Healthcare fraud refers to intentional wrongdoing involving medical professionals, hospitals and allied services. The involved parties tend to claim funds for services that were actually never undertaken or at least not undertaken as required by government rules or the rules of the third party payor while treating a patient or the services were unnecessarily administered during treatment. Most such cases include fraudulent reimbursement claims submitted to the government or third party payors such as Blue Cross or UHC.
Private insurance companies working on their own behalf or on behalf of the government often initiate such allegations of fraud. If you are wrongfully accused or correctly accused of such fraud, hiring a good healthcare fraud attorney who can defend you against such charges successfully in court or out of court is critical to your continued career as a healthcare professional. The legal counsel prepares the defense against such cases in accordance with the state and federal laws regarding healthcare fraud.
Characteristics of a Good Healthcare Fraud Lawyer
1. Good Track Record
A proven track record is important. Knowing from the past that which will help in the present is critical for your future defense against healthcare fraud allegations. Although every case is different in some way or other, the fact your lawyer has been able to successfully defend clients in the past is sure to inspire confidence in your current case and give him the skills to successfully defend you.
2. Thorough Investigation
An experienced healthcare fraud attorney worth his salt will always ask numerous questions during his sessions with the client. The idea is to establish the factual basis of defense and the grounds on which the client may be acquitted, or finding angles leading to the case’s dismissal in court or even avoiding prosecution at all.
3. Knows the prosecution methods
The lawyer in question should be conversant with the common grounds for convictions in healthcare fraud cases. This knowledge and experience will help to narrow down the case in court by suppressing incriminating evidences or carrying out effective pre-trial motions.
4. Has the Backup of a good team
A successful lawyer requires a hard-working, focused team supporting him or her behind the scene. Some examples of the back-up team members required to successfully defend against healthcare fraud allegations alongside an experienced attorney may include:
- Former agents who work as investigators,
- Forensic accountants for combing through the extensive billing records, and
- Medical professionals whose statements can carry weight in court
To conclude, defense against healthcare fraud allegations requires attorneys with a record of excellent experience. Their thorough investigations with a strong backup team can be extremely beneficial for your case. The experienced healthcare fraud attorney is the right professional to save you from getting into the trap of any such fraud allegations.