Brooklyn Healthcare Fraud Defense Lawyers Can Help Professionals Facing Criminal Charges of Medicare or Medicaid Fraud
There are a myriad of laws, regulations, policies, and protocols that must be followed to submit an invoice to different insurance companies, along with state and federal health programs like Medicare and Medicaid. If a mistake is made, it could be misinterpreted as fraud.
If you have been charged with Medicare or Medicaid fraud, one of the most important steps you can take to preserve your medical practice, your license, and your personal freedom is hiring a skilled and aggressive defense attorney.
The Bukh Law Firm in Brooklyn, NY proudly defends doctors and other medical professionals accused of this type of fraud. Contact our offices to hear what your next steps are for this type of case.
Understand the Differences Between Medicare and Medicaid
Medicare is the federal program for U.S. citizens aged 65 years or older or those with severe disabilities to be eligible for health coverage. Because everyone pays taxes for these expenses, all citizens are typically qualified once they reach 65 years of age.
Medicaid provides health coverage for U.S. citizens who have a low income. This is a federal and state program. In order to be eligible, patients must meet one of the following guidelines:
- Patient is pregnant
- Patient is a parent of a minor or teenager living at home
- Patient is aged, blind, or disabled
- Patient has no disabilities and no children under the age of 18, but qualifies for coverage under the provisions of the Affordable Care Act.
What Is Considered Healthcare Fraud?
Billions of dollars are lost every year due to healthcare deception. And while doctors and healthcare facilities due their best to determine appropriate actions to take in the best interest of their patients and the federal administrations, there have been cases where lines have been crossed, which ultimately results in legal action.
Fraud is considered to be a dishonest act that is administered knowingly with potential unauthorized benefits for the person or people committing the act. This may include medical providers increasing their reimbursement , which woefully misrepresents the services rendered. This is considered fraud.
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Other examples of this type of fraud include:
- Phantom Billing: billing for medical services not actually performed;
- Coding: billing for a more expensive service than was actually rendered;
- Unbundling: billing for several services that should be combined into one billing;
- Kickbacks: giving or accepting something (e.g., perks, money, etc.) in return for medical service referrals or types of treatment.
Abuse of these federal and state programs also leaves doctors liable for legal charges. Abuse is considered to be practices that are not consistent with the accepted fiscal, business, or medical standards. In the event that an extreme amount of cost or reimbursement is issued due to unnecessary medical treatments, physicians can be accused of Medicaid or Medicare abuse.
Who Might Be at Risk of Medicaid Charges?
Any single physician or group can be accused of Medicaid fraud. This includes doctors, dentists, counselors, and personal caregivers. Companies can also be accused if they are paid by the Medicaid program. Hospitals, nursing homes, pharmacies, clinics, and homemaker chore companies are all liable. If you have indulged in any of the following actions, you are at risk for impending fraudulent charges for duplicitous actions:
- Billing twice for the same medical service;
- Dispensing generic drugs and billing for brand-name drugs;
- Providing unnecessary services;
- False cost reports and;
- Embezzlement of recipient funds
How a Brooklyn Medicare and Medicaid Fraud Defense Lawyer Can Help
Most doctors are required to obtain malpractice insurance. While most medical professionals are under the assumption that this will save them in the event of litigation, this is not the truth. Insurance company’s primary stance is in their own interests and will work defend their finances before consoling physicians.
A Medicaid fraud defense lawyer, on the other hand, works specifically for any professional accused of malpractice. Services from your Brooklyn healthcare lawyer will include:
- Descriptions for your legal options;
- Counseling on how to delegate your current business while under investigation; and
- Gathering legal documents and evidence to help your case
Medical lawyers will always be your best defense option. It is not only their job to protect you, but it is there job to find the necessary materials to save your medical license.
The last thing you want to be associated with criminal charges. Some options for gathering evidence will include detailed witness statements, professional testimonies, and chronological documentation of patient information or billing statements.
If anything, your lawyer will work to administer a plea deal on your behalf and can drastically reduce the charges against you.
How to Prevent Medical Fraud and Abuse
One of the many reasons that doctors are accused of fraud is due to circumstances outside of their control. In some cases, prescription pads have been stolen and used unethically and often offices are given fraudulent forms insisting the patient has healthcare coverage. In order to cover your assets as a company or sole physician, there are a number of steps you can take to prevent being liable for these sorts of actions.
- Make sure member ID cards are validated before executing your services;
- Ensure all appropriate Referral and Treatment forms are submitted in a timely manner;
- Provide a safeguard and double check for accuracy when submitting bills or claims for medical services;
- Report lost or stolen prescription pads and/or fraudulent prescriptions; and
- Avoid unnecessary drug prescription and/or medical treatments
Take Action Now – Contact an Experienced Brooklyn Medicaid Fraud Defense Lawyer
Retaining an experienced lawyer that deals with healthcare fraud in Brooklyn, NY is one of the most actions you can take in defending your case and protecting your rights. If you are in need of a skilled and savvy defense attorney, speak with one of the lawyers at the Bukh Law Firm, LLC.
Our capable criminal defense attorneys thoroughly investigate the allegations against you and will work tirelessly to build the strongest possible case on your behalf.