Philadelphia Attorney Defends Against Charges of Medicare Fraud
Skilled and determined representation to protect your medical practice
In 1965, Congress created the Medicare and Medicaid programs to strengthen the American social safety net. Unfortunately, these programs have been the targets of rampant fraud, which authorities have tried to stamp out through aggressive prosecutions that too often implicate innocent healthcare providers. Don’t let fraud charges ruin your medical practice and your reputation. When you learn of an investigation, you should immediately retain effective criminal defense to protect your rights. The Law Offices of David Jay Glassman provides aggressive representation that delivers positive results. Our attorney draws on more than 35 years of experience to fight for you.
What is Medicare fraud, and what are the penalties?
Medicare fraud is a theft crime that targets programs run by the United States government. Therefore, Medicare or Medicaid fraud is a federal crime, governed by federal law, investigated by the FBI and prosecuted by U.S. Attorneys of the Department of Justice. The pertinent federal statutes for these offenses include:
- False Claims Act — Also known as the Lincoln Law, the FCA imposes criminal penalties for falsely billing the U.S. government. Anyone who submits claims for payment to Medicare or Medicaid that they know or should know are fraudulent may face prison time, as well as fines of up to three times the programs’ loss plus $11,000 per claim.
- Anti-Kickback Statute — This statute prohibits any payment made knowingly and willfully to generate business related to any service billed to a federal healthcare program. Anyone who pays or receives funds is subject to criminal and administrative penalties. Fines can run up to $50,000 per kickback plus three times the amount of the illicit payments.
- Physician Self-Referral Law — Also called the Stark Law, this statute bars physicians from referring Medicare or Medicaid patients to service providers with which the physician or an immediate family member has a financial relationship. Penalties for Stark Law violations include fines and a ban from participating in the federal healthcare programs.
What is the total cost to American taxpayers of Medicare and Medicaid fraud? While it’s impossible to know precisely, estimates set the amount somewhere between $75 billion and $250 billion. This is why federal authorities aggressively pursue even the slightest violations by well-intentioned healthcare providers.
What are the most common types of Medicare fraud?
A healthcare provider could come under suspicion of Medicare or Medicaid fraud for actions that include:
- Billing for services that weren’t performed
- Billing for more expensive services than were rendered
- Billing for services that are not medically necessary
- Prescribing medications that are not medically necessary
- Ordering tests that are not medically indicated
- Billing for separate steps of the same procedure as if they occurred at different sessions
- Waiving copays and deductibles that do not qualify
- Accepting kickbacks
Any of these acts, even inadvertently, can place a healthcare provider in legal jeopardy.
Why you need a Medicare fraud defense attorney
If you are suspected of Medicare or Medicaid fraud, you should immediately contact an attorney who is qualified by training and experience to handle complex federal criminal cases, because:
- You face steep fines and prison time.
- Your reputation and your medical practice can be ruined.
- You’re going up against highly trained investigators and prosecutors.
Defenses are available, but an attorney must know the law and have extensive experience to be effective. Our firm has often been successful in resolving issues early in an investigation, so the authorities declined to bring any charges. However, when it’s not possible to reach a settlement, we are prepared to fight aggressively to protect you and your practice.
Contact a Philadelphia attorney with experience defending Medicare and Medicaid fraud charges
The dedicated criminal defense attorney at the Law Offices of David Jay Glassman provides an aggressive defense to Medicare and Medicaid fraud charges. Call 215-563-7100 today to schedule a consultation or contact us online. Our Philadelphia office is conveniently located at 1500 Market Street.