Federal Medicaid and Medicare Fraud Defense Attorney
Medicaid fraud occurs when healthcare providers, including doctors, hospitals, and dentists, bill the government for payment of medical goods and services that were never delivered or provided. Medicaid fraud is the theft of government money by making false statements.
Medicare fraud is a felony that the federal government takes very seriously. At Hedding Law Firm, our federal criminal defense attorneys understand the gravity of these charges and will thoroughly examine all aspects of your case to mount a strong defense. The prosecution must prove that there was an actual intent to deceive, a task that must be proven beyond a reasonable doubt. This is where our expertise comes in.
Medicare fraud occurs when people or companies purposely bill Medicare for services that are never provided or received. For example, your Medicare number could be used to bill Medicare for services and supplies you did not need, want, order, or accept. Medicare fraud typically occurs in nursing homes, hospitals, residential facilities, hospices, and other health care providers.
Physicians or healthcare entities found to have committed Medicare fraud face serious consequences. They will be required to repay the Medicare overpayment they received, and they will likely face significant financial fines. Further, they may face criminal prosecution by the federal government. The potential consequences of these charges are severe and should not be taken lightly.
The False Statements Act, 18 U.S.C. §1001:
Healthcare providers found guilty of this federal crime by intentionally providing false statements to the government in documents or written communication that try to conceal facts are guilty under this act.
The penalty for conviction under this Act is a fine not exceeding $10,000 or imprisonment of up to five years.
Medicaid fraud takes different forms—as far as the scheme in which it is committed. Some typical schemes are filing false time sheets, billing for face-to-face visits when there was no meeting, and submitting billings for physician office visits when the clinic has no licensed physician on staff.
Medicaid Fraud Penalties
- Imprisonment for up to 5 years
- Fines up to $20,000
- Civil penalties of $2,000 per false claim
- Exclusion from Medicaid
Different Types of Medicaid Fraud
The government can prosecute several different types and forms of Medicaid fraud. Sometimes, people submit bills for false services. Other times, individuals use other people's medical cards to get services performed against them.
When it comes to this type of fraud where the government is losing money, they will arrest people, charge them with crimes, and force them to pay the money back in the form of what they call restitution. They can punish them with jail time or probation. They can lose certain rights for a significant period. All types of punishment can be related to a Medicaid fraud case.
So, if you're charged with Medicaid fraud, you should get an attorney with experience in this because sometimes the government doesn't get it exactly right and doesn't realize certain things related to you.
Remember, it's an enormous bureaucracy that's set up, and once they see that you do something wrong and there's a perception there as far as their system goes that you violated some rule, then they're going to come at you, but that doesn't mean that they always get it right.
Different Types of Medicare Fraud
The government has ramped up a task force to go after individuals involved in Medicare fraud. This can take many different forms of fraud — doctors can be involved, and patients can be involved.
It involves getting money from the government for health insurance in the form of Medicare and using that money improperly, gaining it improperly, or filing for false services.
There are various scams, and the government is paying hundreds of thousands of dollars related to Medicare fraud claims. They will file criminal charges if they determine that people use that money inappropriately or improperly.
First, it will start in their investigative body, which is more of a bureaucracy in a civil branch. Then, if it is determined that there is some criminal activity involving Medicare fraud, the next thing that will happen is that it will be moved to the criminal task force.
Once it's moved to the criminal task force, they're in a position where the person will be approached and talked to. What will happen is they will try to question that person about what they believe they're doing Medicare fraud-based. If that person says anything to incriminate themselves, they will use that information and prosecute them.
Other times, they simply arrest the person because they have evidence that they are involved in some Medicare fraud scheme. Again, this is the government protecting its money. They're giving thousands of dollars out every single day, so people have taken advantage of this, and in taking advantage of it, thousands of dollars are being wasted.
The federal government needs to police this. Sometimes, this involves doctors, sometimes patients, and sometimes all those entities or individuals stealing money from the government.
Lawyer to Develop a Defense Strategy
That's why sitting down with an attorney and reviewing the facts and details can help the attorney understand precisely what happened so they can adequately defend you. But realize when you get Medicaid services, you will typically have to sign documents and agree to specific rules.
People often don't pay attention to that; the next thing you know, they're violating those rules without even realizing it. That's typically not a defense in a Medicaid fraud case. You're expected to understand and recognize that you have certain things you're supposed to do if you want to collect those benefits and certain things you can't do if you want to collect those benefits.
If you're charged with a Medicaid fraud-related crime, the next step is to develop a defense strategy. This involves deciding whether to fight the case to a jury trial and then working with your attorney to determine your defense. It's crucial to ensure that your defense aligns with the circumstances of your case and the current state of the law.
In these Medicaid fraud cases, I often get the jury instructions that apply to the charges you have pending against you. We see exactly what elements the government will have to prove to find you guilty, and then we can have a frank discussion about whether they can do that.
We also look at potential defenses and see if you can meet any of those defenses with evidence. Depending on the facts and circumstances surrounding your case, you could testify, and other evidence could be brought to bear.
So, if you're charged with a Medicaid fraud crime in Los Angeles, pick up the phone, make the call, and let's sit down and talk. Let's decide what we can do to get you out of the criminal justice system as fast as possible. Contact a Medicaid fraud lawyer at our office today, and we will get your federal criminal charges under control and make every effort to bring you the best results possible.
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