According to the Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that gives health coverage to some people with limited income and resources.
Yes. Here’s why: Healthcare providers have been accused of Medicare/Medicaid fraud by patients who do not understand billing codes – and want to report what they believe to be suspicious activity or exorbitant costs – and disgruntled healthcare workers who are simply trying to put their current or former employers in a difficult legal situation. No matter how the false allegations have led to an investigation, once you reach that stage, it is going to be difficult to counter the allegations on your own. Both state and federal investigators have extensive resources and can collect all types of records from your office — even closing during the investigation. You will need a skilled criminal defense attorney on your side too, so you understand your legal rights and options to defend yourself against these allegations. You do not have to take the investigator’s word for how your case unfolds. We can help protect you from the start.
The Anti-Kickback Statute and Stark Law are both healthcare compliance laws that relate to the unlawful generation of Federal healthcare program business. The difference between the two is how referrals are given (and by whom), which makes them unlawful, and how they are penalized on both criminal and civil levels.
It depends on the details of your case. That includes whether you are a consumer or healthcare provider, which law enforcement branch investigated your case, and the extent of the fraud charges. No matter where your case is prosecuted, our skilled Medicaid/Medicare fraud defense attorney has extensive experience in both state and federal courtrooms and can help protect your rights in either jurisdiction.
Medicaid and Medicare fraud involve deliberately submitting false or misleading information to obtain unauthorized benefits from these government programs. Common examples include billing for services not provided, falsifying patient diagnoses to justify unnecessary tests, and upcoding, which is billing for more expensive services than those actually performed.
Penalties for Medicaid and Medicare fraud can be severe, including hefty fines, restitution payments, exclusion from federal healthcare programs, and imprisonment. The exact penalties depend on the nature and extent of the fraud, as well as any prior criminal history.
A Medicaid and Medicare fraud defense attorney can help you by investigating the allegations, developing a robust defense strategy, negotiating with prosecutors, and representing you in court. They aim to protect your rights and work towards minimizing or dismissing the charges against you.
While intentional fraud is prosecuted, honest mistakes or clerical errors in billing generally do not lead to criminal charges. However, repeated errors or negligence could result in audits, fines, or other administrative actions. It is important to have accurate and compliant billing practices.
The duration of a Medicaid and Medicare fraud investigation can vary widely based on the complexity of the case and the caseload of the investigating agency. Some investigations may take months, while others could extend over several years. It’s important to remain patient and cooperative while your attorney works on your behalf.
