Medicare Fraud Charges Can Mean Big Trouble

Medical fraud, white collar crime, Chicago criminal defense attorneyMedicare fraud is a serious allegation that can affect your liberty, your finances, and your future business opportunities. A conviction of this federal offense can result in an extensive prison sentence and millions of dollars in fines. A recent Illinois case resulted in a sentence of 70 months in prison and more than $1.5 million in restitution payments for fraudulent psychotherapy claims. Another Illinois case resulted in a 10-month prison sentence and $40,000 in fines for a local surgeon.

In addition to the criminal and civil penalties, Medicare fraud cases frequently make the news and negatively affect the reputations of those involved. Your professional license may be suspended or revoked. Additionally, patients or clients may choose to go somewhere else for services. All of these consequences highlight the importance of putting forth a viable defense to Medicare fraud charges.

Federal Medicare Investigations

In 2007, a multi-agency collaboration resulted in The Medicare Fraud Strike Task Force. The goal of the initiative is to investigate and prosecute instances of fraudulent Medicare billing practices using data analysis and community presence. The organization recently began focusing its attention on Chicago, among other large cities. The Task Force uses local and federal law enforcement to prosecute accusations of fraud. Since its creation, more than 1,400 defendants have been convicted and penalized, which accounts for more than $4.8 billion in Medicare insurance claims.

Some common Medicare fraud claims include:

  • Charging for services that were not actually performed;

  • Submitting bills for supplies that were not actually provided;

  • Performing procedures that are not medically necessary;

  • Overcharging for the cost of procedures; and

  • Falsification of medical documents and billing records.

Defending Yourself Against Medicare Charges

With so much force fighting for a conviction, defendants need an experienced attorney to fight just as hard for an acquittal. For a successful fraud conviction, federal prosecutors must prove that the defendant intentionally gave false information to the Medicare billing agency for the purpose of financial gain. An experienced attorney will work to provide reasonable doubt about the intention of the accused to defraud the federal government.

Mistake is a possible defense to Medicare fraud charges. Medicare billing involves numerous steps and requirements. One simple error can result in accusations of fraud. Employers are not immune. The federal government can hold them responsible for the mistakes of their employees. Multiple billing and incorrect coding are common mistakes in Medicare billing. By proving mistake, an attorney may successfully negotiate a reimbursement payment in lieu of criminal penalties.

An attorney may also successfully defend these charges by presenting evidence that the billed services did occur and for the stated amount of time. He may also present evidence to show that the service was a medical necessity.

If you or a loved one is facing Medicare fraud charges, allow federal defense attorney Hal M. Garfinkel to provide you with a vigorous defense. Contact an experienced Illinois criminal defense attorney at the Law Offices of Hal M. Garfinkel LLC, Chicago Criminal Defense Attorney today at 312-270-0999 for a free consultation.

 

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