believe you are involved in Medicare fraud. If you say something to incriminate yourself, you can expect that information to be used against you in prosecution of the case.

Challenge the Federal Healthcare Fraud Allegations

 An investigation of healthcare fraud can be one of the most upsetting things that can happen to a healthcare provider. Any federal investigation is a serious matter.

Facing accusations of fraud can be devastating to your personal and professional life. Even if these charges are false, they can do irreparable harm to your name and reputation.

Federal prosecutor's must prove that the case involved a deliberate intention to deceive the government. Experience and knowledge of the various factors involved in a Medicare fraud case are critical in a strong defense.

Our attorney will assist in evaluating the allegations as to whether there is any basis for the investigation or not.

We will guide you through all aspects of the investigation while preserving your rights in the process..

Contact Us Today

Cron, Israels & Stark is committed to answering your questions about All Misdemeanor and Felony Crime law issues in Santa Monica and Los Angeles, California.

We offer a free consultation and we'll gladly discuss your case with you at your convenience. Contact us today to schedule an appointment.