Just how serious — that is, how ardent and uncompromising — are state and federal officials when it comes to conducting investigative probes of individuals alleged to be involved in health care fraud?
And, following up on that, how adamant are they about subsequently bringing criminal prosecutions against alleged wrongdoers and pushing for flatly harsh sentencing outcomes?
A recent case involving a woman from the southern Texas city of McAllen goes far toward answering those questions. That individual — arrested in June 2016 and convicted by a federal jury in late February — now faces a criminal outcome that could yield many decades in prison.
Her cited offenses: conspiracy to commit health care fraud; multiple counts grounded in false Medicaid billings submitted to the government; witness tampering; identity theft; and additional charges.
The woman formerly managed a durable medical equipment company. At her trial, prosecutors stated that she sent bogus billings to Medicaid over a five-year-plus period for equipment that never reached patients. The government paid out about $1.8 million in response to those fraudulent charges.
It is unquestionable that criminal investigators and enforcement teams spent considerable time, energy and money on the woman’s case, with one national legal publication noting that “it was part of the largest national Medicaid fraud takedown in history.”
In fact, a concerted state/federal probe ultimately yielded criminal charges against more than 300 people, including scores of physicians and nurses.
Health care fraud — both in Texas and nationally — is obviously a top-tier prosecutorial focus these days, underscoring the need for any targeted individual to secure timely and knowledgeable help from a proven criminal defense attorney well versed in fraud-related advocacy.
The stakes are high. Diligent legal representation can sometimes make a material difference for an accused party.