Healthcare Fraud: Why Charges Are Pursued So Aggressively October 10, 2018 | Legal Blog

Any system is vulnerable to fraud, especially our healthcare system. In fact, it is believed that nearly 10% of all money spent in the American healthcare system is paid out to fraudulent claims. It’s important to understand the definition of healthcare fraud and realize that charges are pursued aggressively by the government. If you find yourself entangled in a healthcare fraud situation, even accidentally, contact an attorney immediately for the support you need.

What Is Healthcare Fraud?

Healthcare fraud occurs when a service provider like a doctor misrepresents information to collect insurance payments that he would not otherwise be entitled to receive. There are many different tactics used to commit healthcare fraud:

  • Billing for services that were never rendered
  • Billing for more expensive services or procedures than were actually provided
  • Performing medically unnecessary services for the purpose of generating insurance payments
  • Misrepresenting non-covered treatments as medically necessary covered treatments
  • Unbundling, or billing each step of a procedure as if it were a separate procedure
  • Accepting kickbacks for patient referrals

What Are the Punishments For Healthcare Fraud?

Since healthcare fraud takes advantage of the medical system designed to protect and care for Americans, it is a crime taken very seriously by the FBI and other law enforcement agencies. State and federal laws differ, but both hand down severe punishments for those found guilty of healthcare fraud.

The most common penalties include fines, prison, and restitution. Making a false claim or statement to Medicaid can lead to 5 years in prison per offense, while healthcare fraud that results in serious bodily injury could lead to 20 years in prison. Fines range p to $250,000 to $500,000 per offense, an organizations that participate in ongoing schemes are often charged billions of dollars in fines. Restitution amounts vary based on how much money was improperly swindled from insurance companies and patients.

Find An Attorney Who Can Defend Your Rights

Attorney Robert Eckard of The Law Office of Robert Eckard & Associates offers the background, training, and experience in business litigation and criminal defense to make him uniquely qualified to handle your healthcare fraud case.

Call The Law Office of Robert Eckard & Associates at (727) 497-7811 to schedule your case evaluation and learn more about how Attorney Eckard and his team can help you avoid a criminal investigation and keep your provider’s license and freedom protected.