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Sometimes, you might not have a lot of money to pay your bills, especially if you have been injured in an accident or if you’re elderly and can’t work. However, if you have filed any kind of medical claim that is deemed to be false and Medicare covers that claim, then you could be charged with fraud.
If you have been charged with Medicare fraud, then it often becomes a federal investigation. The investigators assigned to your case will look heavily into the claims that are filed against you to determine if there has been any kind of fraudulent activity that has taken place in a purposeful manner. At times, you might have filed a claim that you didn’t realize was fraudulent at the time. Doctors and medical offices can also file claims that involve your healthcare and Medicare information that you are unaware of at the time. An attorney can examine all of the details to determine if you committed Medicare fraud and craft defenses to use in court.
Once all of the evidence is gathered by the investigators, it will be given to a federal prosecutor who will bring your case in front of the court. It’s important to have an attorney who will represent you to the fullest of the law and who will do everything possible to determine if a true act of fraud was committed. Most of the time, the prosecution will ask for the maximum sentence that is allowed in a case of Medicare fraud.
There are several different activities surrounding Medicare fraud that could occur aside from filing a false claim. A common type of fraud is when a medical provider files a claim for a procedure or service that wasn’t performed. This wouldn’t be of any fault of your own if you were unaware of what happened. However, if you work in a doctor’s office and know that the fraud is taking place, then you could be charged as an accessory. Another common type of fraud that is committed is billing for codes that would net more money for the doctor’s office. Filing multiple claims for the same procedure is a type of fraud as well. This is usually a type that is discovered a bit easier than other types because most Medicare offices and insurance companies will begin to see that there are several claims that are filed and will begin to question what is happening.
A type of fraud that is sometimes committed by medical offices is filing each separate procedure as a separate claim instead of bundling them together. Medical services that aren’t required and that are performed is a type of fraud as well. If you notice that you’re having test after test performed with few results or you notice that there are tests being performed for issues that you didn’t complain about, then the doctor’s office could be committing Medicare fraud. These are only some of the acts that can be committed by medical professionals.
There are ways that you can commit Medicare fraud as well as a recipient of the benefits. One would be to offer kickbacks to the doctor who is filing false claims. Another would be to file information that is false pertaining to your income status or other personal details.
Medicare fraud needs to be taken seriously any time that it occurs. After going to court and being convicted of fraud, you could face up to 10 years in a federal prison along with hefty fines. You could also lose your Medicare benefits. If you’re a doctor who has committed fraud, then you could lose your license to practice medicine.