Covered by NYDaily News. Las Vegas man accused of threatening a prominent attorney and making vile remarks.
Covered by New York Times, and other outlets. Fake heiress accused of conning the city’s wealthy, and has an HBO special being made about her.
Accused of stalking Alec Baldwin. The case garnered nationwide attention, with USAToday, NYPost, and other media outlets following it closely.
Juror who prompted calls for new Ghislaine Maxwell trial turns to lawyer who defended Anna Sorokin.
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The Spodek Law Group understands how delicate high-profile cases can be, and has a strong track record of getting positive outcomes. Our lawyers service a clientele that is nationwide. With offices in both LA and NYC, and cases all across the country - Spodek Law Group is a top tier law firm.
Todd Spodek is a second generation attorney with immense experience. He has many years of experience handling 100’s of tough and hard to win trials. He’s been featured on major news outlets, such as New York Post, Newsweek, Fox 5 New York, South China Morning Post, Insider.com, and many others.
In 2022, Netflix released a series about one of Todd’s clients: Anna Delvey/Anna Sorokin.
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Medicare fraud refers to intentionally deceiving Medicare in order to receive unauthorized payments or benefits. It is a serious crime that costs taxpayers billions of dollars each year and can put beneficiaries’ health at risk. Some common examples of Medicare fraud include:
Medicare fraud can be committed by doctors, hospitals, pharmaceutical companies, medical equipment suppliers, and even by beneficiaries themselves. Healthcare providers and organizations involved in fraud may face criminal charges, civil monetary penalties, exclusion from Medicare, and loss of medical license.
Some of the most common types of Medicare fraud include:
This basic scam involves billing Medicare for services, tests, or equipment that were never actually provided. Examples include billing for phantom patients, fake diagnoses, fictitious appointments, and unnecessary ambulance rides.
Providers disguise treatments that Medicare does not cover, such as cosmetic procedures, as medically necessary covered services.
Billing for more complex and expensive services than were actually performed. For example, billing a basic doctor visit as an extensive medical evaluation.
Breaking apart a procedure into multiple billable components instead of billing as a single service. This leads to higher reimbursements.
Doctors or clinics receive illegal kickbacks in exchange for referring patients to a particular hospital, pharmacy, or medical equipment supplier. This drives up unnecessary costs.
Fraudsters steal Medicare beneficiaries’ personal information to illegally bill services or file fake claims under their names and numbers.
Doctors overprescribe medications for kickbacks from pharmaceutical companies, or prescribe unnecessary drugs and bill Medicare.
Home health agencies bill for services that patients didn’t qualify for or never received. Agencies recruit patients for unnecessary care.
The government has passed strict laws to combat rampant Medicare fraud and abuse:
This civil law imposes penalties on any person or company that knowingly submits false claims to the government for reimbursement. Violators face fines of $11,000 – $22,000 per false claim.
AKS prohibits knowingly paying or receiving bribes, kickbacks, or other “remuneration” to induce referrals for federal healthcare program business. Violations are felonies punishable by fines up to $25,000 and five years in prison.
This prohibits doctors from referring Medicare patients to facilities in which they or their family have a financial interest, unless an exception applies. Penalties include denial of payment, refunds of claims, and civil monetary penalties.
This requires the exclusion of healthcare providers convicted of Medicare fraud from participating in federal health programs. Providers may be excluded permanently or for a period of years based on the offense.
The CMPL authorizes civil penalties for different fraudulent and abusive acts, such as paying kickbacks, violating the Stark Law, and billing for unnecessary services. Fines range from $15,000 – $70,000 per violation.
Doctors, healthcare organizations, and beneficiaries can take steps to prevent fraud:
Medicare fraud can lead to severe criminal, civil, and administrative punishments:
Recovering improperly paid funds is a top priority. Providers may have payments suspended pending fraud investigations.
Medicare fraud drains critical resources from taxpayers and the healthcare system:
Federal and state agencies are employing new technologies and increased collaboration to combat Medicare fraud:
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