Los Angeles Health Care Fraud Defense Lawyer
Federal Criminal Defense Attorneys Defending Individuals Accused of Health Care Fraud
Federal health care fraud charges are covered under 18 U.S.C, Section 1347 and defined as when an individual knowingly and willfully executes or attempts to execute a scheme defrauding any health care benefit program by false pretenses, representations or promises to obtain money or property controlled by any health care benefit program.
Health care fraud is often a federal crime and charges typically come about when an individual or company defrauds a federal government health care program or insurer. In Los Angeles County as well as in other parts of California, health care fraud could also involve Medi-Cal, California’s government-funded health insurance program. Medi-Cal provides health insurance primarily for low-income, elderly, and disabled California residents.
Health care providers, including doctors, nurses, nurse practitioners, and physical therapists, are the most common defendants in health care fraud cases. It is serious problem in the United States, with the Federal Bureau of Investigation (FBI) indicating that it costs the country tens of billions of dollars every year.
If you have been charged with health care fraud, it is essential that you have experienced Los Angeles health care fraud attorney at our law firm in your corner as soon as possible, and throughout your entire case, to provide effective defense against your charges .
Common Types of Health Care Fraud
Health care fraud can take a variety of forms. Some of the most common examples of health care fraud include the following:
- Providing excessive services – as when a health care provider bills Medicare for services greater than what a patient actually required under the circumstances
- “Upcoding” services – or billing for services that were more costly than the services that were actually rendered to the patient
- “Upcoding” of items – or billing for items that are more costly than what the patient actually received
- Billing for services not rendered – billing Medicare for services that were never rendered or which the patient did not need; billing for duplicate services – usually involves billing Medicare twice for the same or similar services, by slightly altering bills and invoices
- Unnecessary services – filing Medicare claims for care that a patient did not need
If you are under criminal investigation or already charged with health care fraud, call a Los Angeles federal criminal defense lawyer at our law firm immediately. Our health care fraud attorneys will need to review all the specific details in order to determine an effective defense strategy. Do not make any statements to federal law enforcement agents as you may make incriminating statements. Remain silent.
Health Care Fraud is Governed by a Variety of Laws
There are a number of federal laws that criminalize conduct related to health care fraud. For example, the Health Care Fraud Statute makes it a crime to knowingly and willfully execute a scheme to defraud a health care benefit program. A violation of this law can result in a prison sentence of up to 10 years and fines of $250,000.
Similarly, the False Claims Act allows for civil liability for individuals for knowingly present a false claim to the government for payment and making a false record or statement that is material to the false or fraudulent claim. Some other federal laws that can be used to prosecute or sue individuals who engage in health care fraud include the following:
- The Anti-Kickback Statute – Federal law that prohibits the knowing and willful offer, payment, solicitation, or receipt of any remuneration, in cash or in kind, to induce or “in return for referring an individual for the furnishing or arranging for the furnishing of any item or service for which payment may be made under a Federal health care program.
- The Patient Access and Medicare Protection Act – Added provisions to the Anti-Kickback Statute, the most important of which created harsher penalties for people who illegally buy, sell, and distribute Medicare and Medicaid numbers and other health information identifiers.
- Exclusion Provisions – Federal law allows the Office of the Inspector General to exclude individuals from participating in federal health care programs. These exclusions can be required under federal law or be left to the discretion of the Office of the Inspector General.
- The Civil Monetary Penalties Law – Authorizes civil penalties for violations of the Anti-Kickback statute.
Call a Los Angeles health care fraud lawyer at our office for more information about your specific case. Health care fraud criminal cases are typically complex. A federal criminal defense lawyer from our office will need to conduct a thorough examination of all the evidence to start preparing a solid defense plan.
Collateral Consequences Associated with Health Care Fraud
As addressed in the information above, there are significant criminal penalties associated with a health care fraud conviction, including fines well into the hundreds of thousands of dollars and significant periods of incarceration. In addition to these court-imposed legal penalties, a health care fraud conviction can have extremely severe collateral consequences as well.
For example, a conviction for health care fraud could easily result in the loss of a medical license and an inability to find work in the health care profession again. In addition, as this type of conviction is a matter of public record, it could have an impact on your ability to find any type of work, rent an apartment, or attend a college or university.
Because of these serious potential consequences, anyone accused of health care fraud should retain a qualified Los Angeles health care defense attorney early in the court process. Immediate intervention by a federal criminal defense attorney at our law firm can have a huge impact on the outcome of your case.
Call a Los Angeles Health Care Fraud Attorney
An experienced Los Angeles health care fraud defense attorney at our office will be able to examine all of the facts and circumstances of your case and formulate defenses, ensuring that your case is brought to the most favorable resolution possible.
Our Los Angeles federal criminal defense law firm has a history of success defending clients against health care fraud related charges. In one case, our client was charged with a Medi-Cal fraud case where he was accused of over $10 million in improper billing.
After extensive negotiations with the prosecutor by a Los Angeles health care lawyer at our firm, the charges were dismissed at the end of the preliminary hearing due to insufficient evidence. Our client was facing substantial prison time if convicted.
If you have been charged with health care fraud, it is essential that you have experienced legal representation in your corner every step of the way. To schedule a consultation with one of the experienced Los Angeles health care fraud defense lawyers at Eisner Gorin, LLP, call our office today at 877-781-1570 or send us an email through our online contact form.
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