What to Do if You’re Charged with Healthcare Fraud Involving Medical Device Distributors

What to Do if You’re Charged with Healthcare Fraud Involving Medical Device Distributors

Getting charged with healthcare fraud can be really scary. I know the feelings – your stomach drops, your palms get sweaty, your mind races. It’s overwhelming. But take a deep breath, because there are things you can do to protect yourself.

First off, don’t panic. Easier said than done, I know. But panicking leads to poor decisions. So breathe. Call a lawyer. And start educating yourself on your rights and options. Knowledge is power.

In this article, I want to walk you step-by-step through what to do if you’re charged with healthcare fraud related to medical device distributors. I’ll cover:

• Understanding the charges against you
• Building your defense team
• Navigating the justice system
• Potential penalties if convicted
• Your options and strategies

My goal here is to empower you with information. I’m not a lawyer and can’t give legal advice. But I can share insights from my own experience and research to help you make the best decisions for your situation.

Understanding the Charges Against You

Healthcare fraud is a white collar crime that involves defrauding healthcare benefit programs like Medicare or Medicaid. There are a few main laws used to prosecute healthcare fraud:

• False Claims Act – Makes it illegal to knowingly submit false claims for payment to the government. This covers billing for services not provided, upcoding services, billing for medically unnecessary services, etc.
• Anti-Kickback Statute – Prohibits receiving or paying anything of value to influence the referral of federal healthcare program business. This includes kickbacks to doctors for referring patients to a specific healthcare provider.
• Stark Law – Restricts physician referrals of Medicare patients to healthcare facilities they or their family have a financial interest in.

So in your case, the charges likely relate to one of these laws. For example, maybe you’re accused of providing kickbacks to doctors for referring patients to your medical device company. Or upcoding claims submitted to Medicare for your devices.

The first thing your defense lawyer will do is get a hold of the formal charges and evidence against you. This includes details like:

• The specific laws you allegedly violated
• The nature of the alleged fraud
• Time periods involved
• Any documents, records, or statements from witnesses

Reviewing this information in depth is crucial for building your defense strategy and understanding what you’re up against.

Building Your Defense Team

Facing healthcare fraud charges isn’t something you want to go through alone. Having an experienced legal team in your corner can make all the difference.

Here are some tips for putting together a stellar defense team:

• Hire an experienced healthcare fraud defense lawyer – Find someone with a proven track record specifically with healthcare fraud cases. This area of law is complex.
• Consider hiring a law firm instead of a solo practitioner – A firm will have more resources and experience to draw from.
• Ask about the lawyer’s background – Do they have experience as a healthcare fraud prosecutor? That inside expertise can be invaluable.
• Make sure they have trial experience – Even if you end up plea bargaining, you want someone who has litigated these cases before.
• Consider hiring additional specialists – Some firms also have forensic accountants, investigators, and other experts on staff.

When researching lawyers, don’t just look at their website bios. Ask detailed questions about their healthcare fraud experience and credentials. This is not the time to skimp on legal fees if you can avoid it.

Navigating the Justice System

Once you’ve built your defense team, you’ll need to navigate the complex justice system process. Here’s a basic roadmap of what to expect:

1. Investigation stage – This is when the government is building its case through legal tools like search warrants, document requests, witness interviews, etc.
2. Charges filed – Prosecutors present charges to a grand jury for indictment. This is when you’ll receive formal notice of the charges against you.
3. Arraignment – You appear in court and enter a plea of guilty, not guilty or no contest. Not guilty is the typical plea in fraud cases.
4. Pretrial motions – Your lawyer can challenge evidence, request documents and file other pretrial motions.
5. Plea bargaining – Your legal team can try to negotiate with prosecutors for reduced charges or sentencing recommendations.
6. Trial – If no plea deal is reached, your case would proceed to trial.
7. Sentencing – If found guilty, the judge will determine your penalty and sanctions.

Having an experienced guide through this process is crucial. Your legal team will advocate for your rights, strategically challenge evidence, and look for the best possible outcome given the circumstances.

Potential Penalties if Convicted

Healthcare fraud convictions often carry stiff penalties under federal law. Exact sentencing is determined on a case-by-case basis, but potential penalties include:

• • Prison time – Years in federal prison are possible depending on the scale of the fraud.
  • Fines – Can range from thousands to millions of dollars.
  • Restitution – Having to repay all funds obtained through fraud.
  • Exclusion from federal healthcare programs
  • Loss of medical license