Healthcare fraud charges are very serious. These charges often come after lengthy and comprehensive investigations. People who are facing healthcare fraud charges must be ready to work hard on a defense. While this won't guarantee you a positive result, it does give you the best chance possible to have an outcome with minimized impacts on your life. Consider these points if you are facing charges for healthcare fraud.
#1: Actions must be intentional
You can't accidentally commit healthcare fraud. You must know what you are doing. Defendants who truly didn't know what was going on can't necessarily claim ignorance of the law as a defense, but they could potentially show how the alleged fraud was just a mistake or unintentional action.
#2: More than one type of issue is possible
Healthcare fraud is an umbrella term for several different criminal acts. Duplicate billing, accepting kickbacks, improper billing and health care identity theft are all types of fraud that can occur. For this reason, ensuring proper billing practices is crucial if you are involved in the billing for the business.
#3: Healthcare fraud can occur at any point in the care system
From the time that a person calls to make an appointment through the point when the final payment occurs to close out the account, there are opportunities for health care fraud to occur. Even after a patient leaves a facility and the facility closes the account, healthcare fraud can still occur if a person uses that patient's information.
#4: Medical identity theft is common
Taking another person's medical identity is a criminal act. This usually occurs when someone creates an account using that person's information to initiate fraudulent billing. An example of this is a doctor who creates false patient accounts in order to bill the insurance companies for appointments using the information from a person with a valid policy.
#5: Healthcare fraud is sometimes tied with organized crime
Organized crime and healthcare fraud sometimes go together. This sometimes occurs when a person in the organization needs health care. The organization will find a practitioner who is willing to use fraudulent billing and information to provide care for the injured party.
#6: Penalties are severe
Healthcare fraud usually falls under federal laws. The penalties for these crimes are severe. You may be facing time in federal prison, heavy fines and the loss of professional licensing. A conviction on a basic healthcare fraud charge can lead to up to 10 years in prison. You can also face collateral consequences like loss of reputation.
With the stakes this high, it is crucial for anyone facing healthcare fraud charges to mount an aggressive defense.