In recent years, various Dallas officials as well as a specified strike force have cracked down on Medicare fraud by health care practitioners and businesses across the city and throughout the surrounding area. If you are facing charges related to Medicare fraud, it is vital that you partner with a knowledgeable, experienced Dallas medicare fraud defense attorney who is on your side. At The Criminal Defense Firm, we assist clients in Dallas, Garland, Mesquite, Richardson, McKinney and surrounding communities in federal health care investigations.
The Criminal Defense Firm is here to help. To learn more about our Dallas Medicare fraud defense legal services, to ask a question, or schedule a consultation, please call us, seven days a week, at 866-603-4540.
Understanding Medicare Fraud In Dallas
Dallas is one of nine cities in the nation with a taxpayer underwritten Medicare Fraud Strike Force. Established in the spring of 2007, the strike force has, as of 2016, charged almost 2,300 defendants with over $7 billion in Medicare fraud.
In addition to the strike force, which is supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the Northern District of Texas, Medicare fraud in Dallas is also monitored by the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU) and the HHS Centers for Medicare & Medicaid Services. Many of the state-level Medicare fraud enforcement authorities are the Result of Senate Bill 8, which was passed in 2013 and which expanded investigations of health care fraud and abuse across the state of Texas.
Here are just a few recent cases of Medicare fraud in Dallas:
- According to the Dallas Morning News, a federal jury in Dallas in 2012 found a Rockwall doctor guilty of what may be the largest case nationally of Medicare fraud, in which he and a team of cohorts ran a $400 million home health care scam.
- According to the United States Department of Justice, in February 2016, six people, including two doctors, were charged with Medicare fraud and health care fraud for falsely certifying beneficiaries for home health care when the patients were not under their care.
- In February 2012, the Texas Attorney General cracked down on 31 orthodontists around the state, including 13 offices in Dallas, who were committing Medicare fraud related to children’s dental visits.
The Most Common Types of Medicare Fraud In Dallas
Put simply, the definition of Medicare fraud is the submission of false or fictitious claims by a health care provider to a governmental health care program. This definition is outlined in the False Claims Act, the Anti-Kickback Statute, the Physician Self-Referral Laws (Stark Law), the Social Security Act, and the U.S. Criminal Code.
While Medicare fraud take on many different forms, some types of fraud are more common than others. These include:
- Billing for services that weren’t performed, also known as phantom billing.
- Billing for medically unnecessary services.
- Billing for medically unnecessary supplies or equipment.
- Billing for medical supplies that were never ordered.
- Billing for services that are not covered by Medicare as services that are covered.
- Certification for services that were medically unnecessary
- Certification for supplies that were medically unnecessary.
- Double Billing.
- Up-Coding.
- Inflating Bills.
- The offering of or accepting of kickbacks.
Which people or entities may be involved in a Medicare fraud case? The most common parties involved in Medicare fraud investigations include:
- Doctors
- Nurses
- Hospitals
- Home health care centers
- Hospice care centers
- Nursing homes and assisted living facilities
- Rehabilitation centers
- Registered care facilities
- Pharmacies
- Toxicology laboratories
- Medical devices companies
- Medical supply companies
- Physician syndications
- DNA testing centers
- Cancer treatment centers
- Durable medical equipment companies
You may wish to discuss your rights and legal options, whether you have been charged with Medicare fraud, whether you are an employee at a business being investigated for Medicare fraud, or whether you are otherwise associated with a person or business being investigated for Medicare fraud.
The Penalties For Medicare Fraud In Texas
Being convicted of Medicare fraud or similar charges can have a number of serious and long-term consequences. In addition to having to pay back money wrongfully taken from the government, individuals may also face heavy fines and imprisonment. Finally, both medical professionals and other employees may face the stigma of being convicted of a crime, repercussions involving their career, and repercussions in their personal lives.
Specifically, the consequences for Medicare fraud in Texas may include:
- Fines of up to $11,000 per false claim.
- Recoupment requests.
- Non-payment of future claims.
- Exclusion from federal health care programs.
- Exclusion from federal health care program reimbursements.
- Treble damages.
- Legal fees.
- Criminal indictment.
- Time in federal prison.
- Loss or suspension of medical license.
- Loss or suspension of hospital privileges.
The prison time faced by those convicted of Medicare fraud can be extensive. In Texas, a person may face up to 10 years in prison for each count of fraud and up to 20 years in prison if the case of fraud caused bodily harm to a patient. Life in prison may be the Result if a fraudulent Medicare action Results in a patient death.
Selecting The Right Medicare Fraud Defense Attorney For You in Dallas, TX
As you can see, the consequences of being convicted of Medicare fraud are serious, long-term, and financially devastating. Because of these serious consequences, and because of the complexity of the law surrounding Medicare fraud issues, it is vital that you are represented by an attorney and law firm that is both experienced and knowledgeable.
We encourage anyone seeking legal representation regarding Medicare fraud charges to ask potential attorneys the following questions during a consultation:
- How many Medicare fraud cases have you handled in the past?
- How often were these cases dismissed, and how often were your clients found not guilty of civil or criminal charges?
- How often have you taken a Medicare fraud case to court, and what has been the Result?
- How familiar are you with health care law?
- Why are you passionate about Medicare fraud cases?
- What are your best strategies for defending against Medicare fraud cases?
Although some general health care attorney and criminal defense attorneys will take on Medicare fraud cases, they may not have the depth of knowledge or the range of experience of a law group that has a specific history of handling Medicare fraud cases.
Learn More About The Criminal Defense Firm
We believe deeply that we can make a difference in your case due to our experience and background, and our passion for what we do and how we do it.
We represent everyone from individuals to practices to entire health care systems, and we can help you if you are being investigated by:
- The United States Department of Justice (DOJ)
- The United States Department of Defense (DOD)
- The Federal Bureau of Investigation (FBI)
- The Drug Enforcement Administration (DEA)
- The Internal Revenue Service (IRS)
- The Office of the Inspector General (OIG)
- The Medicaid Fraud Control Unit (MFCU)
- The Medicare Fraud Strike Force (MFSF)
- The HHS Centers for Medicare & Medicaid Services
- Texas State Police
- Dallas Police
We are not only familiar with assisting our clients with Medicare fraud investigations, but also with a number of charges that often go hand-in-hand with health care fraud, such as mail fraud, wire fraud, tax evasion, or money laundering.
Our Track Record
- Defense of Medicare laboratory against investigations by the Department of Justice and the U.S. Attorney’s Office for alleged Medicare Fraud.
Result: No civil or criminal liability.
- Defense of a health care services company against an investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for alleged False Claims Act and Stark Law violations.
Result: No civil or criminal liability.
- Defense of Medicare laboratory against investigations by the Department of Health and Human Services and the Office of Inspector General for alleged Health Care Fraud.
Result: No civil or criminal liability.
- Defense of nationally operating health care company against an investigation by the Department of Defense for alleged Tricare fraud.
Result: No civil or criminal liability.
- Defense of health care marketing company against an investigation by the Office of Inspector General for alleged False Claims Act and Medicare violations.
Result: No civil or criminal liability.
- Defense of a laboratory against an investigation by various branches of the federal government for alleged fraud.
Result: No civil or criminal liability.
- Defense of physician-owned entity against an investigation by the Department of Health and Human Services for alleged Stark Law violations.
Result: No civil or criminal liability.
- Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged fraud.
Result: No civil or criminal liability.
- Defense of a physician-owned entity against an investigation by the Department of Justice for alleged fraud.
Result: No civil or criminal liability.
- Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged Stark Law violations.
Result: No civil or criminal liability.
- Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged False Claims Act violations.
Result: No civil or criminal liability.
- Defense of a physician-owned entity against an investigation by various branches of the federal government for alleged False Claims Act, Stark Law, and Medicare violations.
Result: No civil or criminal liability.
- Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged fraud.
Result: No civil or criminal liability.
- Defense of a physician-owned entity against an investigation by the Department of Defense for alleged Tricare fraud.
Result: No civil or criminal liability.
- Defense of a physician-owned entity against an investigation by the Department of Justice for alleged Medicare Fraud.
Result: No civil or criminal liability.
- Defense of physician-owned entity against an investigation by the Department of Health and Human Services for alleged Stark Law violations.
Result: No civil or criminal liability.
- Defense of health care management organization against an investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for alleged Medicare Fraud.
Result: No civil or criminal liability.
- Defense of nationally operating laboratory against an investigation by the Office of Inspector General for alleged fraud.
Result: No civil or criminal liability.
Our Dallas Medicare Fraud Defense Attorneys
Our Dallas Medicare Fraud defense group is made up of an unparalleled group of attorneys with a wealth of knowledge and breadth of experience particularly suited for these very specific and complex cases.
Contact The Criminal Defense Firm Today
We want you to know that it is vitally important to know your rights and to act quickly when facing charges of Medicare fraud or a Medicare fraud investigation. Having an experienced law group at your side throughout the process can ensure that you are treated justly and that you will receive the best outcome possible for your case.
We are here to help you, educate you, support you, and stand up for you during this time. To learn more about our legal services, or to meet our team, please call our offices today. At this time, 92 percent of our representation have resulted in no criminal charges.