Healthcare fraud is a severe offense that targets healthcare workers who have committed various crimes. It is termed as a fraud when defendants jointly get into an agreement to commit fraud in the healthcare sector. When the workers get convicted of the crimes, they need to get in touch with healthcare fraud conspiracy lawyers to create a defensive plan.

Involving a lawyer helps the workers with defense tactics to run the federal conspiracy investigations that aid criminal charges against them. Below are the various elements and statutory information affecting healthcare workers, the types of conspiracies involved, sentencing, defense, and penalties.

Types of Conspiracy Fraud

There are various elements that the government needs to prove beyond doubt against the healthcare defendants. Two of the facts that need proof are that two or more people consented to commit an unlawful plan. Another point is that the defendants committed the act with the knowledge that the law prohibits the offense. However, they still went on to attempt or willfully accomplish the intention to defraud a healthcare program. Such crimes include;

• Medicare fraud
• Medicaid fraud
• False prescription of drugs
• Misuse of services
• Misdiagnosis procedures
• Billing for drugs not filled by a pharmacy
• Giving false certification of the recovery of a patient
• Paying for patient recruitment
• Waiving co-payments
• Wrong information of provider of services
• Prescription drug buy-backs
• Issuing bills of unnecessary medication

According to the legal concept, the defendants get charged whether they directly or indirectly conspired in the fraud. One can be accused of healthcare conspiracy without knowing the identity of the other party or the alleged defendants. In most cases, some of the defendants may have never heard about the co-accused, or they may have never communicated at any time. The government will still lump the defendants together because they all agreed to act as agents to each other.

Penalties for Healthcare Fraud Conspiracies

Some guidelines state the level of offense for the defendants. If the defendant has previous criminal records, the offense levels are either added or subtracted from the current crime. It results from the calculation of the offense level that guides the court in determining the criminal history of the defendant.

With the right information, the court matches the two results and gives a sentencing recommendation range for each offense. The length of the sentence increases as the two numbers increase. The court applies the rules based on different kinds of frauds and the associated losses.

For instance, when the related loss amounts to a high volume of money, the court adds more points to the defendant, which increases the sentence. The judges ensure that they factor in many guidelines to give a proper assessment of the deserved punishment. Where one gets convicted under the False Claims Act, they will serve life in a prison sentence and a fine amounting to $250,000. The penalties vary from the value of the dollar as at the time of sentencing and the statute charged.

Factual Defenses

The lawyer ensures that they downplay the role of the client and establish the relationship between the client and co-defendants. When the obligations of the defendant are acknowledged, it means that he/she has the requisite mens rea. It shows the intent of the criminal to further the illegal objective.

The lawyer can persuade and provide information where the client did not intend to commit the crime, especially if the government lacks enough evidence against the defendant. Another channel is to acknowledge the participation of the defendant in the conspiracy and create a plan to mitigate the situation. Such include low financial gain, the hardship of the defendant, and a short period of involvement in the fraud.

The lawyer needs to be familiar with the whole process, which includes;

• Corporate integrity agreement
• Asset forfeiture and seizure laws
• Incarceration
• Insurance of Billing privileges’ denial
• Medicare exclusion
• Restitution and fines
• Probation
• National Practitioner Databank
• Staff privileges
• Loss of state license
• Loss of DEA rights

Get Professional Healthcare Fraud Legal Services

Whether or not you feel guilty of healthcare fraud, you may need legal experts who have adequate experience in such cases. A proper defense might be costly but comes with high mitigation plans that will prevent further advancement of the situation and might aid in preempting formal charges against the defendant. When involving a lawyer, they ensure a compliance plan to implement the matter and establish possible avenues to mitigate the situation.