17 Oct 23

Can I be charged individually if my company is committing healthcare fraud?

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Last Updated on: 28th October 2023, 06:50 pm

Can I be charged individually if my company is committing healthcare fraud?

Getting charged with healthcare fraud can be scary, especially if your company is the one actually doing it. As an individual, your probably wondering – can I personally get in trouble for this?

The short answer is yes, you definitely can. Even if your not directly involved, failing to report fraud committed by your company can make you liable too. But don’t panic! Read on to understand exactly how companies commit fraud, when individuals get charged, and what defenses you may have.

How do companies even commit healthcare fraud?

There’s a few common ways a company can break the rules:

  • Billing for services that where never performed
  • Billing for more expensive services then where actually done
  • Performing unnecessary medical procedures just to charge more
  • Billing multiple times for the same procedure
  • Using false diagnosis codes to charge for uncovered conditions
  • Accepting kickbacks for referrals

Often times it’s the companies executives or management involved in shady billing practices. But not reporting fraud you know about can make you an accomplice.

When can individuals get charged for corporate fraud?

Prosecuters often go after individuals in addition to the company itself. Your at risk if:

  • You directly participated in the fraud
  • You knew about the fraud but did nothing
  • You were willfully blind to what was going on

Actively participating is obvous. But “knowing” about fraud and not reporting it can also land you in hot water. Same goes for sticking your head in the sand. If you had reason to suspect something illegal but deliberately avoided learning more, that’s “willful blindness.”

What kind of penalties are we talking?

Healthcare fraud is a felony with serious penalties like:

  • Up to 10 years in federal prison
  • Massive fines up to $250,000
  • Restitution to pay back money gained illegally

And that’s per charge! With multiple charges these penalties can add up fast. Your looking at serious jail time and crippling expenses.

What defenses can protect me?

Don’t panic yet! Skillful legal defenses can get charges dismissed or penalties reduced. Some options include:

  • You didn’t actually know about the fraud
  • You reported the fraud through proper channels
  • You where following orders from superiors
  • You acted in good faith and had no intent to defraud
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An experienced attorney knows how to argue these defenses persuasively in court. They can also negotiate with prosecutors for reduced charges or penalties.

Bottom line – get a lawyer immediately

If your company is being investigated for fraud, consult a lawyer right away even if your not a main target yet. They can advise you on cooperating with investigators while avoiding self-incrimination.

Having an attorney with you early on can make a huge difference down the road. Don’t wait until charges get filed to protect yourself!

For a free case evaluation from an experienced Orlando healthcare fraud defense attorney, click here or call (407) 555-1234.