Steps to take if you face Medicare fraud charges

On Behalf of | Apr 8, 2024 | Medicare and Medicaid Fraud

Medicare fraud charges can have serious consequences for healthcare providers. You may feel confused and fearful when facing these accusations.

Taking the right steps to address the situation can help you protect your rights.

Cooperate with authorities

If facing Medicare fraud charges, cooperate fully with authorities. Provide any requested information, documents or records relevant to the investigation. Doing so demonstrates a commitment to resolving the situation.

Conduct an internal investigation

You should perform an internal investigation to review your billing practices. Go over documentation procedures and compliance with Medicare regulations. Identify potential issues or areas of concern so you can proactively address these issues. This shows a dedication to compliance with appliable laws.

Review Medicare guidelines

You should become familiar with the rules governing billing, coding and documentation. Refreshing your knowledge about Medicare guidelines to ensure compliance. This step can help you avoid future allegations. Providers should also stay informed about updates and changes to Medicare policies.

Maintain documentation

Keep accurate billing records, particularly when facing Medicare fraud charges. Providers should ensure that they have complete, compliant documentation. These records can serve as evidence to support the provider’s defense.

Implement compliance measures

Training programs and other strategies can help practices prevent Medicare fraud. Providers should educate staff on Medicare guidelines. Conduct regular audits of billing practices and establish procedures for reporting potential fraud or abuse.

The average Medicare fraud conviction carries 30 months in prison according to the U.S. Sentencing Commission. Taking appropriate action can help protect your livelihood, reputation and legal rights.

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