Phishing and identity theft

Fraudsters may impersonate a financial institution to obtain login credentials or personal information. If you receive an unexpected message, use the bank’s known website or phone number rather than a link in the message. Report unauthorized activity promptly to the bank and consider the Federal Trade Commission’s IdentityTheft.gov recovery guidance. A person accused of using another’s identifying information should have counsel examine how the information was obtained, who controlled the account, and what transactions can be attributed to whom.

Checks and loan records

Altered checks, disputed deposits, and alleged misrepresentations in loan documents can lead to state or federal investigations. Florida’s section 832.05 addresses certain worthless checks and deposits made with intent to defraud. An overdraft or returned check does not automatically prove every element of a crime. The timing, account records, notices, and intent can be central.

If you are under investigation

Preserve statements, communications, and transaction records. Do not alter documents or contact other participants to align stories. Before giving an investigative statement, ask a criminal defense attorney to review the allegations and any request for records. Roy J. Kahn, P.A. handles fraud defense matters in Miami. No outcome is guaranteed. This is general information, not individualized legal advice.

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What conduct raises questions?

Examples include billing for a service not provided, using a code that does not describe the service, billing for a service that was not medically necessary, or paying for referrals. Some issues may lead to repayment or administrative remedies; others may trigger civil or criminal investigation. The HHS Office of Inspector General summarizes the False Claims Act, Anti-Kickback Statute, Physician Self-Referral Law, exclusion authorities, and civil monetary penalties. Each has distinct requirements and consequences.

Responding to an inquiry

Preserve claims, patient records, coding guidance, contracts, and communications under applicable privacy rules. Do not change records to make a claim appear different. Identify the precise claim periods and services at issue, and consult counsel before making an investigative statement or producing records. A facility owner or clinician should not assume that a staff member’s actions automatically establish personal criminal liability, or that delegation eliminates every responsibility.

Penalties and program exclusion depend on the law, findings, and case. The old blanket dollar and prison figures in this article do not apply to every allegation. Roy J. Kahn, P.A. handles health care fraud defense matters in Miami. No outcome is guaranteed. This is general information, not legal advice.

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Review documents before signing

Check the application, closing documents, and supporting records for accuracy. Disclose debts and the source of funds as required by the lender, and correct an error before signing. Do not sign a blank document or allow another person to insert an inflated income, fabricated employment, or false occupancy statement. The FBI specifically advises borrowers to read loan documents carefully before signing.

Common warning signs

Be cautious when someone offers to use a “straw buyer,” asks you to misstate who will live in the home, or presents an appraisal or purchase price that appears manipulated. Foreclosure rescue offers warrant independent scrutiny, but a legitimate loan modification request is not automatically a fraud. A property flip is not inherently illegal; the concern is a deceptive representation or other unlawful conduct in the financing.

If accused

Preserve applications, emails, bank records, appraisal reports, and closing documents. Do not change files or coordinate accounts with other participants. Counsel can assess what was represented, who prepared each document, what you knew, and the specific legal elements alleged. Roy J. Kahn, P.A. handles fraud defense matters in Miami. No result is guaranteed. This is general information, not legal advice.

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Rules for providers

The HHS Office of Inspector General explains the distinct False Claims Act, Anti-Kickback Statute, Physician Self-Referral Law, exclusion, and civil monetary penalty rules. These are not a single offense with a fixed fine. Liability and potential remedies depend on the conduct, statute, current penalty schedule, and evidence. A referral within a practice is not automatically unlawful; financial relationships and exceptions require careful analysis.

Protecting a Medicare number

Beneficiaries can review claims and Medicare Summary Notices for services or equipment they did not receive. Medicare.gov advises protecting the Medicare number and reporting suspicious claims. Do not assume a free screening or legitimate medical service is fraudulent solely because it is free; verify the provider and offer.

If investigated

Providers and staff should preserve claims, medical records, contracts, and communications in compliance with privacy duties. Do not change records or discuss a shared account of events with witnesses. Counsel can examine the relevant billing period, coding, medical necessity, and any claimed knowledge or intent. Roy J. Kahn, P.A. handles health care fraud defense matters in Miami. No result is guaranteed. This article provides general information, not legal advice.

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