Midland Medicare Fraud Defense Attorneys

As state and federal authorities launch an unprecedented number of investigations into cases of Medicare fraud and health care fraud, thousands of physicians, practices, medical facilities, and medical supply businesses have come under increasing scrutiny. If you, your business, or your organization is being investigated for Medicare fraud or if you have been charged with Medicare fraud, it is vital that you know your rights and the law.

At The Criminal Defense Firm, our team of legal professionals has helped hundreds of individuals and entities as they face health care fraud investigations and charges. Specifically, our Midland Medicare fraud defense attorneys can assist you with:

• Health Care Fraud Defense
• Compliance Programs
• Internal Investigations
• Qui Tam Defense
• Asset Protection
• Licensure & Disciplinary Proceedings
• Jury Trials

With our knowledge and experience, we will stand at your side throughout the process, tirelessly investigating your case, forming a strategy for action, and working toward the best possible outcome based on the available evidence. To talk to one of our Midland Medicare fraud defense attorneys, to learn more about our services, or to schedule a legal consultation, please call us today, seven days a week, at 866-603-4540.

Medicare Fraud In Midland & Odessa, Texas

Medicare fraud is the misuse of the Medicare reimbursement system for financial gain. Because Medicare billing practices are currently based largely on an honor system, requesting reimbursements based on false pretenses is far too common and Texas has been a hub of such cases of fraud in recent years.

In the Midland & Odessa areas, Medicare fraud is investigated by a number of different state and federal organizations, including:

• 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 Office of the Inspector General (OIG)
• The Medicaid Fraud Control Unit (MFCU)
• The Health and Human Services Centers for Medicare & Medicaid Services
• Texas State Police
• Midland Police
• Odessa Police

In 2013, Texas lawmakers passed Senate Bill 8, authored by representative Jane Nelson of Flower Mound, Texas. The bill was specifically written to combat health care fraud across Texas and hold guilty medical providers responsible for their actions. The measure accomplished four actions:

• It created a data analysis team at the Texas Health and Human Services Commission that detects trends in Medicaid claims and specializes in detecting patterns that point to potential fraud.
• It established that medical providers found guilty of Medicaid or Medicare fraud in Texas or other states would be banned from participating in the state’s health care programs in the future.
• It strengthened laws that prohibit entities from directly soliciting Medicare and Medicaid patients for treatments.
• It battled against transportation fraud by adding medical transportation services to managed care and improving the way in which Medicaid patients could verify their eligibility for transportation services.

What Is Medicare Fraud?

Generally, medicare fraud is the act of illegally collecting money from government health care programs. Medicare fraud can take on a large number of different forms, from a medical practitioner billing you for services that you never received to a business using false information to seek reimbursements.

Some of the most common types of Medicare fraud include:

• Submitting bills for services not provided. Known as phantom billing, this takes place when a provider says that a person received a treatment when in fact they did not.

• Submitting bills for unnecessary services. This type of health care fraud takes place when a provider provides a service regardless of need in order to seek a Medicare reimbursement.

• Service upcoding. This type of fraud occurs when a medical provider charges for a more expensive service than the one that was actually rendered.

• Unbundling services. When a provider submits a bill that includes a set of services that are intended to be bundled together, but that are listed separately in order to increase the reimbursement, it is considered Medicare fraud.

• Billing for uncovered services. One form of common Medicare fraud takes place when a medical facility or doctor performs an uncovered service on a patient but bills Medicare for a covered service.

• Billing for returned home medical supplies. A medical supplier is committing fraud if he or she bills Medicare for home supplies that are returned and reused.

• Offering or accepting kickbacks. Suppliers may illegally offer Medicare patients money or other promotions in exchange for agreeing to medical exams and unnecessary medical supplies.

The Consequences Of Medical Fraud Conviction

A medical fraud conviction can have serious and long-term personal and professional repercussions, Specifically, being convicted of this and related charges can impact:

• Your freedom. A Medicare fraud conviction can result in 10 years in federal prison for each case of medical fraud, as well as even harsher sentences if the medical fraud led to the harm or death of a patient.

• Your finances. Not only do those who commit Medicare fraud need to pay back what they have wrongfully taken, they are also faced with heavy fines of up to $11,000 per case.

• Your career. Medical professionals guilty of Medicare fraud face loss or suspension of their medical license and possibly the loss or suspension of their hospital privileges. In addition, violators may not be able to collect federal health care reimbursements in the future.

• Your reputation. Medicare fraud is often covered in the media and discussed by individuals and organizations across medical fields. A conviction may mean judgments by colleagues, friends, family, and others in the profession.

Because Medicare fraud can have such stark consequences, it is vital that you act early to protect yourself and your rights and that you act with the help of a knowledgeable and experienced Medicare fraud defense attorney at your side.

Successfully Defending Medicare Fraud Cases

At The Criminal Defense Firm, we have a long track record of getting optimal outcomes from Medicare fraud investigations and charges. Depending on the details of each individual case, we have successfully gotten charges dismissed or reduced, helped clients avoid prison time, helped clients avoid criminal charges, and helped clients avoid felony charges. In addition, we have helped medical professionals retain their licenses and their ability to continue to work in conjunction with the federal health care system.

Our three strongest strategies in these cases are:

• Early intervention. Getting legal help as early on in the investigation (and before charges are filed) is vital to attaining the best outcome. Within hours of hiring our services, we will begin investigating your case and finding out as much information as possible about who is investigating your activities, why they are investigating, and what is at stake.

• Understanding the evidence. Evidence that clearly illustrates Medicare fraud is essential to a conviction. If prosecutors cannot collect specific and clear evidence that fraud has taken place, they cannot prove the fraud beyond a reasonable doubt. Likewise, if we uncover evidence that fraud did not take place, that can lead to dismissed or reduced charges.

• Understanding intent. In busy, quickly growing, or disorganized practices and businesses, mistakes can be made that appear to be Medicare fraud. In each case we take on, we take a very close look at intent and pinpoint whether what first appears to be Medicare fraud is merely a case of human errors, outsourcing errors, or processing errors.

Selected Medicare Fraud Case Results

• 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.

Schedule A Meeting With The Criminal Defense Firm Today

We are available to talk to you seven days a week. Call today to ask a question, learn more about our legal services, or talk to an attorney.