Health care fraud in the United States is estimated to be in the billions of dollars. Federal and state agencies aggressively follow thousands of tips and leads in an effort to combat health care fraud. Many innocent providers and employees are sometimes caught up in these investigations. Even experienced medical professionals can easily become the targets of fraud accusations due to the confusing Medicare and Medicaid billing systems.
Health care fraud can be difficult to establish. While accounting or billing errors may be discovered, prosecutors must establish intent to commit fraud in order to prove a crime has been committed.
Types of Health Care Fraud in New York
State and federal prosecutors prosecute the following practices as health care fraud. Conviction for any of these activities can carry heavy financial penalties and a prison sentence.
- Medical billing fraud
- Bundling and un-bundling schemes
- Fraud involving CPT codes
- Medicare or Medicaid fraud
- DME fraud
- Filing false cost reports
- Billing for medical services that were not provided
- Prescribing or billing medical equipment that is unnecessary or not actually provided
- Making kickbacks or self-referrals
As a New York City City Health Care Fraud Attorney, I represent doctors, nurses, pharmacists, physical therapists, health care providers, medical supply company owners and labs in New York City. I represent clients accused of such health care crimes as: health care fraud, Medicare fraud, Medicaid fraud, over-billing, improper billing, accepting kickbacks, false medical claims, and improper coding practices.
Allegations of health care fraud in New York City come in many forms. Some of the allegations associated with Medicare and Medicaid investigations involve paying patients and doctors to subscribe unnecessary medication, billing for services never rendered and receiving and giving kickbacks.
Why It’s Important Not to talk to Investigators
Federal investigators of New York health care fraud will not tell you everything they know about your investigation while they are talking with you. A person under investigation is also unaware whether he or she is the target of an investigation or only a suspect.
If your answers contradict what someone else has told the investigators then you could be charged with a crime and whatever you say could be used against you later during a trial. If you are the target of a health care fraud investigation it is important that you have qualified legal representation as early as possible.