Medicare fraud and abuse is a serious offense and is punishable to the full extent of the law. Generally, Medicare abuse is when a provider fails to follow good medical practices. One of the most common illegal practices involves performing services that aren’t medically necessary. Continue reading below for more information regarding Medicare fraud and abuse.
Common Medicare Abuse Practices
- Excessive charges for supplies
- Excessive charges for services
- Unnecessary billing for services
- Misuse of codes on a claim
- Billing for supplies and services that were not used
Federal Laws Governing Medicare Fraud
If your medical facility has been involved in Medicare fraud you should refer to the following federal laws.
- Social Security Act
- Anti-Kickback Statute
- False Claims Act
- United States Criminal Code
- Physician Self-Referral Law
What happens if a health practitioner is found guilty?
If you are a health practitioner that has been found guilty of Medicare fraud or abuse you can be fined up to $10,000 per service or more. In addition, you will also be banned from participating in the Medicare program. If convicted you can also face up to twenty years in prison per offense. If you have been charged with multiple counts of Medicare fraud your prison time can add up to a lifetime.
What if I didn’t know the fraud was happening in my facility?
Sometimes medical facility owner’s hire managers and other staff to oversee various departments. If you truly had no understanding that office management and staff were conducting fraud you need to speak to an attorney immediately. An attorney will advise you on your specific situation and provide the best defense for your case.
Do you think I will get caught?
Yes. Medicare fraud cases are reported on local and national news on a frequent basis. The following headlines are just a few reported in South Florida in 2017.
- A woman in Miami who had been honored for her work in the health care field and ran a health care service pleads guilty to defrauding Medicare out of millions of dollars. She faces up to five years in prison.
- Ten owners of assisted-living facilities located in Miami-Dade County were charged in a kickback scheme. The owners received kickbacks for referring residents to specific pharmacies for medical equipment and medication.
- Federal and State agencies arrested more than 100 South Floridians who were involved in major health care fraud.
If you knowingly have been committing Medicare fraud you need to stop immediately! Contact an experienced attorney today to further assist you with the case.
Roy J. Kahn, with years of legal experience in a wide variety of criminal law, heads a “boutique” firm, which means that your attorney is Roy J.Kahn, not a paralegal. If you have been charged or are about to be charged with a crime—or if you have been contacted to be a witness in a federal grand jury case, you need a qualified defense. You should consult with an attorney immediately and know that you have a right to make no statement until you have consulted with an attorney To contact Mr. Kahn, he can be reached at 305-358-7400.
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