Medicare is a federally funded program designed to help a specific demographic afford medical care. It’s typically used to assist the elderly, and those who have disabilities that do not allow them to work, function, or afford their medical care. The federal government works to fund this program so that these people can have access to fair and just medical care, and many doctors and their offices spend time each year defrauding the federal government for financial gain. It’s called Medicare Fraud, and it’s illegal in a court of law in every state, not just New Jersey.
Any doctor accused of Medicare Fraud is going to lose their medical and professional license, face prison time, pay fines, and repay all the money stolen as a result of their successful Medicare Fraud. Anytime an office or doctor is faced with Medicare Fraud charges, it’s imperative they seek the legal counsel of an experienced Medicare Fraud attorney to assist with the investigation and the legal process.
How Medicare Fraud is Committed
Medicare Fraud is committed in several ways. Sometimes it’s nothing more than a careless accident, and it’s not always the doctor’s fault. There are several cases throughout the country when Medicare Fraud was committed knowingly or otherwise by administrative staff, but doctor’s must know they’re still liable for this fraud. The most common types of Medicare Fraud are numerous.
1. Charging for services not rendered: There are times when doctors make a list of different services they performed on a patient during a visit when they didn’t perform said services. It’s a simple as adding a service to an already long list of services performed on a patient, and no one is the wiser. It’s difficult to get caught doing this as so many patients don’t bother reading their insurance statements if they’re not responsible for the cost of the services out of their own pockets.
2. Performing unnecessary services: When a doctor performs services on a patient that aren’t needed simply because they are profitable to the office, it’s considered Medicare Fraud. It’s another charge that’s difficult to prove, since most patients are unaware they don’t need a specific service. Most people trust their doctor is providing them with honest service and knowledge.
3. Submitting duplicate billing: When a doctor submits more than one bill for the same patient for the same services, it’s considered Medicare Fraud. This is a case that’s sometimes only a mistake on behalf of the billing department that’s easy to prove.
Any doctor who is accused of any of the above is going to face a federal investigation, and eventually punishment for his or her activities if found guilty. If it’s nothing more than a simple mistake, it’s typically easy to prove. It’s helpful to have an experienced attorney help with this process. If a Medicare fraud case is proven, but it’s due to administrative error such as an employee who is careless at his or her job, it’s still the responsibility of the doctor and the owners of the practice, and administrative sanctions are then filed against the company.
Punishment for Medicare Fraud
Any doctor or medical facility accused of Medicare Fraud and found guilty faces numerous punishments.
– Prison time
– Loss of professional license
Fines are imposed on anyone committing Medicare Fraud, and they start at $10,000 per charge. All Medicare Fraud cases are required to impose restitution for those guilty, and all monies stolen from either patients or the federal government must be repaid. Sometimes the fines and restitution are more than the actual amount taken, and the amount is put in place by the federal government.
Prison time begins at up to 5 years per offense. Doctors who commit multiple acts of Medicare Fraud can quickly see their prison term extend decades and even a lifetime if there are numerous cases. Loss of professional license is par for the course. A medical facility committing Medicare fraud will be shut down, and the doctor will lose his or her medical license and ability to practice medicine. A legal professional can help with this type of investigation and fraud charges by providing the knowledge necessary to get through this kind of charge.
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