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The Federal Government funds a program called Medicare, which is designed to provide healthcare services and assistance to those who cannot afford medical care and/or live with disabilities and cannot afford the cost of medical help. Medicare fraud happens all the time, and it’s defined as the act of defrauding or working to defraud the government-funded program for personal gain by a patient or medical professional. The long list of people and/or professionals accused of Medicare fraud includes any of the following:
– Nursing homes
– Nursing agencies
– Health care providers
The sheer complexity of Medicare Fraud is astounding. It encompasses such a broad array of legal complaints it’s nearly impossible to list them all. Many healthcare providers and individuals are falsely accused of misconduct, but no investigation is considered too small when it comes to Medicare Fraud. The most common complaints of Medicare Fraud include the following:
– Filing false claims
– Filing excessive claims
– Durable products fraud
– Unauthorized billing
– Excessive billing
– False billing
The risks of being accused of Medicare Fraud are numerous. Many doctors and medical facilities fail to see the importance of hiring an attorney to handle any accusations of Medicare Fraud due to the lack of realization how the accusation affects their future. Not only is the doctor accused of Medicare Fraud at risk of seeing his or her reputation ruined, the loss of a medical license is a chance they take. The employer for whom a doctor works might not want the negative publicity associated with a Medicare Fraud accusation and might let go of the doctor. His or her professional and financial future is in jeopardy. The doctor is at risk for paying hefty fines and even doing jail time if found guilty of Medicare Fraud. Knowing the rights in place for the accused is necessary anytime this might occur.
United States Law
The United States Healthcare system is complex and difficult to understand even on a good day. Any doctor or medical practice accused of Medicare Fraud is essentially being accused of attempting to or successfully defrauding the United States Government, which is not something the government takes lightly. Anyone who is found guilty of Medicare Fraud is required to pay fines and penalties, make restitution, and face time in prison. Every case is different, and each one is handled accordingly.
Prison time is handled based on each case. The penalty is up to five years in prison for each count of Medicare fraud a doctor of medical professional is accused of. For example, a doctor accused of Medicare Fraud against one person might face up to five years in prison. A doctor accused of Medicare Fraud against 10 patients might face up to five years in prison per offense, for a total of up to 50 years in jail.
Even if the doctor who owns a medical practice is not the one guilty of Medicare Fraud, he or she still faces legal repercussions. Sometimes it’s the staff of an office working to make more money for the office for various reasons, such as to embezzle the funds or even up the bottom line so the doctors in the office offer bigger Christmas bonuses, for example. All doctors are subject to administrative sanctions if the office is found guilty of Medicare Fraud. Even this offense is enough to have a doctor’s license suspended and/or revoked.
Every state has different laws governing Medicare Fraud. The moment a complaint is filed against a doctor or office, it’s imperative the office seek the counsel of a Medicare Fraud attorney to help fight the charges and/or prove them incorrect. In many instances, the issues are true but the result of a simple mistake in billing or in filing information. It’s unfortunate, but accidents and mistakes like this happen all the time. An attorney with experience and legal knowledge is the best case a doctor has for keeping his or her license, staying out of jail, and rectifying any situation of the magnitude in any state.