Federal Health Care Fraud – WHAT IS IT?

  • By:David Bate

Federal Health Care Fraud includes a variety of serious federal offense that can expose one to potential significant prison time and large fines.  The penalties can include prison sentences of between 10 to 15 years (or more) and fines up to $500,000.  The charges that can be brought are broad, and cover a large range of actions including the following:

Potential Chargeable Actions:

* schemes that involve overbilling for services provided

* receiving “kickbacks” or referral fees

* lying or omitting information on Medicare forms

* forging prescriptions and overprescribing

* selling or obtaining prescription drugs without authorized prescriptions

* selling personal prescription drugs to others

* medical billing fraud (such as performing unnecessary medical procedures or not doing them but billing for them)

* obtaining medical treatment with false documents (such as insurance cards), or providing false information to doctors or insurance companies

* practicing medicine without proper licensing

The list of potential criminal actions continues…In short, federal Health Care Fraud can include a variety of actions that are perceived to be attempts or actions that deceive or cheat health insurance companies out of money for the benefit of another.   Both providers of services or products and the recipients or those services or products can be charged.  The federal agencies that oversee these types of federal crimes are generally the FBI and the DEA.

You might also be charged in the State with similar or identical conduct, since States have their own health care fraud statutes that can be very similar to the federal statute.

If you are charged or threatened with a health care fraud crime, you need a lawyer who has extensive experience in handling these matters such as the experienced criminal defense attorney Verona NJ locals turn to.  You need an experienced white collar, federal, criminal defense attorney –and one that has familiarity with the federal court system.

Thanks to authors at Lorraine Gauli-Rufo for their insight into Criminal Defense law.

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