New York healthcare fraud charges can arise in several ways

On Behalf of | Jul 13, 2021 | Fraud |

Many people believe that white-collar crime involving healthcare fraud is a victimless crime. However, this type of fraud typically receives much attention from federal agencies like the Federal Bureau of Investigation (FBI).

The government nearly always seeks conviction on such charges. New York City is filled with many medical facilities, making it vital for all to understand the impact of healthcare fraud.

What constitutes healthcare fraud?

Such fraud occurs in many ways. Sometimes, citizens may commit fraud by impersonating medical personnel or forging prescriptions for their benefit. Other times, medical providers engage in fraud, knowingly or perhaps even accidentally. Below, you will find a list of four fraudulent practices that the FBI rigorously investigates:

  1. Phantom billing: Phantom billing occurs when providers submit bills for supplies or services that a patient never received.
  2. Double billing: Double billing occurs when healthcare providers submit more than one claim for a single service.
  3. Upcoding: Upcoding occurs when providers submit bills for more expensive treatments than a patient receives.
  4. Unbundling: Unbundling occurs when providers submit several bills for a single service and is much like double billing.

A conviction on healthcare fraud comes with severe penalties like lengthy prison sentences and massive fines. Recently, a Manhattan doctor convicted on fraud charges incurred two separate prison terms (121 months and 210 months). He must also pay a fine of $75,000 and forfeit more than $300,000.

If you work in the medical industry, it is wise to learn as much as possible about healthcare fraud defense in New York. Doing so can help you avoid criminal charges that could change life for you and your family.

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