Health Care Fraud

We work with our clients to aggressively defend and prevent Health Care Fraud allegations. Health Care Fraud criminal charges are unlike any other criminal charges a client will face. The regulatory scheme for health care in the United States is complex and largely unknown by most criminal defense attorneys. Health Care Fraud attorneys require specialized knowledge of health care statutes, Medicare guidelines, criminal statutes, as well as the Health and Human Services, Office of the Inspector General (OIG) administrative rules and procedures.

A Health Care Fraud Attorney providing proper defense requires the analysis of thousands of records, along with the cooperation of the right experts available at every stage of the criminal proceedings. Defense to Health Care Fraud charges can be costly, but can also be mitigated by an aggressive investigation at an early stage to prevent formal charges.

Anyone who knowingly and willfully executes, or attempts to execute a scheme to defraud any health care benefit program can be convicted of Health Care Fraud. Examples include the following:

  • Billing for services not provided or not medically necessary;
  • Falsely certifying that a patient is home bound which is often called Home Health Care Fraud;
  • Paying for recruitment of patients or services or Anti-Kickback and Stark law violations;
  • Up coding, Unbundling;
  • Misrepresenting dates of service;
  • Misrepresenting provider of service;
  • Waiving deductibles and/or co-payments;
  • Billing for drugs not actually filled by a pharmacy;
  • Incorrect reporting of diagnoses or procedures;
  • Overutilization of services;
  • False or unnecessary issuance of prescription drugs;
  • Prescription drug buy-backs;
  • Medicaid Fraud;
  • Unlawful Prescribing and Dispensing.

A proper defense to formal Health Care Fraud charges can be costly, but can also be mitigated by an aggressive trial attorneys who will fight for you at every stage. If you are facing charges call Jonathan Bedi and Dena Singer at 312 525 2017.