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What could happen if I face a Medicare fraud investigation?


There are a lot of federal crimes that can affect nearly every profession. Those who work in professions that require billing may be especially susceptible to fraud allegations. Alleged wrongdoing like price fixing, overcharging, and misrepresenting services could all give rise to criminal charges, leaving individuals in need of strong legal representation. If you are a medical professional, then you may be concerned about being accused of Medicare fraud which could carry significant penalties if convicted.

So, what is Medicare fraud? Medicare fraud often occurs when you overbill for supplies and services that were never rendered to a patient. The idea behind this type of fraud is that doctors can be reimbursed from Medicare without providing those services, and the patient may not know or care since he or she is not paying for it anyway.

Though Medicare fraud can occur when services are not rendered, it can occur in other ways as well. It can take place when a Medicare patient is billed for equipment that he or she never received, a business offers patients a drug plan that is not approved by Medicare, and false information is utilized to get an individual to join a Medicare plan. Since this criminal offense costs the government billions of dollars a year, federal prosecutors aggressively pursue those they believe to have acted fraudulently.

The penalties for Medicare fraud can be harsh. Fines can quickly skyrocket and prison may become a real possibility. Therefore, if you have become a suspect in a fraud investigation, you should not wait to start your defense. A competent, experienced, and aggressive defense attorney may be able to help you create a legal strategy that is right for you and your situation and, hopefully, will allow you to reach a fair outcome.

Source: U.S. Department of Health and Human Services, "What is Medicare Fraud," accessed on May 29, 2015

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