Medicare Fraud Defense Attorneys Defending Medical Doctors Charged with False Billings
Due to the recent stories of the opioid epidemic in the news and the increase in opioid addiction and death, investigations into prescription drug use has been on the rise. Just this week, an investigation led by the Medicare Fraud Strike Force resulted in more than 400 medical professionals being charged with $1.3 billion in false billings. Many of these defendants – about a third in total – were associated in some way with the abuse of pharmaceutical opioids.
412 Defendants Across 30 States
The investigation involved 115 doctors, along with many nurses and other medical professionals. The nationwide investigation included more than 1,000 law enforcement agents in at least 30 states. In many of the cases, the fraudulent activity focused on false billing involving the prescription and distribution of opioids.
In an announcement regarding the investigation, Attorney General Jeff Sessions said that the operation started with tips from people in the community as well as computer software used to identify outliers. “We will continue to find, arrest, prosecute, convict, and incarcerate fraudsters and drug dealers wherever they are.”
However, not everyone in the investigation was charged with a pharmaceutical-related crime. For instance, in one felony charge, the defendants were accused of submitting false claims for healthcare benefits. These claims were for toxicology and DNA cancer screening tests that investigators allege were not legitimately prescribed (or needed) and possibly the result of kickbacks.
Other defendants include professionals charged with paying doctors who never saw patients, as well as allegedly placing false diagnosis codes on TRICARE claim submissions for testing that wasn’t actually needed. This practice was intended to encourage TRICARE to accept and pay claims that were allegedly invalid.
Medical Professionals and Criminal Charges
In medical investigations like these, the people involved are typically medical professionals who, for the most part, are attempting to do their jobs in the best way possible. This could mean that simple mistakes are made, or someone is inadvertently included in a wide sweep of medical professionals detected by computer software or word of mouth. As you can guess, neither is always a reliable source and can result in people being included that shouldn’t.
This means that anyone working in the medical field, including doctors, nurses, pharmacists, and others are at risk of facing criminal charges, which can drastically change your life forever.
What Criminal Charges Mean in the Medical Field
Criminal charges are almost always serious charges, but they can be even more severe when involving a medical professional. This means you not only lose your ability to practice or work in the medical field, but you also often face thousands of dollars in penalties and fines as well as years in prison. In this case, each person faces a maximum penalty of 5 years in federal prison and a $250,000 fine for each instance of false billings and fraudulent behavior.
Mistakes in Medicare Fraud Investigations
Not only are the sources that are used in Medicare fraud investigations susceptible to errors and false accusations, but there are also other mistakes that can happen that lead to charges where they shouldn’t. Examples include:
- Errors in entering data
- Mistakes made in documenting treatment
- Incorrect logging
- Multiple caregivers and multiple errors
Especially in cases where there are multiple caregivers, it can be difficult tracking down just who or what facility was responsible for the error. Nevertheless, this can lead to serious charges against medical facilities and professionals, and it’s up to the defendants to prove that there was no criminal intent.
Criminal Defense Attorneys with Experience
The best way to protect yourself against fraud charges is to make sure you follow procedures set in place as carefully as you can. In many cases, however, you can still find yourself being blamed for something that wasn’t your fault. Rather than risk losing your job and facing penalties and prison time, protect yourself in the best way possible with an experienced criminal defense lawyer.
Dr. Nick Oberheiden is an authority on health care fraud defense in the U.S., and has successfully argued against the Department of Justice, Department of Defense, the Federal Bureau of Investigation, and the Drug Enforcement Agency. Health care fraud defense is one of his key focuses, and he’s built a team of experienced attorneys who understand the health care fraud litigation process in and out.
Bill C. McMurrey has over 30 years of legal experience, and has routinely worked on cases involving the Department of Health and Human Services, the Office of Inspector General, the U.S. Attorney’s Office, and the FBI. He is a former DOJ trial lawyer, a former Assistant United States Attorney, and the former Chief Coordinator for Criminal Health Care at the Justice Department in North Texas.
Lynette S. Byrd has a great deal of experience working within the agencies involved in Thursday’s effort, including as a federal prosecutor for the Department of Justice. If you’re in need of someone who understands how the prosecution is approaching these cases, Lynette is a seasoned professional with years of trial experience on her side.
Glenn Harrison has also worked for the prosecution in health care fraud cases, completing three assignments for the U.S. Attorney’s Office as a Special Assistant United States Attorney. He has a great deal of insider knowledge about the Department of Health and Human Services, the Office of Inspector General, and the FBI.
Don’t Delay – Get in Touch with Oberheiden & McMurrey, LLP Today
If you are facing medical fraud charges, we understand that you have a lot on the line. Our lawyers have the experience and knowledge you need to make sure you don’t end up taking the blame for charges you shouldn’t. Let us help you navigate the criminal defense process on your behalf and get you the best possible outcome. Don’t make the mistake of putting your case in the wrong hands. Contact our attorneys at Oberheiden & McMurrey, LLP. For a free and confidential consultation, call (888) 727-5159 or complete our online contact form today.