Have You Been Charged with Federal Healthcare Fraud?

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Have You Been Charged with Federal Healthcare Fraud?

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What Are Federal Healthcare Crimes?

Allegations of health care fraud are federal offenses handled by the Federal Bureau of Investigations (FBI). This agency has access to advanced technology and resources that put clients who are facing these charges at a disadvantage.

Any individual who intentionally deceives the health care system can be charged with federal health care fraud. These cases often involve one or more parties and may include patients, doctors, or other healthcare providers.

What Healthcare Crimes Do Medical Providers Face?

Healthcare billing fraud

Health care providers often face charges of intentionally defrauding the insurance company to obtain more money. 

Anti-Kickbacks and Stark Law

Anti-kickback and Stark laws were developed to prevent health care fraud. Both of these statutes deem it illegal for health care professionals to pay for or accept payment for medical referrals. Medical providers are not legally allowed to accept any form of compensation for referrals.

Unbundling

Submitting multiple bills, or unbundling, is when medical providers defraud the insurance company by submitting more than one bill for the same services.

Phantom Billing

Phantom billing is when medical providers submit bills to the insurance company for services or medical equipment that the patient never receives.

Upcoding

Upcoding occurs when a medical provider charges the insurance company for more expensive services than were received.

What Healthcare Crimes Do Patients Face?

Health Care Fraud Defense

There are several common health care crimes that patients can be charged with on a federal level.

Identity Crimes

These crimes involve a patient intentionally using another individual’s health insurance to cover their medical services. If an individual knowingly allows another person to use their insurance they may also face federal health care fraud charges.

Impersonation

It is a federal health care crime for an individual to impersonate a medical provider without a medical license. These crimes include performing or billing patients for medical services.

Doctor Shopping

It is a federal crime to visit multiple health care providers to obtain prescriptions for controlled substances.

What Defense Strategies Can Be Used for Federal Healthcare Crimes?

The prosecution will need to prove that an individual intentionally committed these crimes for financial gain. This means that they will need to convince the jury that it could not have been a simple billing mistake.

Gallian Firm will use advanced strategies to create this reasonable doubt by disputing the unique evidence in your case. Reach out to Gallian Firm today to discuss the unique elements of your case.