If there’s one thing that most Americans know, it’s that our healthcare system is complex. There are many layers and so much to understand that mistakes in the system are practically unavoidable. These mistakes can be expensive, but some of the costliest issues for health care, including Medicare, aren’t mistakes at all, but instead intentional crimes.
A percentage of all the money spent on healthcare is used to pay out fraudulent claims. Health care fraud can be committed on multiple levels, including patients, providers and insurers who lie, deceive of falsify information on health care claims for financial benefit. These crimes of fraud can be addressed on both a state and federal level. This means that in some cases, they carry very severe penalties.
If you’re facing health care or Medicare fraud charges, your best defense is to be prepared. Not every case is cut and dry, and in some cases, there are reasonable defenses that can be used to reduce or eliminate the charges.
Here are four tips for forming a good defense against health care fraud allegations.
Provide Evidence That You Made a Mistake
While on the surface an act might seem like health care fraud, mistakes are common, and it could be that the event occurred without an intent to achieve financial gain. Mistakes can include incorrect paperwork, billing mistakes, improper payments and omission of information. To be considered fraud, a person must plan to commit or intentionally engage in providing falsehoods for personal or business benefit. A simple mistake in billing where a procedure is billed incorrectly does not qualify as fraud. Some cases can be defended simply by showing that there was no malicious intention.
Learn the Lingo
Those who prosecute health care fraud cases are members of a legal community, not a medical one. The language of health care laws and billing codes is complicated and even the smallest misinterpretation can make a major difference in how a fraud case is approached. The more educated you and your legal team are in medical terminology and lingo, the better prepared you’ll be with a defense that makes sense.
Understand the Penalties
A common mistake that we see people facing health care fraud charges make is not understanding the severity of the consequences that they’re facing. Health care fraud comes with serious penalties, and when we move into the realm of Medicaid or Medicare fraud, the outlook can be even more severe. If convicted, you can be facing anywhere from 6 months to decades in jail. Often, understanding this is key for the defendant to cooperate fully with their legal team.
Seek Out Legal Counsel with Health Care Fraud Experience
There’s one thing that the right legal team can provide you with that you won’t get anywhere else, and that’s experience. We have experience in defending health care fraud of all types, and we’re here to help you. If you’re looking at fraud charges, don’t wait a second longer to reach out. Contact Elden Law Group today for a free consultation.