Federal Healthcare Fraud

As a healthcare professional, the biggest threat to your medical career is the allegation that you have committed a crime. Instances of healthcare fraud are on the rise, and healthcare providers in Orlando face a callous system in which authorities scrutinize their actions. Doctors, nurses, hospital workers, and others face a higher risk of being the subject of a federal Medicare or Medicaid fraud investigation in Orlando than providers in other areas. If you are the subject of a federal healthcare fraud investigation, the Umansky Law Firm is ready to provide quality legal representation.

Healthcare fraud encompasses a variety of illegal acts that suck billions of dollars from the government and private insurers annually. Having healthcare-related fraud charges against you eis an effective way to damage your reputation, lose your license, and destroy your practice. Don’t go down without a fight.

Definition of Healthcare Fraud

The general definition of fraud is any dishonest act intended to result in financial or personal gain to which the perpetrator or other beneficiaries are not entitled. In the realm of healthcare, fraud may include Medicare or Medicaid fraud. Both state and federal statutes address these crimes.

Orlando Medicare and Medicaid Fraud Defense Attorneys

Medicare is a government-sponsored health insurance program that provides health insurance to seniors 65 and older or those who have a disability. The government funds Medicare through tax revenue. When a person or corporation defrauds Medicare, the individual or entity steals from the federal government; hence, Medicare fraud is a federal offense.

Medicaid is a public assistance program for low-income Americans of any age in need of health insurance. While each state administers Medicaid separately, Medicaid funds come from the government. Medicaid providers may unknowingly perpetrate fraud in several ways. These acts not only result in losses for the government and taxpayers, but they put the health and safety of beneficiaries at risk. Like Medicare fraud, Medicaid fraud is a federal offense.

Actions That May Constitute Healthcare Fraud

In the complex world of healthcare, it is not uncommon for providers to make mistakes. Unfortunately, significant errors can attract the attention of state and federal authorities. Patients can also participate in or commit fraud. Some of the most common examples of healthcare fraud are:

  • Upcoding
  • Unbundling
  • Billing for services not rendered
  • Billing multiple times for a single service
  • Prescription drug fraud
  • Prescribing or billing unnecessary medical equipment
  • Providing unnecessary services
  • Kickbacks (paying for referrals)
  • Using another’s Medicare card to receive products or services
  • Filing insurance claims for services and items not received
  • Selling medications and medical equipment obtained from Medicaid
  • Destroying medical records or financial documents

Any one of these actions or a combination of them can lead to civil and criminal penalties. A person may spend a decade or more in prison depending on whether the offense resulted in the injury or death of a patient.

Why You Need a Federal Fraud Defense Lawyer

Orlando healthcare fraud allegations can be civil or criminal. In many cases, minor allegations begin as civil allegations and blossom into a criminal investigation. How can you tell whether your healthcare fraud investigation is a criminal matter? Search and seizure warrants, arrest warrants, communications from a federal criminal prosecutor or discovering that the IRS is getting involved in your case are all significant red flags. The sooner you contact a federal fraud defense lawyer, the better your chances will be of avoiding the most damaging charges.

A federal healthcare fraud defense attorney with the Umansky Law Firm can conduct a thorough investigation of the charges against you and uncover evidence that is favorable to your case. If you are a doctor, nurse, hospital worker or manager, medical equipment provider, home health care company, or have other ties to the medical industry, call 407-228-3838 for a free consultation or email us a description of your case.

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