Under ORC 2913.40, Medicaid fraud occurs when a Medicaid provider knowingly makes or causes to be made a false or misleading statement or representation for use in obtaining reimbursement from the medical assistance program. This would include but is not limited to, billing for services not provided, charging Medicaid more than the reasonable value of the services, providing services that were medically unnecessary, etc.

Medicaid providers include doctors, dentists, hospitals, nursing homes, pharmacies, clinics, counselors, personal care/homemaker chore companies, and any other individual or company that is paid by the Medicaid program. If a provider intentionally misrepresents the services rendered, and therefore increases their reimbursement from Medicaid, Medicaid fraud has occurred.

Medicaid fraud includes:

• Billing for medical services not actually performed, known as phantom billing;
• Billing for a more expensive service than was actually rendered, known as up coding;
• Billing for several services that should be combined into one billing, known as unbundling;
• Billing twice for the same medical service;
• Dispensing generic drugs and billing for brand-name drugs;
• Giving or accepting something in return for medical services, known as a kickback;
• Bribery;
• Providing unnecessary services;
• False cost reports;
• Embezzlement of recipient funds.

Any New Yorkers who have been investigated for, accused of, charged with, arrested for, or convicted of Medicare/Medicaid fraud should contact NYC-based Medicaid fraud attorneys at Bukh and Associates PLLC to schedule a consultation.

Bukh & Associates represents clients in matters involving Medicaid throughout New York, including allegations of:

• Coverage claims for non-existent illnesses
• Claims for coverage for staged, fraudulent auto accident injuries such as back or neck pain
• Medicare/Medicaid claims for fraudulent, falsified, or exaggerated alcohol dependency treatment
• Medicare/Medicaid claims filed under phony names
• Medicare/Medicaid coverage claims for home health care, therapy, or treatment which never occurred

Our New York Medicare/Medicaid fraud defense lawyer defends patients, doctors, medical clinics, nursing homes, assisted living facility personnel, and so-called "Medicaid mill operators" accused of filing fraudulent Medicaid or Medicare claims for non-qualifying health care services.

Our skilled criminal defense attorney thoroughly investigates allegations and builds the strongest possible case on behalf of the accused. Contact us to discuss Medicare/Medicaid fraud defense matters with an experienced lawyer.

If you think you are under investigation for fraud, call Bukh & Associates immediately.

When the feds come in, they often take documents. Even if they are in the wrong, defendants must request copies of their own records in an effort to prepare for their own defense. Quick action is most likely to bring about a fruitful recovery and exposure of illegally obtained evidence. Begin your defense preparations before the indictment. The sooner we research and prepare your case, the better your chances are for a successful outcome.