Among the top areas of law that our criminal defense law firm represents is healthcare fraud, which can include anything from billing for services that were never provided to accepting certain kickbacks for patient referrals. The penalties associated with this type of fraud can be severe, which is why it’s important to retain legal representation that will help guide you through your case and hopefully obtain a favorable outcome.
What Is Healthcare Fraud?
This type of fraud can be perpetrated by both healthcare providers and consumers. This crime occurs when a consumer or healthcare provider intentionally submits information that’s false or misleading for the main purpose of receiving some kind of benefit. Most examples of healthcare fraud pertain to healthcare providers and can include:
- Billing for specific services that weren’t performed
- Accepting kickbacks for referrals
- Falsifying the diagnosis of a patient to justify a surgical procedure or test that was not wholly necessary
- Unbundling a treatment, which refers to billing for every phase of a procedure as opposed to billing for the procedure as a whole
Consumer healthcare fraud is typically more straightforward and can include such acts as using another person’s insurance card or coverage, forging receipts or bills, or filing a claim for a medication or service that you didn’t actually receive. When you commit one of these crimes, it’s likely that you will face an array of penalties and fees unless the charges can be changed or dropped altogether.
Potential Penalties for Healthcare Fraud
When you commit healthcare fraud in Miami, Florida, there are a range of penalties that could be assessed based on both state and federal laws. State healthcare laws for Florida typically center around self-referral laws, anti-kickback laws, and false claim laws. For instance receiving kickbacks for patient referrals in Florida is usually a first-degree felony that comes with fines of $500,000. As for federal law, civil and criminal penalties could apply to a case of healthcare fraud.
Civil penalties focus more on paying restitution, while criminal penalties can include restitution, fines, and prison time. If you make a false statement or claim pertaining to Medicare or Medicaid, you could face up to five years of prison and $250,000 in fines for each offense. Among the more common defenses used for cases such as these is to prove that the act of fraud was a mistake as opposed to intentional. Mistakes are easy to make as both a healthcare provider and consumer, which is why it’s important that you provide us with every detail of your case.
If you’ve been arrested for healthcare fraud and require legal representation, contact our offices in Miami today to schedule your first consultation.
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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