Health Care Fraud
Health care fraud is a significant concern of the government. The government uses its extensive resources to thoroughly investigate and intensely prosecute health care fraud cases. Penalties are harsh, often life-changing personally and professionally, if found at fault.
If you are under investigation from the Department of Justice and the Department of Health and Human Service’s Office of Inspector General you can be prosecuted in a federal court. If convicted, you can also be sentenced in a federal prison. The possibility of spending time in prison is a significant concern. In addition, losing the ability to bill a federal health care program often means a death to your professional career.
Federal investigators regularly rely on confidential informants, former employees, and others with potential inside information to aid with investigations and prosecutions. Often, incidental errors or negligent mistakes can be identified as possible fraud. The mandated billing procedures are often difficult to understand. Coding errors or a failure to understand something correctly can have detrimental ramifications. With health care fraud cases being such a high priority for the government, the investigations are often intrusive to the health care professional.
Therefore, it is critical for you to choose a highly experienced health care fraud law firm to effectively represent you if under investigation. Michael Padula is a former federal prosecutor who worked in the health care fraud unit. Padula has the unique insight into how health care fraud cases are investigated, charged, and prosecuted. As a prosecutor himself he handled countless health care fraud cases against doctors, patients, recruiters, and others.
Health care fraud is a white-collar crime involving illegally profiting from federal health care programs.
Examples of health care fraud include:
- Kickbacks
- Submitting false claims to CMS for payment
- Billing for ghost patients
- Billing for services not provided
- Billing for equipment not provided
- Billing for services of such low quality that they are virtually worthless
- Up-coding
- Billing unbundled services
- Over-utilization of certain medical procedures or services
- Lack of medical necessity
- Utilization of excluded providers
- Making false statements on applications or contracts to participate in Medicare or Medicaid program
- Providing false or misleading information expected to influence a decision to discharge a patient
- Violating Medicare assignment provisions or the physician agreement
Contact Expert Health Care Fraud Attorney Michael Padula
If you are being investigated for health care fraud by the federal government, having an experienced defense attorney on your side is vital to your defense. Call the offices of Michael Padulal at (305) 455-5206 to arrange your free and confidential consultation.