Last Updated on: 19th October 2023, 01:16 pm

Medicaid/Medicare Fraud Defense Attorney: Who They Are and Why You Might Need One

Dealing with accusations of Medicaid or Medicare fraud can be an incredibly stressful and frightening experience. However, with the help of an experienced defense attorney, you may be able to get the charges reduced or even dismissed. In this article, we’ll take a look at who Medicaid/Medicare fraud defense attorneys are, why you might need to hire one, and what exactly they can do to help in your specific situation.

Why Might You Need a Medicaid/Medicare Fraud Defense Attorney?

There are several reasons why you could potentially be investigated and charged with Medicaid or Medicare fraud, some more justified than others. Having an experienced attorney on your side can help ensure your rights are protected and that you get the best possible outcome given the circumstances.

You’re Falsely Accused

One possibility is that you have been wrongly accused of fraud when you did not actually intend to do anything illegal. Healthcare providers often have to deal with complicated rules about billing and documentation, and it can be difficult to avoid honest mistakes. Clerical errors or a misunderstanding about what services can be covered could potentially lead authorities to suspect fraud where none exists.

A defense attorney will thoroughly analyze the facts of your case to prove your innocence. They may demonstrate that errors were unintentional, policies were followed correctly, or that you had no knowledge of any wrongdoing.

The Investigation Itself was Flawed

There are very strict procedures investigators have to follow when building a Medicaid/Medicare fraud case. But if they fail to operate fully within the law, it can jeopardize the entire case. Your attorney will closely examine the investigation to spot any missteps.

For instance, if evidence was obtained improperly without a warrant, your lawyer can file to have it excluded. Or if investigators used coercive interview tactics, those admissions may get thrown out. Procedural mistakes like these could result in the case being dismissed.

You Made an Honest Mistake

Another possibility is that you did in fact accidentally commit some degree of fraud, but should not be fully culpable due to the circumstances. There are many complex rules and frequent changes within Medicaid and Medicare, so misunderstandings can occur. Failing to properly document services or not realizing certain patients were ineligible could be honest oversights.

Your attorney will investigate the context around the violations to make a case that they were not intentional or malicious. They may be able to negotiate reduced charges or secure a favorable plea bargain. Admitting fault and demonstrating you have corrected your practices could potentially minimize penalties as well.

You’re Being Targeted Unfairly

Sadly, some Medicaid/Medicare fraud investigations are driven more by political agendas or profit motives rather than facts. An overzealous prosecutor may want a marquee case to propel their career. Or an auditor might be financially incentivized to identify fraud. Your lawyer will look for any signs you are being unfairly targeted.

For instance, the attorney could argue you are being selectively prosecuted compared to others engaging in similar behavior. Or they may show that investigators have a bias or conflict of interest underlying the case. Uncovering wrongful motivations could cast doubt on the credibility of the charges against you.

Avoiding Costly Mistakes

When facing Medicaid/Medicare fraud allegations, it can be tempting to take actions you think will help your case but ultimately backfire. An attorney knows what strategies to avoid. For example:

• Providing statements or documents without legal guidance.
• Sharing suspicions about the investigation with colleagues.
• Altering or destroying records after receiving a subpoena.
• Making public accusations against investigators or prosecutors.

Well-meaning but ill-advised moves like these can actually worsen your defense. Lean on your lawyer’s expertise to avoid missteps.

Key Takeaways

Here are some key takeaways to remember if you find yourself needing a Medicaid/Medicare fraud defense attorney:

• Work with a lawyer who specializes specifically in these complex cases. Their experience is crucial.
• Be proactive and start strategizing your defense as soon as possible.
• Cooperate fully with your attorney and their investigation tactics.
• Your lawyer may be able to negotiate away charges or minimize penalties.
• Honest mistakes can potentially be defended differently than intentional deceit.
• Avoid actions that could worsen your case – let your lawyer guide you.

Medicaid/Medicare fraud accusations can be intimidating. But an experienced defense attorney can advocate for justice on your behalf. With their counsel, even severe allegations may result in unexpectedly favorable outcomes. Don’t hesitate to exercise your rights.