HEALTH CARE FRAUD DEFENSE ATTORNEYS
Federal Health Care Fraud Criminal Charges
No matter what criminal charges you’re facing, they’re serious. White collar crimes like health care fraud, however, are the generally the most complex and difficult to navigate. They are document intensive, and to fully understand the scope of the allegations, every piece of evidence needs to be combed through and thoroughly processed by your attorneys. If you are convicted, you can expect a significant prison sentence. Therefore, you need a strong team of Boston criminal defense attorneys to fight your health care fraud charges.
What is Health Care Fraud?
Health care fraud includes a number of crimes and actions. One of the most common examples is a doctor billing for services that were not provided, or that were not medically necessary. Other types of health care fraud claims include upcoding claims, submitting duplicate claims, submitting false claims, or receiving kickbacks.
More specifically, in order to be convicted of health care fraud, the prosecution has to prove that you:
- Participated in a scheme to defraud a health care benefit program;
- Had the intent to defraud the program; and
- That the scheme was in connection with the delivery of, or payment for, health care benefits, items, or services.
The United States Attorney’s Office takes health care fraud allegations seriously, and investigations can take months or years to complete. The target of an investigation may not even know they are being watched until an indictment is secured. Other times, the FBI will pay a visit to the target’s home or office to attempt an interview. The potential defendant may also get served with a target letter, or a document subpoena.
Given the complexities of a health care fraud investigation, it is vital to get an experienced attorney on board as soon as possible. Sometimes a good defense attorney can mitigate the consequences or even prevent an indictment from being sought.
Penalties for Health Care Fraud
If you are convicted of health care fraud, the punishment can be severe. The most obvious are the felony conviction(s) on your record and a lengthy prison sentence. Depending on the number and nature of the indictments, the potential prison sentence can vary widely. Under the general health care fraud statute, the maximum prison term for health care fraud is 10 years. If the violation results in serious bodily injury, the maximum increases to 20 years in prison, and if the violation results in the death of the patient, the maximum goes up to life in prison. These are the maximum sentences, but the actual term of imprisonment will be left to the judge at your sentencing hearing.
In addition to the conviction and prison sentence, you will likely be ordered to pay restitution and a fine. If you are a physician, the Board of Registration in Medicine will typically initiate disciplinary proceedings, which could lead to the suspension or revocation of your license to practice medicine.
Health Care Fraud Defense Attorneys
With the severe potential penalties of a conviction, our defense attorneys move quickly to begin preparing a defense. As a first step, we conduct our own investigation, so that we can begin to understand that the federal prosecutors are looking at, and what they might do next.
If we are retained before an indictment is returned, we often meet with the federal prosecutors leading the investigation. Sometimes we are able to prevent charges. If an indictment is inevitable, though, we look toward mitigating risks, and preparing for litigation in court.
Even after the indictment, there is a lot of work to be done to strenuously defend against health care fraud charges. Requesting and reviewing discovery is a monumental task, where there are often hundreds of thousands of papers through which to review and comprehend. Sometimes search warrants or other investigative procedures can be challenged in court. If the law enforcement agents obtained evidence in violation of your constitutional rights, for example, that evidence can be “suppressed,” or kept out of court. In other words, even if the evidence exists, the government can’t use it against you if the agents secured it illegally.
Our defense attorneys often utilize experts of our own in order to fully understand the nuances of your practice. The better we understand your practice and the allegations, the more likely we can help you achieve the best possible outcome in your case.