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Healthcare Defense Hospice Care Fraud Defense Lawyers

June 30, 2020

When someone is in their final stages of life, hospice care can be provided. The patient is cared for in order to remain comfortable. The family is able to spend quality time with the patient instead of being concerned about providing medications and the physical care that is needed as these tasks are often performed by a hospice care nurse. However, there are times when services are billed multiple times or when there are payments requested for services that aren’t provided. This can lead to hospice care fraud. If you have been charged with this type of fraud, you can seek the assistance of an attorney who has experience in this matter so that all of your financial documents can be properly reviewed and so that the best defense strategies are used in court.

Most of the time, hospice care fraud is investigated with other types of healthcare fraud instead of on its own as there are often more parties involved, such as pharmacies, doctors, and hospitals. A common type of hospice fraud that occurs involves certifications for patients. When patients or families are unable to pay for the care that is needed, documents are sometimes altered in order for Medicare, Medicaid, and insurance companies to cover the expenses that are involved. Nurses and other employees working with doctors and other providers are sometimes paid kickbacks if they are willing to falsify records so that patients can obtain the help that they need through hospice. Although this might seem as though it’s an act that is helping the patient and the patient’s family, it’s often considered a criminal act that could be classified as a felony.

The Office of Inspector General is responsible for looking into each claim of hospice care fraud that is reported. This person will look over the evidence that is provided and make a report and recommendation to the court based on the findings. If there is enough evidence to support a charge, then the person who is under investigation will usually be arrested. You should seek the assistance of an attorney before this time comes so that you can work together to discuss the financial documents that you have.

After reviewing the evidence presented, there are a few things that could happen. The state could request that you repay the money that was taken from insurance companies to pay for services that weren’t provided or that weren’t eligible to be provided. You could also be ordered to receive no payments for any future claims that are made. This would mean that you would not be able to charge insurance companies for services. Fines could be ordered in a civil suit up to $11,000. You could also lose your medical license or the ability to participate in programs that are provided by the federal government. Attorney fees could be attached to any amount that you would need to pay back. A jail sentence is possible as well depending on how long you have been committing hospice care fraud and the extent of the damages that have occurred.

An attorney can work with you to craft a defense so that you pay as little as possible and so that you spend the least amount of time in jail if you are sentenced. Many hospice care fraud defense attorneys have worked as prosecutors, which is beneficial as the attorney will likely know of some of the defenses that are commonly used and when it’s best to enter into a plea deal. Your attorney should understand billing codes, government payment options and how payments are collected, and how to decipher medical records in order to provide the best defense as possible.



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