Washington DC Medicaid/Medicare Fraud Lawyer

Health care costs continue to rise, and as the American population ages, so does spending on health care needs. Medicaid and Medicare fraud occurs more often than you might think. If you suspect that you are being investigated for or accused of healthcare fraud, you should not hesitate to contact a Washington DC Medicaid/Medicare fraud lawyer for a legal opinion.

As there are many federal agencies that collaborate to investigate and uncover healthcare fraud, you may become the subject of an investigation long before you have any idea that it is occurring. When you do become aware of any ongoing fraud investigation, you may wish to immediately consult a practiced fraud attorney.

Medicaid/Medicare Fraud in Washington DC

The primary federal statute that deals with healthcare fraud is 18 US Code § 1347. This section makes it illegal to intentionally carry out any type of scheme to defraud a health care benefit program or obtain any money owned by a health care benefit program through false or fraudulent means.

Under 18 US Code § 287, it is illegal to make inaccurate or fraudulent claims against the United States or any of its agencies. This statute includes making false statements to the Medicaid and Medicare programs, which are programs administered by the federal government. Likewise, 18 US Code §1001 makes it unlawful to provide materially false or fraudulent statements or documents concerning any matter within the jurisdiction of the federal government. These are broad federal laws that can cover a variety of fraudulent behavior, but they also encompass those who submit fraudulent claims and statements to the Medicaid and Medicare programs.

Common Forms of Fraud

In practice, Medicaid/Medicare fraud can take on many different forms. In most cases, doctors or other healthcare providers develop some sort of scheme by which they can obtain funds from Medicaid or Medicare to which they are not lawfully entitled. Some examples of these healthcare fraud schemes may include:

  • Using the identities of others without their consent in order to file claims for services that never were provided to the patients
  • Billing for more expensive medical equipment and unnecessary medical tests and procedures than warranted
  • Inflating claims to include services that are more expensive than the services that the patients received
  • Billing for medical equipment that was never provided to patients

The ultimate goal of each of these schemes is to obtain more money in reimbursements than that to which the medical provider is entitled. In order to carry out these fraudulent schemes, medical practitioners and/or their employees typically file false and fraudulent claims with Medicare and Medicaid in one or more of the ways described above.

Potential Penalties for Those Convicted

False statements made in Medicaid or Medicare claims may result in a maximum prison sentence of five years, a maximum fine of $250,000, or both. As the penalties for multiple counts of fraud can be quite harsh, individuals facing such charges may want to confer with a Medicaid/Medicare lawyer in Washington DC as soon as they become aware of the fraud accusations.

Individuals and businesses also may be ordered in the context of a healthcare fraud prosecution to pay restitution to the US government. This can include the total value of any funds that they wrongfully received as a result of their fraudulent actions, as well as fines and penalties in some cases.

Finally, a conviction for Medicaid or Medicare fraud also makes individuals or businesses ineligible to submit any further claims for reimbursement from any federal healthcare program. As a practical matter, given the prevalence of public healthcare coverage across the US, this restriction may make it impossible for healthcare providers to stay in business.

Work with a Washington DC Medicaid/Medicare Attorney Today

In Washington DC, nearby federal government agencies tend to be quick to investigate and prosecute any suspected health care fraud. As the punishments for a health care fraud conviction at the federal level can be so severe, you may wish to call a Washington DC Medicaid/Medicare lawyer for help if you are suspected of involvement in this type of fraud.

Failing to take swift action to defend yourself against these very serious federal criminal charges can be devasting to your personal and professional life. If convicted, you may no longer be able to return to the medical field. Seeking legal representation is likely to be the most effective way to protect yourself from these serious allegations. Call today to get started.