Medicaid providers are professionals who offer medical services. They include doctors, nurses, pharmacists, hospitals, clinics, and counselors. If they provide false information regarding a person’s health or misrepresent the services rendered to increase their reimbursement, then this is regarded as a Medicaid fraud.
According to the Whistleblower Attorneys, this particular crime costs American taxpayers a lot of money every year. It is due to this fact that many medical practitioners and institutions are being reported to the authorities and being investigated even when there is no case to prove, or when the fraud was committed unknowingly. This article discusses the various ways that a Medicaid fraud is committed, possible penalties, probable legal mitigating factors, and other legal aspects of the crime.
Ways which Medicare Fraud can be Committed
Listed below are instances that may see on charged with Medicaid fraud:
• Inflating the time spent with a patient
• Billing private insurance and Medicaid for the same services
• Falsifying information such as medical records
• Prescribing medications that a patient does not need
• Billing unnecessary services, tests, or procedures
• Charging procedures or tests that were not conducted
• Submitting multiple bills for the same procedures
• Prescription kickbacks
• Prescription falsification
• Billing for patients who do not exist
• False billing or overbilling
Penalties for Medicaid Fraud
When charged with such a crime, the option one can take is hiring an attorney who is well versed with such matters. This is because it is regarded as a serious offense and has grave ramifications. The Medicaid system is also a complicated, so it is to let someone who is highly experienced to represent you in a court of law or any legal hearing.
A lawyer can prove that the accused did not commit the crime they have been charged with, or they committed it unknowingly. There are also cases whose evidence is strong, and the penalty will, therefore, be quite severe. Either way, it is essential to hire legal representation. If a claim is not defendable, there are things a lawyer can do to minimize the accused’s criminal exposure. The types of penalties under this kind of fraud include:
The accused can be charged tens of thousands of dollars or less. The amount is highly dependent on the exact charges they are faced with. If the evidence provided is substantial, the amount will be high, but if there is no damning proof, then the fine will be low. Also, the higher the number of people involved in a Medicaid fraud the higher the amount fined.
An experienced lawyer can, however, be able to negotiate the amount on behalf of their client. They can achieve this by providing any evidence that will portray the accused in a good light.
When one is put on probation by a court of law, it means they will be under constant supervision for a given period instead of serving time in a prison. During this time, they may be required to report to an assigned official regularly, attend probation meetings, or even live and operate within a specific area only. Breaking any probation terms may result in harsher penalties.
If a given fraud resulted in an individual or insurance company losing funds, then the accused may be required to pay the victims. The amount paid is usually equivalent lost money plus compensation for damages, loss, or injuries experienced by the victim due to the fraud. Just like a fine, the amount here is also not fixed. It could be on a high or low end. It depends on a lawyer and the evidence provided against the accused.
This is the most severe type of penalty a person can face. According to Robert Malove, the number of years ranges from five to life imprisonment. In a Medicaid fraud, such a sentence is issued if the crime resulted in death or severe injury to a patient.
Whether the penalty faced is hefty or not, the accused will have a criminal record even after the case has been heard and finalized. Such a record can taint one’s reputation. It exempts them from many activities, and they may even be overlooked when it comes to new opportunities.
One can avoid such a record by agreeing to settle the matter outside court. It means that both the defendant and the victim will meet in a neutral environment with their attorneys, and the issue at hand will be discussed and solved.
Numerous law firms deal with Medicaid fraud. Making sure that you hire the right one to represent you is critical, so one has to conduct an extensive research. Some of the things to consider here include experience and the amount to be charged. It is also crucial to be honest with your chosen law firm and provide them with all the information regardless of its importance. It will help a lawyer prepare for your defense.