Medical care providers have a certain obligation to their patients, and they also bear the responsibility of billing insurance companies appropriately. Failure to follow proper billing procedures and willingly filing false claims are only two examples of health care fraud that could result in serious legal repercussions for those accused of this crime. There are different types of fraud that can occur in health care, but they are all federal-level offenses.
It may be helpful for you to learn about the different types of health care fraud and what they entail. If you are facing accusations of this type of offense, or you are under investigation, you will benefit from knowing what you are up against. You cannot wait to take action to defend yourself when facing these types of accusations.
Actions that count as health care fraud
Like other types of fraud, health care fraud is committed with the intent of receiving some type of financial gain. Health care fraud schemes can be complex and incredibly difficult to investigate as they often involve many different people. They can also operate at several different locations simultaneously. Common types of health care fraud often involve trying to seek more money from insurance providers through the following ways:
- Misrepresentation of individual services rendered
- Billing for services or items that are not medically necessary
- Billing insurance for services not actually rendered
- Unbundling services in order to bill insurance for more money
- Seeking payment for services at a higher billing rate than appropriate
- Misusing codes on a claim or charging excessively for services
Health care fraud is responsible for the loss of exorbitant amounts of money each year by Medicaid, Medicare and other insurance providers. Conviction of this type of crime could result in decades behind bars for a Michigan defendant.
Fighting back against these accusations
If you are facing charges of health care fraud, there are legal options available to you. One of the things you can do to protect your interests is to learn about the defense options available to you as soon as possible. You have the right to a presumption of innocence, as well as the right to a defense, and your quick action may help you successfully protect your interests at every step of the criminal justice system.