You went into the medical profession so you could heal the sick, not so that you could be a bureaucrat. However, medical providers have a lot on their plate regarding billing. To say that dealing with health insurance is an inexact science is an understatement; the rules and prices are always subject to change, except when they aren’t. A mistake or misunderstanding could bring your medical practice under investigation for fraud.
If you are being accused of health insurance fraud, contact a Texas white-collar crime lawyer.
Texas Healthcare Fraud Laws
Plenty of ambiguities go along with running a practice and collecting payments for services that you could be accused of healthcare fraud, all while being unaware that you were breaking any rules.
Healthcare fraud happens when there is intent to deceive patients out of money that a provider does not earn or deserve. Examples of healthcare fraud include:
● Billing more for more costly services than the one that was performed.
● Billing for services that were not performed.
● Taking kickbacks for new patient referrals.
On the other hand, there is healthcare abuse which is engaging in behavior and practices that is not consistent with accepted practices. Examples of healthcare abuse include keeping a patient’s prescribed drugs for personal financial gain.
You should hire a financial crimes defense lawyer if you get accused of health insurance fraud or abuse. Misunderstandings and mistakes do not deserve criminal penalties, especially when they do not physically harm patients.
Texas healthcare fraud laws say that punishments for fraud can include:
● Class C misdemeanor, when the monetary value of the fraud is less than $100, comes with a fine of up to $500.
● Class B misdemeanors happen when the monetary value of the fraud is $100 to $750 and comes with fines as high as $2,000 and up to 180 days in jail.
● Class A misdemeanor happens when the fraud is in the monetary amount of $750 to $2,000 and comes with a fine as high as $4,000 and jail time of up to one year.
● State jail felony happens when the monetary value of the fraud is $2,500 to $30,000 and comes with a fine of up to $10,000 and prison time for at least 180 days and as long as two years.
● 3rd-degree felony when the fraud is $30,000 to $150,000 and comes with a $10,000 fine and at least two years in jail or up to 10 years.
● 2nd-degree felony when the fraud is $150,000 to $300,000 and comes with a $10,000 fine and as many as 20 years in prison.
● 1st-degree felony when the fraud is $300,000 or more and comes with a $10,000 fine and as many as 99 years in jail.
A criminal defense lawyer can help you fight your charges and clear your name.
Contact the Law Office of Patrick J. McLain, PLLC, About Financial Crime Cases
It is in your interest to hire a Dallas criminal defense lawyer if you are facing charges for a financial crime as a result of the claims your medical office submitted to Medicare, Medicaid, or private health insurance companies. Contact the Law Office of Patrick J. McLain, PLLC, in Dallas, Texas, to discuss your case.