Healthcare Fraud Cases

A healthcare fraud charge can have dire repercussions on your life. Depending on the circumstances of your case, you could face incarceration, fines, loss of license or certifications, and other damages. If you are arrested for healthcare fraud in Florida, do not wait until it’s too late — seek competent legal help now. An experienced federal crime attorney can protect your reputation, business, and freedom.

Charges for Healthcare Fraud

To convict a person of healthcare fraud, the prosecution must show that there was a knowing submission of a false claim or representation to receive a federal payment not otherwise entitled to. Some of the most common types of healthcare and Medicare fraud include:

• Overbilling — Billing for unnecessary services, over-diagnosing, and billing for services not rendered, are all examples of fraudulent overbilling.
• Upcoding — Medical procedures and visits performed by doctors all have what is called Current Procedural Terminology (CPT) codes established by The American Medical Association (AMA). When a healthcare provider or physician sends a bill to a payer, they use CPT codes to describe the procedures performed. Upcoding is the fraudulent practice of submitting codes for more costly procedures than were actually performed.
• False invoices — Another type of healthcare fraud occurs when false or duplicate invoices are submitted. A business may submit the same invoice multiple times, generate an entirely fake invoice, or inflate a real invoice.
• Double billing — Performing a procedure once but charging a patient multiple times, is known as double billing.

Some of the professions where healthcare fraud typically occurs include the following:

• Acupuncturist
• Audiologist
• Certified home health and nurse’s aide
• Chiropractor
• Dentist and dental assistant
• Dietician
• EMT/paramedic
• Nurse
• Ocularist
• Optician and optometrist
• Osteopath
• Pharmacist
• Physician
• Podiatrist
• Psychologist
• Psychologist
• Radiologic technologist
• Researcher
• Social Worker
• Therapists – marriage, massage, occupational
• X-Ray technician

Record and bookkeeping mistakes happen. However, to be charged with healthcare fraud, you must knowingly and willfully execute or attempt to execute a plan to defraud a healthcare benefit program. Other types of behavior which may be construed as fraudulent include inducing or paying others for referrals, wrongly referring patients, billing for skipped appointments, billing for services more complex than patient needs, and billing for services not provided.

Misdemeanor Crimes

Misdemeanor crimes are generally considered some of the least severe crimes that a person can be charged with, however, that doesn’t mean that you should take the charges any less seriously. The penalties that you can potentially face include jail time, fines, community service, and a permanent criminal record that you will carry with you the rest of your life.

Examples of misdemeanor crimes include but are not limited to :

• Assault (simple)
• Disorderly conduct
• Prostitution and/or solicitation
• Indecent exposure
• DUI or DWI (first, second, and third offenses are misdemeanors in most cases)
• Vandalism
• Trespassing
• Petty theft/shoplifting

If you are convicted of a misdemeanor crime, your life will likely change substantially. Not only do you run the risk of being sentenced to jail, your criminal record will make it difficult for you to rent a home, obtain a home or auto loan, get a credit card, and even obtain a professional license. The most important thing you can do after being charged with a misdemeanor is to secure quality legal representation as quickly as possible.