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Rise in Federal Investigations of Medical Billing and Filing of Federal Health Care Fraud Charges
Health Care Fraud (Medicare Fraud, Medicaid Fraud) has been a growing concern of the federal government for several years now, and it is expected that federal investigation and prosecution of health care fraud and health insurance fraud will increase in the upcoming decade, especially as facets of Obamacare become effective.
In October 2012, for example, U.S. Attorney General Eric Holder and Secretary of the Department of Health and Human Services Kathleen Sebelius announced health care fraud charges filed against 91 people (doctors, nurses, other licensed professionals) as a result of an investigation crossing 7 different cities by their “Medicare Fraud Strike Force.” The nationwide federal investigation into health care billing practices by medical care givers across the country is expected to continue.
Even Mere Suggestions of Health Care Fraud or Abuse Can Have Serious Consequences
For those medical professionals and health care companies that are under investigation, suspect that they may be investigated, or face charges that have been filed in state or federal court, not only is there the danger of criminal sentencing with incarceration and fines, but there is the reality that these kinds of things, even rumors of being investigated for fraud, can cause serious harm to professional reputations and the future success of medical practices and company growth.
Years of dedicated service can be endangered even if no formal fraud charges are ever filed in court.
What is Health Care Fraud (Medicare Fraud, Medicaid Fraud)?
A charge of health care fraud is simply an allegation that there has been deception where insurance claims are made for services or equipment with commercial insurance carriers as well as Medicare or Medicaid. The health care fraud charge is that the service or equipment listed on the claim was never provided to the patient, or that the patient did get something – but was told was it was being provided to them at no charge. These are felony charge allegations that there has been:
- Fraud in charges for services not given;
- Fraud in charges for equipment not provided; and / or
- Fraud in providing and billing for things given or provided that the government now alleges were unnecessary.
Free equipment (wheelchairs, scooters, etc.), for example, in health care fraud cases is offered by the manufacturer to an individual and then, the insurance company receives a claim for the equipment – equipment that the government will argue was not needed or was never received.
Another common allegation of health care fraud is exaggerated insurance claims filed by health care providers. Here, physicians, therapists, testing labs, clinics, hospitals, and any other kind of medical provider completes and files insurance claims for the convenience of the patient and later, the government charges that these claims are either padded or are totally phony.
What about the physician’s review of the claim? While doctors must sign certificates that claims are authentic, health care fraud charges assert that either the physician was deceptive and signed fake claims for profit, or someone working in claims processing forged the necessary doctor’s signature on the claim certificate.
Medicare Fraud | Medicaid Fraud | Health Care Fraud – Defense against Government Fraud Charges
Texas Board Certified Criminal Defense attorney Michael Lowe represents clients throughout the State of Texas who face federal or state charges of health care fraud. Providers that can face investigations or charges of Medicare Fraud, Medicaid Fraud, or other forms of Health Care Fraud include:
- Physicians / Doctors
- Personal Care / Home Health Care Attendants
- Nursing Homes
- Long Term Care Facilities
- Equipment Providers
- Home Health Care Companies
- Medical Billing Claims Services Companies
Texas Health Care Fraud Lawyer
As a former prosecutor turned criminal defense lawyer with over 150 jury trials defending clients against charges brought by district attorneys and U.S. federal prosecutors in Dallas County, Tarrant County, and elsewhere in the State of Texas, Board Certified Criminal Lawyer Michael Lowe not only brings his years of experience to each case, he also dedicates 100% of his law practice to the defense of those being accused of a crime under Texas or federal law.
With a streamlined law firm that coordinates its efforts to give each client the personal attention that they need and deserve when fighting against the government and the possibility of jail time, fines, permanent marks on public records, prison incarceration, loss of licensure, loss of jobs, absence from family events and everyday living, Michael Lowe maintains an efficient and excellent criminal trial practice that is ready to help you or your loved ones in your defense against criminal charges from pre-arrest investigation to post-trial appeals.
To discuss your case in a free and completely confidential consultation, please contact Dallas Board Certified Criminal Lawyer Michael Lowe today.