As a healthcare provider, you are already well aware of the fact that you are open to all sorts of legal claims being made against you. One of the more serious charges that can be brought against you at any time is a Medicare Qui Tam case. In such situations, you need a professional law firm that is well versed in such areas as health care accounting and financing laws, along with utilization and medical reviews. In other words, you need a lawyer who can trust to mount a vigorous defense on your behalf, while understanding the unique nature of Medicare fraud and related charges.
What A Healthcare Lawyer Can Do For You
If are you accused in a Qui Tam case, you will want a legal professional who can represent your interests as a healthcare provider. The includes the specific areas of litigations, investigations into financial wrongdoing, and audits of the Medicaid program. Within any given system, any of the following entities or people can be accused of Qui Tam violations:
- Home Health Agencies
- Nursing Homes
- Mental Health Professionals
- Medical Groups or Firms
If you receive an audit notice from the Medicaid Program, do not ignore it. It is critically important that you get this to your attorney right away in order for your response to begin to be generated. An audit itself can be quite complex. It is essential that all questions be answered completely and correctly. Your lawyer will ensure that coherent and well written responses are provided to each question in order to represent the true intentions and actions of the healthcare provider.
The Provisional Agency Audit Report
This is yet another area where your lawyer will assist you. This particular report offers the provider an opportunity to hand over any documents and written explanations that justify all payments received from the Medicaid program. It is also important for your lawyer to demonstrate any medical or legal authority that might have been present, complete with all corresponding documents, that can help reduce or even eliminate any repayments that you are being asked to make to the Medicaid Program itself.
What To Do If An Overpayment Demand Receipt Is Received
If you have received a demand for overpayment from the Medicaid Program, you will want your lawyer to look into it right away. It is possible that a negotiation is still possible. In the end, your attorney might be able to arrange a settlement that will be favorable to the provider. It is important to pursue all avenues in this regard and to exercise all of your rights under the law.
If a settlement cannot be reached, then a formal administrative hearing might need to be held. This is another area where your lawyer will be there every step of the way to protect your interests. Your lawyer can respond to subpoena’s or search warrants. This is important because they will be going through all types of records that are meant to either support or disprove your claims. It is important to resolve any case that has been brought against a healthcare provider before formal criminal charges are actually filed. This will be the goal of your lawyer.
Consult With A Lawyer
At the first sign of a Qui Tam Action being taken against you, consult with a lawyer specializing in healthcare law. This is a complex issue that requires a competent professional working on your side. Respond to all requests for information in a timely manner and you will be able to move on from this in the end.