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Medicare fraud is one of the most serious types of white collar crimes prosecuted by the federal government. If you find yourself in the midst of an investigation based on an allegation of Medicare fraud, or if charges already have been lodged against you, you are in a significantly serious situation.
Finding yourself involved in a Medicare fraud case, it is crucial that you understand some of the basic facts associated with this type of crime. In addition, you must take a proactive stance to protect fully your legal rights and interests. This includes moving promptly to engage the services of experienced Philadelphia Medicare fraud lawyers.
Understanding What Constitutes Medicare Fraud
Medicare fraud can take a number of different forms. One of the most common types of Medicare fraud is up-coding. In simple terms, what this is that a healthcare provider improperly codes patient procedures rendered in a bill to Medicare. The healthcare provide codes in a more expensive procedure of treatment than what actually was provided to a patient.
Another type of Medicare fraud is called phantom billing. This illicit practice gets its name from cases in which bills are submitted to Medicare for patients that did not actually receive any services.
A related scheme involves prescribing expensive and unnecessary procedures for patients. This results in heftier bills being sent to Medicare for these unnecessary treatments or procedures.
In some cases, a patient becomes involved in a Medicare fraud scheme. In this situation, a patient is brought into the scheme and the healthcare provider pays what can best be described as a kickback to the patient.
Penalties Upon Conviction for Medicare Fraud
The potential penalties upon conviction for Medicare fraud can be significant. The Federal Sentencing Guidelines provide parameters a judge can consider when imposing a sentence in a Medicare fraud case.
Three significant factors come into play when a determination is made regarding a sentence in a Philadelphia Medicare fraud case. First, the amount of money involved in the scheme is a prime consideration under the U.S. Federal Sentencing Guidelines. Simply, the more money involved in the scheme, the longer the possible prison sentence and the higher the possible fine.
Second, a defendant’s criminal history is another factor considered during the sentencing phase of a Medicare fraud case. A lack of a criminal record works to at least somewhat contain the length of imprisonment and the amount of a fine in a Medicare fraud case.
Finally, the Sentencing Guidelines give a person what can be described as credit for “cooperating” in the case. What this usually means is that the defendant enters into a plea agreement fairly early on in the case.
With that noted, a person charged with Medicare fraud should never attempt to negotiate a plea agreement on his or her own and without legal representation. A healthcare provider could seriously, unknowingly jeopardize his or her rights and interests by trying to take a resolution of these serious criminal charges into his or her own hands.
Philadelphia Medicare fraud lawyers can also assist you with ancillary problems that likely are to rise in the aftermath of this type of criminal charge. A physician faces the loss of his or her medical license. In addition, he or she will face a revocation of hospital privileges.
Depending on the scope of the alleged Medicare fraud, the possibility can exist to contain some of these ancillary issues. This objective further underscores the need to be proactive in retaining Philadelphia Medicare fraud lawyers.
Retain Philadelphia Medicare Fraud Lawyers
Philadelphia Medicare fraud lawyers are available to consult with you about your case. Keep in mind that the general practice for Philadelphia Medicare fraud lawyers is to charge no fee for an initial consultation.
During the course of an initial consultation, an Medicare fraud defense attorney will provide you with evaluation of your case. This includes a discussion of possible defense strategies that may be available to you.
In addition to providing a comprehensive overview of possible defenses in your situation, a Medicare fraud defense lawyer will also respond to any questions that you may have about your case. For this reason, you need to come to the meeting fully prepared with the key questions for which you desire answers from legal counsel.