Inappropriate billing practices may be health care fraud
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Inappropriate billing practices may be health care fraud

On Behalf of | Mar 23, 2021 | Healthcare Fraud

Federal criminal charges can come with penalties that may alter the course of a person’s life. If charged with a federal offense, such as health care fraud, it could result in years or decades behind bars and much more. If you work in the medical field and are accused of committing inappropriate billing practices, it is in your interests to know what you are up against and how you can defend yourself.

The federal government considers certain types of billing practices fraudulent, and they could result in serious criminal charges. You would be wise to take an investigation or formal allegations of health care fraud seriously. You can protect your interests by working to develop the most practical and effective defense strategy possible for your individual situation as soon as possible.

Illegal billing practices

Fraudulent billing leads to millions of dollars lost each year from Medicare, Medicaid and other types of government health care programs. An individual, company or group of people can commit this type of fraud. It involves intentional misrepresentation in health care bills in order to get more money in return. The government prosecutes these cases to the fullest extent of the law. Fraudulent billing practices include:

  • Billing for services that were not medically necessary
  • Billing for health care service that were not rendered
  • Misrepresenting a diagnosis to increase payments
  • Asking for kickbacks for providing certain services
  • Misrepresenting costs and changes in reports
  • Billing separately for services that should be bundled together

It is possible to commit health care fraud against government health care programs, insurance companies, workers’ compensation insurance programs and private companies. It can be complicated to prosecute these cases, and the investigative stage of a health care fraud case can be lengthy.

Defend yourself now

You do not have to wait until there are formal charges against you to benefit from a strong defense. Michigan defendants have rights at every stage of the criminal justice process, and you are entitled to a presumption of innocence. One way to protect your interests is to seek an understanding of the allegations or potential charges you are facing. When you understand what health care fraud entails, you will be better equipped to defend your interests. Do not delay in taking steps to protect yourself, starting as soon as you learn of an investigation into your alleged actions.