Health Care Fraud cases are pursued by both federal and state officials. However, the federal government is much more likely to investigate, arrest, and charge a large number of doctors, pharmacies, third-party billers, and others involved in their perceived scheme. Health care fraud is, most simply, defined as misleading a health care provider into believing that a patient needs medical services or prescriptions that are not actually medically necessary. Said another way, if you or someone being investigated for health care fraud ever billed an insurance provider for goods or services that were not necessary or, even worse, not provided, you can be held liable under both the federal and state statutes.
Federal officials often charge health care fraud cases under a conspiracy – two or more people conspiring either to commit any offense against the United States, or to defraud the United States, or any agency thereof in any manner or for any purpose – because health care fraud normally requires more than one individual to create the fraud. For example, if a doctor’s office is fraudulently billing a health care provider for services rendered that were not actually rendered, it is very common to find that multiple individuals were aware of the conduct – doctors, office managers, receptionists, and third-party billing companies. Very seldom are health care fraud schemes perpetrated solely by one individual.
If you find yourself under investigation and need a Dallas federal health care fraud lawyer, you need to find a lawyer or law firm with extensive experience of these cases. Federal criminal defense lawyer Gregg Gallian of Gallian Firm LLC has handled numerous Health Care Fraud cases criminally. These cases have been investigated all across Texas. And, most importantly, Gregg has successfully convinced federal prosecutors not to charge his clients in some situations. Additionally, Gregg’s trial experience includes one of the largest criminal health care fraud/commercial bribery cases ever prosecuted.
Call today to schedule your free case review and let Gallian Firm fight for you!
(a)Whoever knowingly and willfully executes, or attempts to execute, a scheme or artifice—
Sec. 35A.02. HEALTH CARE FRAUD. (a) A person commits an offense if the person:
(1) knowingly makes or causes to be made a false statement or misrepresentation of a material fact to permit a person to receive a benefit or payment under a health care program that is not authorized or that is greater than the benefit or payment that is authorized;
(2) knowingly conceals or fails to disclose information that permits a person to receive a benefit or payment under a health care program that is not authorized or that is greater than the benefit or payment that is authorized;
(3) knowingly applies for and receives a benefit or payment on behalf of another person under a health care program and converts any part of the benefit or payment to a use other than for the benefit of the person on whose behalf it was received;
(4) knowingly makes, causes to be made, induces, or seeks to induce the making of a false statement or misrepresentation of material fact concerning:
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