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Providing False Medicare Information Is Fraud

Insurance policy with pen

Medicare is a national health insurance program for citizens who may have trouble paying medical bills. Medicare recipients are typically persons who are 65 years of age or older, young people with disabilities, and people with End-Ste Renal Disease (ESRD). Most medical facilities accept Medicare payments, and the administration of those claims and payments is a tangle of rules and regulations.

For as long as Medicare has been in existence, it has been under constant fire and criticism from those who say Medicare gives too much away, it costs taxpayers too much money, and it is too easy to defraud. Many medical care providers and medical institutions find themselves subject to criminal investigation for alleged Medicare fraud on allegations that they fell afoul of rules and regulations in that program. This article gives you an overview of this area of law.

What Exactly is Medicare Fraud?

Healthcare fraud includes allegations against healthcare providers and medical institutions of defrauding an insurer by submitting false claims, fraudulently ordering medical equipment or prescriptions, or billing for procedures contrary to Medicare’s rules and regulations. Medicare fraud is a form of healthcare fraud that deals specifically with Medicare recipients and their benefits.

Today’s health care professional has to work long and busy days caring for patients, and very often, documentation, especially for insurance claims, such as Medicare, does not receive the attention it requires. There are many clients who have come to the Law Office of Patrick J McLain PLLC who have run afoul of healthcare rules and regulations because those clients were simply too busy caring for patients to ensure that there documentation was done right. To avoid an investigation, or worse yet prosecution, for Medicare fraud, it is imperative that every clinic, hospital, and medical office have employees who sole job is to keep medical care professionals complaint with the law.

Protecting Yourself from Medicare Fraud Accusations

Nonetheless, many innocent persona have been accused of Medicare fraud. Such an accusation is intimidating. If you do not have good legal counsel, it could mean being sentenced to time behind bars, paying high fines, permanent reputation damage, and the end of your ability to practice medicine. You should take action as soon as possible to counter accusations and start protecting yourself.

If you are being accused of Medicare fraud, the following are several legal defenses your lawyer can use to avoid conviction and prove your innocence:

  • Lack of intent – In order to convict you of Medicare fraud, it must be proven that you participated knowingly in fraudulent activity. An experienced criminal defense lawyer can provide evidence that you did not intend to defraud Medicare by supplying false information.
  • Lack of knowledge of submitting a false claim – You must be aware that what is written or said in your claim was false. If you didn’t know that any of your provided information was inherently false, your lawyer may effectively use the lack of knowledge defense.
  • Employment of experts – A good criminal defense attorney will know when to use experts in the fields of medicine, medical administration, and accounting, and who to hire in each of those fields. Very often a court or jury needs to be educated on the realities of running a medical practice, office, or facility. A great criminal defense attorney will know how to put together the right team to fight for you.

No matter what defense would best suit your case, it is imperative that you hire an experienced criminal defense attorney to build that defense. The Law Office of Patrick J. McLain, PLLC can protect your rights, reputation, and freedom after being accused of Medicare fraud by being proactive and determining any weaknesses in the prosecution’s case. Attorney Patrick McLain is a former federal prosecutor and a retired Marine Corps military judge. In other words, he knows how to fight and he knows how to win.

For more information about Medicare fraud defense in Dallas, contact us today at (214) 238-9392.