A Look at Health Care Fraud

Posted By Law Offices of Jeffrey C. Grass || 16-Aug-2012

Health care fraud allegations are serious, and, if you have been accused of committing fraud, it is important to contact a law firm that can protect your rights. Health care fraud is the act of filing false health care claims in an attempt to turn a profit. According to the Federal Bureau of Investigation, this crime is estimated to cost the country $80 billion a year—and the costs just keep rising.

The Department of Justice and Health and Human Services have been using strike force teams since 2009 to prevent people from committing health care fraud. In 2009, these strike forces charged 323 defendants, and the average prison sentence for those found guilty was more than 47 months. Here are some examples of fraudulent health care schemes:

Methods Doctors Use

Doctors, just like the average consumer, can be found guilty of health care fraud. Crimes may include billing for care they never rendered, filing duplicate claims for the same service, billing for a non-covered service as covered, and accepting kickbacks for member referrals. Other crimes include waiving member co-pays, obtaining prescription drugs that are unnecessary and then selling them illegally for a profit, altering dates, patient identities, or descriptions of the services rendered, and using unlicensed staff in their offices.

Methods Patients Use

Patients may also be found to commit healthcare fraud. Crimes may include providing false information on service applications, selling prescription drugs, using transportation benefits for non-medical purposes, loaning someone else their insurance cards, and using someone else’s insurance card.

The federal government has been increasing efforts to stop and prevent fraud in the last few years. While this is an admirable goal, simple mistakes in a complicated and sometimes ambiguous system can lead to allegations of health care fraud.

If you are being investigated for or are charged with health care fraud, now is the time to contact a criminal defense attorney. These are serious charges, and you will need the help of a criminal defense lawyer to build a defense based on the facts of your unique case. To schedule a consultation with the Law Offices of Jeffrey C. Grass, contact us.