In Florida and across the United States, accusations and arrests for Medicare fraud are common. Since Medicare is a government system, there is no doubt there are avenues where overbilling, phony treatments and other types of illegal behaviors can occur. This can rise to significant sums of money. Penalties for a conviction for fraud can be severe with jail time, fines and the inability to return to work in the medical field. People who are caught up in an investigation for these allegations should be aware of how to formulate an effective defense.

Apparent addiction treatments are said to have been fraudulent

A doctor, 46, who was treating patients for addiction has been arrested in a Medicare fraud case worth $681 million. The scheme lasted for nearly a decade until this past March. Not only was Medicare charged, but private insurers were too. Testing procedures and other treatments did not take place or were not needed, but were billed. The insurers paid around $121 million of the total billed. Patients were sometimes charged up to $20,000 for a single visit.

The medical practice the doctor ran was for addiction, family heath and urgent medical care. He was also listed as the medical director for dozens of other facilities. Fraudulent tests were charged for these locations. A complex strategy he supposedly used involved patients who went to these other facilities for which he was the medical director and would subsequently have treatment and care at the main practice, allowing him to bill Medicare and insurers for the services. Medication to treat opioid addiction was prescribed to people who had no need for it. He is also said to have committed wire fraud and health care fraud.

Legal assistance is essential for Medicare fraud defense

There are many twists and turns when medical professionals are conducting treatments and providing care to patients who are covered by Medicare. The federal government is serious about ensuring that providers and recipients of Medicare are aboveboard in their treatment and do not overcharge the government. Treatments that were not provided, overbilling, buying unnecessary equipment and other violations happen often. These can lead to other charges like evading taxes and money laundering.

It is vital for those who are dealing with an investigation or have already been arrested to be cognizant of the potential consequences for a conviction. Perhaps a plea bargain could be reached or there is a reasonable explanation and the person is innocent. Calling for immediate help from a firm experienced in defense for Medicare fraud may be key.

  • In the Media:
  • abc Nightline
  • the O'Reilly Factor
  • Court TV
  • abc 2020
  • CNN
  • Larry King Live
  • The Miami Herald
  • Good Morning America