To avoid any criminal charges, medical employees should take precautionary steps to ensure the safety of their patients and uphold their lifesaving responsibilities. Should a court accuse you of healthcare fraud, contacting an experienced attorney may provide you with the best defense and opportunity to avoid penalties.
Common Healthcare Fraud Charges
Although you strive to work ethically when dealing with patients, accidents happen, and opportunities still exist for a court to convict you of medical fraud. Providing only necessary services and avoiding serious missteps in the medical care of your patients may save you from significant penalties.
Healthcare fraud usually involves the violation of the following statutes.
- The Federal False Claims Act: If you commit offenses against the False Claims Act, a court may find that you submitted claims to Medicare or Medicaid for services not provided to your patient. Perhaps:
- You charge a patient or their insurance company for an x-ray, but the x-ray scan never occurs.
- You provide a medical service for a patient that insurance does not cover, but you bill their insurance anyway.
- The Anti-Kickback Statute: If found guilty by a court under the Anti-Kickback Statute, your hospital may have illegally paid you to induce referrals from healthcare programs. Maybe:
- Your hospital pays you compensation based on the number of labs or x-rays you order.
- The Stark Law: Those charged with violating the Stark Law usually refer their own services to an entity with they hold a financial relationship. Perhaps:
- You make a deal with a local homeless shelter to have the shelter refer homeless patients to you, knowing that government benefits will pay for their treatment.
- Civil Monetary Penalties Law: If found guilty of violating the Civil Monetary Penalties Law, a court may find that you defrauded a healthcare benefit program or illegally obtained money from programs. Maybe:
- You decide not to put certain patient test results in an insurance- or court-ordered document to deceive either entity.
- You lie about your patient’s condition so that you can perform more costly tests.
Penalties For Healthcare Fraud Convictions
Committing any medical fraud acts against the government may designate serious charges. Some penalties for healthcare fraud, based on the crime itself and its severity, include:
- Felony charges
- Fines from $50,000 to $250,000
- Jail time for up to 10 years
- Loss of medical care license
Your responsibility as a medical care provider involves taking accurate notes, giving only necessary treatment to patients and billing for exact services given. If a court accuses you of any healthcare fraud, and you believe you acted innocently, you must contact an experienced healthcare fraud attorney. Your career may depend on the expertise of your defense.