Medicare Fraud & Health Care Fraud Defense Attorneys Serving the state of Texas
Just last year, the owner of a McAllen ambulance company, Vic’s Texas Transport Inc., was convicted of health care fraud and aggravated identity theft in federal court. The investigation, which was conducted by the U.S. Department of Health and Human Services, Office of Inspector General, and the Texas Attorney General’s Medicaid Fraud Control Unit, found that the owner of the company had false submitted claims for reimbursement of ambulance transportation services totaling $450,000.
This is just one of a number of health care fraud cases that are cropping up around Texas as state and federal investigators crackdown on practices and companies that are filing false bills for financial gain.
If you or your business are facing
a Medicare fraud investigation, it is imperative that you understand all details of the investigation as well as your rights under the law. At The Criminal Defense Firm, we are here to make certain that you know the law, that your case investigated correctly, and that you receive the best possible outcome based on the details of your case.
To learn more about our McAllen Medicare fraud defense attorneys, our legal services, and how we can help, please call us today.
Medicare Fraud In McAllen, Texas
Texas is populated with millions of Medicare beneficiaries as well as tens of thousands of doctors, dentists, medical professionals, and medical suppliers. Although the vast majority of practitioners, companies, and patients use the Medicare system correctly and with good intent, a minority take advantage of the program’s honor system for financial gain.
In recent years, Texas has cracked down on Medicare fraud and health care fraud in two major ways:
- The passage of Senate Bill 8. In 2013, Texas lawmakers passed a bill that was designed to curb Medicare fraud, punish those who were violating laws, spread fraud awareness, and ultimately save taxpayer dollars. Among other things, Senate Bill 8 created a new data analysis team at the Texas Health and Human Services Commission, tightened some existing Medicare fraud laws, and put in place tougher consequences for those guilty of Medicare fraud.
- The formation of the HEAT Task Force. The Health Care Fraud Prevention and Enforcement Action Team (HEAT) task force was created by the Department of Health and Human Services (HHS) and Department of Justice (DOJ) in order to help curb waste, fraud, and abuse in government health care programs. Since its inception in 2007, the HEAT task force, which has an office in Dallas, Texas, has convicted 1,800 individuals of health care felonies and investigated $7 billion of fraud cases.
Four Common Examples Of McAllen Medicare Fraud
New scams, schemes, and strategies are always being developed related to Medicare fraud, the submission of false claims by a health care provider or medical supply company to the government health care program. However, some forms of fraud are more common than others,s and evidence of some forms of fraud are investigated more often than others. Here are five types of health care fraud that we seen in and around McAllen, Texas:
- Submitting bills for services not provided. Also known as phantom billing, this is likely the most common type of Medicare fraud committed in Texas. Submitting bills for services not provided occurs when a provider falsely claims that a service or treatment was rendered when it was not.
- Upcoding a service. Upcoding takes place when a provider, such as a doctor or a dentist, charges Medicare for a more expensive service than the service that was actually provided to the patient. For example, if a provider bills for a complex procedure when only stitches were needed, he or she is guilty of upcoding.
- Unbundling services. This form of Medicare fraud occurs when a medical provider submits separate bills for medical services that combine three or four sub-services that are intended to be billed as one service. Unbundling services results in providers receiving much larger reimbursements than they deserve under the law.
- Engaging in false medical equipment billing. Medical equipment supplies may also commit Medicare. This could take place when a medical supplier lies about purchasing equipment for a patient, about the type of equipment purchased for a patient, or about the cost of equipment purchased for a patient.
Finding The Right McAllen Medicare Fraud Defense Attorney For Your Case
Connecting with the right attorney and law firm when you, your practice, or your business are under investigation for fraud is key to securing the optimal outcome for your case. What should you look for in a Medicare fraud defense attorney?
- Someone who is not just a health care lawyer. Just because an attorney is familiar with health care law does not mean that they are familiar with how Medicare fraud cases are handled or the common defenses used in these cases.
- Someone who is not just a criminal defense lawyer. Many people turn to general criminal defense attorneys who may have caseloads centered on DUIs, drug offenses, assault offenses, and violent crimes. However, these attorneys may not have specific health care law experience that will help you and your case.
- Someone who has specific experience with Medicare fraud cases. The most important question to ask an attorney is how many Medicare fraud cases they have handled and what the outcomes have been. It is even better if the attorney has had past experience both as a prosecutor and a defender.
- Someone who has trial experience. In an ideal world, you would like your fraud investigation to end before charges or pressed or you would like your charges dropped. But in some cases, a trial is necessary. At these times, it is vital that you have a seasoned trial attorney on your side who is comfortable and adept in the courtroom.
At The Criminal Defense Firm, our attorneys have the knowledge, experience, and acumen to take on even the largest and most complex Medicare fraud cases. The consequences of a conviction are often severe and life-altering, including retribution, heavy fines, prison, and other penalties. Choosing an attorney with appropriate background and with a history of good outcomes is a solid step toward successfully defending yourself against charges.
Recent Medicare Fraud Case Results From Our Law Group
- 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.
Profiles: McAllen Medicare Fraud Defense Lawyers at The Criminal Defense Firm
Our attorneys are selected based upon their experience, their in-depth knowledge of the law, their track record, and their ability to form and execute complex strategies. Each one of our Medicare defense attorneys brings something unique to the table, including past experience as state and federal prosecutors and various awards and recognitions.
Contact An Experienced Medicare Defense Attorney In McAllen
Getting help quickly in the wake of a Medicare billing audit or Medicare fraud investigation is key to securing the best outcome possible for you or your organization. The McAllen Medicare fraud defense attorney at The Criminal Defense Firm have the experience, knowledge, and strategies to help. To learn more about your investigation, including the best steps forward, please call our offices today to request a consultation.