Did you know that you could be committing Medicare fraud without even knowing about it? That is right; some acts that may seem only ethically questionable may actually be prosecutable offenses under federal law. Medicaid and Medicare fraud are hot-button topics at agencies like the Department of Health and Human Services, which is why a growing number of defendants are facing criminal charges related to this offense in Florida.
Medicare fraud occurs when health care providers misrepresent the care they are providing to their patients. In many cases, these health care professionals are accused of knowingly submitting claims that do not accurately portray the services that have been rendered through their practices. These defendants may be accused of altering statements to receive repayment from the government for services that would normally not be reimbursed. Further, health care professionals can face fraud allegations if they solicit or accept compensation to increase the number of Medicare referrals they receive.
Physicians are not the only group to commit health care fraud. In fact, mental health services groups, transportation companies and Medicare suppliers — along with many other groups — can also be implicated in such allegations. The violations that lead to federal fraud charges generally are not innocent errors or simple systematic shortcomings; rather, they often consist of intentional improper billing or billing for services that were never provided in the first place.
If you are facing a federal investigation for fraud, you should know that you have rights in criminal court. Federal allegations are generally far more severe than their state-level counterparts, so it makes sense to proceed with caution and care when choosing your legal representation. Appropriate strategies are necessary for managing a white collar crime case in federal court as opposed to a state venue.
Source: Department of Health and Human Services, “Medicare Fraud & Abuse” Sep. 01, 2014