Posts Tagged ‘medicare frauds’

Medicare Frauds: Types And Penalties For Fraudsters

September 11th, 2017

According to data, medicare fraudsters skim around $60 billion annually from the government—that is almost 10 percent of the entire healthcare budget. The figure reveals a bitter truth that indeed many caregivers conscientiously commit frauds and receive money from government illegally. To make money, fraudster healthcare professionals—including include doctors, hospitals, dentists, pharmacies, clinics, nursing homes, counselors, personal care providers, and home chore companies—provide forged documents for services not offered, charge government more than the value of the healthcare services, and offer services that are not necessary.

Therefore, as a safeguard the governmental organizations investigate healthcare professionals regularly to weed out the deceitful personnel and companies. As a result, many honest medical caregivers also face the investigating agencies, and thus, to represent them, they need medicare fraud lawyer, who could help the defendants prove their innocence. The fraud attorneys are important, as the prosecution can lead to grave penalties and criminal charges.

What are the penalties for fraud?

Healthcare personnel whom agencies prosecute—and found to be have committed the fraud—face strict penalties, such individuals face major consequences in terms of their career. In the typical case, the offenders under law are mandated to reimburse the overpayments to the governments, along with the high financial fines for committing the fraud. In some case, the federal government also prosecutes defendants under criminal laws. People who are found to be guilty of the swindle also face prison, running up to five years, for every offense committed.

Types of cases for which medicare fraud lawyer is required:

  • Phantom billing

Billing the government under medicare for needless procedures—as well as procedures that are never performed. Forging documentation for the cost of medical tests and medical equipment also comes under phantom billing.

  • Up-coding

In such cases, the bills are inflated by using incorrect code; typically, the billing codes of the expensive treatments are used rather than the one provided in the patient billing.

  • Patient billing

There are people who knowingly share their medicare number in exchange of kickbacks from the fraudsters. Commonly, a small portion of money received by the government is shared to the people who colluded with swindlers. However, there are other ways of kickback as well.

Healthcare professionals who are facing above charges, or even inquiry about the accusations, should get in touch with medicare fraud lawyer, who with their experience in handling such cases and understanding of the functioning of prosecuting agencies, can help you clean your name from the charges.