What to Do if You Are Charged with Health Care Fraud in Florida?
Health care fraud is a growing problem around the country. As such, the government is reserving additional resources to investigate and charge people for it. When someone is charged with health care fraud, it means they filed a health care claim under false pretenses in order to gain a benefit or make a profit. Health care fraud involves the use of falsehoods, lies, or deception when making the claim. It can be committed by everyone from patients to health care providers and insurers.
If you have been charged with health care fraud in Florida, you need to retain a skilled Florida health care fraud attorney. Health care fraud is a serious charge, and you want an attorney who can build the best defense possible.
What if Your Claim was a Mistake?
Distinguishing a mistake from actual fraud is important. To be convicted of fraud, you must have knowingly planned or schemed to provide a false claim in order to gain in some way. A mistake is not the same thing. A mistake might be charging a patient for treatment they didn’t receive, but there was no intent to commit fraud or receive financial benefits.
Examples of Health Care Fraud
There are a number of different actions that will qualify as health care fraud. Some of the most common types of health care fraud include:
- Medicaid fraud;
- Unbundling, upcoding;
- Falsifying records;
- Certifying a patient is homebound in order to qualify for home health care when they aren’t;
- Misrepresenting providers and service dates;
- Unnecessarily prescribing drugs;
- Unlawful prescribing and dispensing of drugs;
- Payment for recruiting patients (kickbacks);
- Pharmacy billing when drugs are not filled; or
- Overutilizing services.
Try to Prevent Charges from Being Filed
If possible, the best outcome is to try and get the matter resolved before any charges are filed. When you suspect you are under investigation by the government for health care fraud, you need to pick up the phone and contact a Florida health care fraud attorney. Your attorney might be able to negotiate an agreement or keep them from pursuing charges at all. When you retain an attorney who is experienced in health care law, they will use their knowledge to help identify weaknesses in their case. It might discourage them from filing charges or reduce the total amount of alleged fraud.
Possible Penalties for Being Convicted for Health Care Fraud
Penalties for a health care fraud conviction can vary based on the charges and what the total value of the loss was to the government. The court will use the Federal Sentencing Guidelines to decide on a recommended sentence. The sentence will also depend on whether you are the patient, the provider, or the insurer who is on trial. Some possible penalties include:
- Jail or prison time
- Fines and restitution
- Loss of DEA Registration or state license
- Actions on your credentials or on your staff privileges
- Medicare exclusion
Contact a Federal Health Care Fraud Attorney in Florida
If you have been charged, or are under investigation, for a federal health care fraud charge in Florida, don’t attempt to handle it on your own. Contact the West Palm Beach white collar crimes attorneys at Bruce L. Udolf, P.A. today to schedule an initial consultation.