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Healthcare Fraud

Every year hundreds of physicians, surgeons, and business owners in Florida become targets of healthcare fraud investigations. Successful medical practices are often a prime target for Medicare audits. Unfortunately, if an overzealous auditor or prosecutor wrongfully declares you a suspect of health care fraud, your reputation and business could face irreparable damage.

Healthcare fraud is a federal felony that carries severe penalties. At OA Law Firm, we understand the strain that a healthcare fraud charge can put on your business and quality of life. If you’re being investigated for healthcare fraud, it’s crucial that you seek the advice of a Florida health care fraud defense attorney as soon as possible. For a confidential discussion of your case, contact us online or call (813) 461-5291 today.

What is Healthcare Fraud?

Health care fraud is a white-collar crime that typically involves businesses filing dishonest health care claims with the aim of turning a profit. Violators can be prosecuted under 18 U.S.C. 1347. The Federal Bureau of Investigation (F.B.I.), the U.S. Postal Service (USPS), and the Inspector General’s Office are the agencies responsible for investigating healthcare fraud. However, as congressional legislation stipulates that healthcare insurance must pay legitimate claims within 30 days of receipt, there is rarely enough time to perform a thorough investigation into fraudulent claims before an insurer has to pay.

Common Healthcare Fraud Schemes

There are many different fraudulent healthcare schemes. Common practitioner schemes include:

  • Billing for care that was never rendered
  • Obtaining prescription pills that are then sold on the black market for profit
  • Filing duplicate claims
  • Billing for a non-covered service as a covered service
  • Intentionally reporting incorrect diagnoses or procedures to maximize payment
  • Altering the description of services, dates, identities of members or identities of providers
  • Accepting kickbacks for member referrals
  • Giving kickbacks for member referrals
  • Prescribing additional or unnecessary treatment
  • Modifying medical records

Any time a healthcare provider knowingly gives false information or misrepresents the truth with the goal to obtain payment, they could face healthcare fraud charges. For example, billing the government for Medicare services that were rendered, could still be considered fraud if there was a misrepresentation of fact at any point.

When building an effective healthcare fraud defense case, time is of the essence. If you’re a healthcare provider facing prosecution for healthcare fraud, you should immediately retain an experienced Florida healthcare fraud defense attorney. If convicted, you could be subject to a lengthy prison sentence, severe financial penalties, and the loss of your livelihood. Prompt legal advice is critical to a successful defense. Contact us online or call (813) 461-5291 today for a confidential discussion of your case.

What are the Penalties for Healthcare Fraud in Florida?

Many allegations of healthcare fraud stem from whistleblower complaints filed under the federal False Claims Act. Federal prosecutors are often the ones tasked with prosecuting healthcare fraud in Florida.

One of the most commonly prosecuted healthcare frauds pertains to Medicare. Due to the Civil Monetary Penalty Law and the False Claims Act, if convicted of Medicare fraud, healthcare providers can face extortionate fines of more than $ 10,000 per individual violation. The severe financial penalties and asset forfeiture associated with Medicare fraud are often devastating to businesses.

Florida Healthcare Fraud cases are often complex, and the penalties you could face are dependent on various factors. The presiding judge in a healthcare fraud case will typically use the Federal Sentencing Guidelines to determine a sentence. The important thing to note is that anyone convicted of healthcare fraud in Florida should expect severe penalties.

Building a Florida Health Care Fraud Defense

If your business has received a subpoena from the Department of Health and Human Services, or the U.S. Attorney’s Office, detailing suspected civil healthcare violations, it’s crucial that you seek legal advice immediately. Successfully building a Florida health care fraud defense requires an in-depth knowledge of the federal legal process. As healthcare fraud is often a complex arm of the law, it’s important to retain an experienced criminal defense attorney who can effectively and aggressively defend your legal rights.

According to 18 U.S.C. 1347, in order to obtain a conviction of healthcare fraud, the government must be able to prove certain elements of their case beyond a reasonable doubt. This includes proving that the defendant knowingly and willfully executed or attempted to execute, a scheme designed to defraud a healthcare benefit program, or illegally obtain money or property from a healthcare benefit program.

Put simply, in order for the government to prove that a crime has taken place, it must be evident that the defendant knowingly committed the fraud or acted recklessly or negligently. For example, a coding error could potentially lead to a fraud investigation. If, however, it can be argued that the billing or coding violation was a misunderstanding, rather than an attempt to defraud the government, it’s unlikely a crime was committed. Similarly, if a person loses their Medicare card — and their account information is then used to commit healthcare fraud — they may not be held responsible for the crimes committed.

Why Should You Choose an O.A. Law Firm Healthcare Fraud Defense Attorney?

O.A. Law Firm understands the overwhelming financial and emotional toll that a healthcare fraud prosecution can take on healthcare providers. As one of the most heavily regulated industries in the U.S., the American healthcare system is a complex maze of extensive rules and regulations that can be challenging to navigate. Omar Abdelghany is a Florida healthcare fraud defense attorney who is dedicated to defending providers against fraud and abuse allegations. O.A. Law Firm leverages extensive criminal defense experience to secure the best possible legal outcome for our clients.

Successfully fighting Florida healthcare fraud charges requires a strategic and aggressive defense. Our Florida health care fraud defense attorneys are committed to providing effective and confidential legal counsel. Whether you need advice about the federal False Claims Act, the Stark Law, or the Anti-Kickback Statute, our knowledgeable attorneys are here to help.

Contact us today, or call (813) 461-5291, for a confidential discussion about your Florida healthcare fraud case.

Client Reviews
★★★★★
"Lawyer Abdelghany, has been a tremendous blessing and stress reliever, not only to me but also to my family members in need of professional help. He was understanding of my situation and worked with me financially. I am overall grateful for him and would refer all my family and friends to hire him." Khalil G.
★★★★★
"I was in the unfortunate situation of having to hire a lawyer for my grandson and since I did not know of anyone that could refer me, I had to rely on my judgement of character and when I sat down in front of Omar, I knew that I had made the right decision. He is a very professional, well versed in the law, knowledgeable young man that takes the time to explain every aspect of your case to you. He returns calls promptly, knows your case inside out and is very punctual in meetings and court hearings. I could not have chosen a better, more qualified lawyer to represent my grandson. He comes highly recommended by me and you will not go wrong in obtaining his services." Gloria
★★★★★
"It is with pleasure that we wish to recommend Mr. Omar Abdelghany in his practice as a Criminal Defense Attorney. He was hired in the defense of our son. The defense included more than one offense, which required legal maneuvering to address the issues. Omar's skills came into play in positioning the case, which resulted in a good outcome given the facts at hand." Ted