Urbana Healthcare Fraud Lawyer
Healthcare fraud is considered a white-collar crime, but it is also one that is aggressively pursued by federal prosecutors. Healthcare fraud usually occurs in medical settings, such as doctor’s offices, hospitals, and nursing homes. Many healthcare professionals think healthcare fraud involves an overt act, such as intentionally defrauding Medicare. However, even the smallest mistake may be viewed by federal investigators and prosecutors as an intentional act that is considered a crime. If you have been charged, it is critical that you speak with an Urbana healthcare fraud lawyer who can defend against the charges.
Kickbacks Under the Law
The Anti-Kickback statute prohibits any healthcare provider from receiving or offering funds from a federal healthcare program in an effort to purchase, lease, or procure a patient referral. Under the law, the prosecution must show that the defendant had the intent to give or receive a kickback. Still, sometimes innocent people are charged because there was a transfer of funds or property after a patient referral, even when the two had nothing to do with each other.
Inaccurate Billing and Coding
One of the most common types of healthcare fraud is inaccurate billing and coding and again, sometimes it is just a minor error that results in federal criminal charges. This type of healthcare fraud can involve double billing a federal healthcare program, billing for costs not available under federal programs such as operating costs, and choosing stand-alone rates when bundled rates apply.
Anyone who intentionally uses inaccurate billing and coding practices to defraud the federal government will face a separate charge for each account. For example, if a doctor regularly billed for stand-alone services instead of a cheaper bundled rate, they would face a separate charge for each invoice.
The term ‘false claims’ is a broad one that encompasses many different types of healthcare fraud. The False Claims Act prohibits anyone from making false claims when applying for reimbursement from federal healthcare programs. Again, these false claims must be made intentionally. False claims can result in not only criminal penalties but civil legal action, too.
Billing for Services, Supplies, or Equipment
Healthcare fraud that involves billing for services, supplies, or equipment falls into one of two categories. The first is when healthcare providers bill federal agencies for the use of these when they were not necessary. For example, a doctor might charge a federal agency for the reimbursement of a walker for a patient who did not suffer from mobility issues. The second type of this healthcare fraud occurs when healthcare professionals charge for certain items when there were lower-cost options available.
You Need a Healthcare Fraud Lawyer in Urbana to Protect Your Rights
Healthcare fraud charges are extremely serious, and due to the fact that they involve defrauding the federal government, they are pursued very aggressively by law enforcement. If you believe you are under investigation, or if you have been charged, our Urbana healthcare fraud lawyer at Patel Law, PC, can provide the strong defense you need. Call us today at 217.384.1111 or connect with us online to schedule a free consultation.