Oakland Healthcare Fraud Defense Lawyer
You’re here because you or someone you care about is facing healthcare fraud charges. It’s a serious situation – one that could potentially derail your career and future. But you’ve come to the right place.At Spodek Law Group, we understand what you’re going through. We’ve defended countless clients against healthcare fraud allegations in Oakland and across the nation. Our healthcare fraud defense team is comprised of aggressive litigators who leave no stones unturned in pursuit of justice.We know the stakes are high; that’s why we fight tirelessly to have charges reduced or dismissed entirely. When prosecutors come after you, we respond with force – crafting airtight defense strategies tailored to your unique circumstances.This article will provide an in-depth look at healthcare fraud charges and how our Oakland defense lawyers can help protect your rights and freedom. We’ll explore:
- Common types of healthcare fraud schemes
- Potential penalties you could face
- Proactive defense strategies we employ
- Why you need elite legal representation
Healthcare fraud is an extremely complex area of law. Having the right defense attorney is crucial – it could mean the difference between a dismissal and a lengthy prison sentence.So keep reading to understand exactly what you’re up against and how the Spodek Law Group can advocate for you.
Contents
- 1 What Constitutes Healthcare Fraud? Common Schemes to Be Aware Of
- 2 Billing for Services Not Rendered
- 3 Upcoding
- 4 Unbundling
- 5 Kickbacks
- 6 Falsifying Patient Records
- 7 Prescription Fraud
- 8 You Could Face Devastating Penalties – Your Entire Livelihood at Risk
- 9 Proactive Defense Strategies to Fight Healthcare Fraud Charges
- 10 Why You Need an Elite Oakland Healthcare Fraud Defense Lawyer
- 11 Potential Scenarios and Defense Approaches
What Constitutes Healthcare Fraud? Common Schemes to Be Aware Of
Healthcare fraud encompasses a wide range of conduct aimed at defrauding public or private healthcare benefit programs. At its core, it involves knowingly executing or attempting to execute a scheme to:
- Defraud a healthcare program like Medicare, Medicaid, etc.
- Obtain money/property from a healthcare program through false pretenses
Some common healthcare fraud schemes we’ve defended clients against include:
Billing for Services Not Rendered
This occurs when a provider bills a healthcare program for services, procedures or supplies that were never actually provided to the patient.
Upcoding
Upcoding refers to billing for a more expensive service than was actually performed. For example, a provider might bill for a higher-level office visit despite only conducting a minor examination.
Unbundling
Unbundling involves billing each component of a service as a separate charge when they should be billed together under a single code.
Kickbacks
Offering or receiving anything of value in exchange for patient referrals is considered a kickback and is illegal under the Anti-Kickback Statute.
Falsifying Patient Records
Altering patient records to justify services that weren’t medically necessary or to make it appear a service was provided when it wasn‘t.
Prescription Fraud
This can include writing prescriptions for drugs the patient doesn’t need, billing for higher quantities than prescribed, or distributing controlled substances illegally.The list goes on – from billing for outdated services to excessive services not medically warranted. Essentially, any attempt to overcharge or receive reimbursement through deception can constitute healthcare fraud.Charges often stem from whistleblower complaints or data mining by federal agencies. But innocent billing errors can also raise red flags, leading to a costly investigation.That’s why you need a skilled Oakland healthcare fraud lawyer from the moment you become aware of allegations or an audit. We can intervene early and ensure your rights are protected.
You Could Face Devastating Penalties – Your Entire Livelihood at Risk
If convicted of healthcare fraud, you’re facing potentially devastating penalties that could destroy your career and future. Punishments can include:Federal Prison Time
- Up to 10 years for each healthcare fraud count
- Longer sentences if higher dollar amounts are involved
Massive Fines and Financial Penalties
- Up to $250,000 in fines per healthcare fraud violation
- Repayment of claims paid, plus up to triple damages
Exclusion from Federal Healthcare Programs
- Potentially barred from participating in Medicare, Medicaid, etc.
Loss of Professional Licenses
- Medical, nursing, other professional licenses could be suspended/revoked
Damage to Reputation
- Public shame that could irreparably harm your personal/professional reputation
The consequences extend far beyond just fines and potential incarceration. Your entire livelihood and life’s work could be in jeopardy. That‘s why you need to take healthcare fraud charges seriously from day one.At Spodek Law Group, we’ve witnessed firsthand how devastating these charges can be. But we’ve also helped many clients avoid the most severe punishments through strategic defense approaches.Our goal is simple – to protect your rights, freedom and future at all costs. We‘ll work tirelessly to poke holes in the prosecution‘s case and explore all avenues for dismissal or minimized sentencing.
Proactive Defense Strategies to Fight Healthcare Fraud Charges
When you hire Spodek Law Group, we spring into action immediately, executing a multi-pronged defense approach tailored to your unique situation. Here are some of the key strategies we may employ:Lack of Intent
- We’ll argue you had no intentional scheme to defraud
- Billing errors, misunderstandings, or lack of training don’t prove intent
Prosecutorial Overreach
- Aggressive prosecutors often pursue charges that don’t fit the crime
- We’ll push back against overcharging and disproportionate penalties
Entrapment
- If you were induced into committing fraud, we can argue entrapment
- Undercover stings or reliance on shady informants could be entrapment
Lack of Admissible Evidence
- We’ll scrutinize how evidence was obtained and its admissibility
- Improper searches, unauthorized wiretaps, etc. could get evidence tossed
Good Faith Reliance on Advice
- Following advice of a supervisor, lawyer or compliance officer negates intent
- We can argue you acted in good faith based on professional guidance
Vigorous Pre-Trial Motions Practice
- We’ll file motions to dismiss charges or suppress key evidence
- Poking holes in the prosecution’s case from the outset
These are just some of the potential defense avenues we may pursue based on your circumstances. The key is having a defense team that explores every possible angle and leverage point.Our healthcare fraud defense strategies are always evolving based on the latest case law and prosecutorial tactics. You can be confident we’ll leave no stones unturned in aggressively defending you.
Why You Need an Elite Oakland Healthcare Fraud Defense Lawyer
Choosing the right legal team is crucial when facing healthcare fraud charges. These are highly complex cases that require strategic maneuvering and in-depth knowledge of healthcare laws and regulations.At Spodek Law Group, our healthcare fraud defense attorneys have:
- Decades of combined experience in state/federal courts
- Extensive background handling healthcare fraud cases
- Comprehensive understanding of healthcare laws like Stark, Anti-Kickback, etc.
- Proven track record of getting charges reduced or dismissed entirely
- Resources to go toe-to-toe with powerful federal prosecutors
We’re not just skilled litigators – we‘re also counselors you can trust during this stressful time. Our attorneys will walk you through the process, answer all your questions, and ensure you understand what‘s happening every step of the way.When you hire us, you get:
- A dedicated defense team singularly focused on your case
- Proactive strategies to resolve charges favorably
- Open communication and transparency from day one
- Aggressive negotiation and litigation when needed
- Tireless commitment to protecting your rights
Facing healthcare fraud charges without elite legal representation is simply too risky. The penalties are far too severe. You need a powerful advocate to level the playing field against federal prosecutors.At Spodek Law Group, we have the skills, resources and determination to vigorously defend you. Our healthcare fraud defense team will give you the best possible chance at a favorable outcome.Don’t take on the federal government alone. Hire the elite defense lawyers at Spodek Law Group. Your future depends on it.
Potential Scenarios and Defense Approaches
To give you a better sense of how we operate, let’s walk through some hypothetical healthcare fraud scenarios and potential defense approaches:Scenario 1: Billing Errors Lead to an InvestigationYou run a small medical practice. During a routine Medicare audit, it’s discovered that your staff made coding errors on a number of claims over the past year – resulting in $75,000 in overpayments.The auditors immediately assume fraud and refer the case to federal prosecutors for criminal charges. But you had no knowledge of the errors, which were simply mistakes made by undertrained staff.Our Defense Approach:
- Argue lack of intent to defraud – coding errors don’t prove criminal intent
- Highlight your practice’s compliance program and training procedures
- Negotiate with prosecutors to have charges reduced or dismissed entirely
- Push for a civil repayment agreement instead of criminal prosecution
Scenario 2: Whistleblower Alleges Kickback SchemeA former employee files a whistleblower lawsuit alleging you were involved in an illegal kickback scheme with a medical device company. Specifically, they claim you received cash payments in exchange for using the company’s products for certain procedures.Federal agents execute a search warrant on your practice and start building a criminal case against you for healthcare fraud and Anti-Kickback violations.Our Defense Approach:
- Attack the whistleblower’s credibility and motives for filing suit
- Scrutinize the methods used to obtain evidence against you
- Argue any payments were legal “rebates” rather than illegal kickbacks
- Negotiate for deferred prosecution or pre-trial diversion program
Scenario 3: Falsifying Patient Records AllegationsYou’re a physician accused of routinely falsifying patient records to justify unnecessary procedures and tests. Prosecutors claim you put patients through invasive procedures for no reason other than to bill insurers.The evidence appears damning – with expert witnesses prepared to testify about clear misrepresentations in your medical recordkeeping.Our Defense Approach:
- Hire expert medical witnesses to counter prosecution experts
- Argue any record discrepancies were unintentional/sloppy paperwork
- Highlight your history of providing quality care to undermine allegations
- Negotiate for reduced charges/sentencing in exchange for cooperation
These are just a few examples, but they illustrate our comprehensive approach. We‘ll explore every possible defense avenue – from lack of intent and entrapment to prosecutorial overreach.Our goal is always the same: To protect your rights and secure the best possible outcome, whether that‘s outright dismissal or minimized penalties. You can count on us to fight tirelessly on your behalf.