The federal government does not look kindly on Medicare fraud. Not only do false claims adversely affect the public, but this kind of cheating is also extremely expensive, involving hundreds of millions of dollars in false billings. In short, it is illegal to defraud the government and its healthcare programs, and imprisonment is a possible penalty. Defendants might include physicians, pharmacists, home healthcare providers and others in the medical field. Fines can escalate to many thousands of dollars, and even if those convicted do not have to serve time, they can expect to lose their licenses.
Types of Medicare fraud
If you knowingly submit a false claim, cause it to be submitted or misrepresent the facts about a treatment or procedure in order to obtain a payment, you are committing fraud. It is fraudulent to bill Medicare for an appointment a patient did not keep, to bill for services or supplies you or the facility did not provide or to produce false records of deliveries that were never made. It is also illegal to inflate charges. For example, you might submit a bill for a motorized wheelchair when you only provided your patient with a standard model.
The False Claims Act
The False Claims Act is one of several fraud and abuse laws that makes it illegal to knowingly submit false claims for payment to Medicare or Medicaid. The word “knowingly” refers not only to misrepresentation of the facts, but also to instances where a defendant acted in reckless disregard or even deliberate ignorance of the truth. Enforcing the law is the duty of the Department of Justice, the Office of the Inspector General and the Centers for Medicare and Medicaid Services.
Seeking the best defense
If you have been charged with Medicare fraud, you are facing a serious situation: Your career is in jeopardy, and you could spend the next few years of your life behind bars. You may benefit from assertive legal representation. Your next step should be to contact an attorney experienced with such matters who will work diligently to obtain the best outcome possible for your case.