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Joshi Law Firm, PA Joshi Law Firm
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Orlando Medicaid/Medicare Fraud Lawyer

If you are a healthcare provider and you are reimbursed by the federal government for your services, you are required to know the rules for Medicaid and Medicare and comply with them. If you do not comply with the regulations, such as over-billing for s services, or providing kickbacks for businesses, you may become the subject of a federal investigation.

If you are indicted and convicted, you will face a lengthy prison sentence, high fines, and a suspension or revocation of your professional license. Do not let your case get this far. Our Orlando Medicaid/Medicare fraud lawyer can provide the defense you need.

What is Health Care Fraud?

Before you can understand Medicaid or Medicare fraud, it is important to have an understanding of health care fraud overall. Health care fraud is a broad term used to refer to any scheme that involves committing fraud against a healthcare insurance program. Fraud is defined as making a material, or important, misrepresentation for the purpose of financial gain. With health care fraud, the misrepresentation is usually within a claim submitted to an insurance company such as Medicaid or Medicare.

Common Types of Medicaid and Medicare Health Care Fraud

There are many different types of Medicaid and Medicare health care fraud. The most common are as follows:

  • Billing fraud: Billing for services that were not performed, or a service that is more costly than what was performed, duplicating times for one service, and billing for a covered service when it was not covered are all common types of billing fraud.
  • Falsifying documents: Fabricating medical records to justify payments from Medicaid or Medicare, making a false diagnosis, changing medical certificates, invoicing for services separately when they should be bundled, and forging receipts are all common ways health care providers sometimes falsify documents.
  • Misrepresentation: Failing to provide full disclosure about procedures and diagnoses when billing patients, ordering inappropriate or excessive tests, and prescribing unnecessary medications are all forms of misrepresentation that constitute Medicaid and Medicare fraud.
  • Kickbacks: Health care providers are prohibited from offering kickbacks in exchange for referrals or patients. For example, it is illegal for one provider to offer an incentive for every patient referral to another provider.

Penalties for Medicaid and Medicare Fraud

Medicaid and Medicare fraud is taken very seriously by the federal government. Those convicted face very harsh penalties, which include:

  • Maximum criminal fine of $250,000
  • A maximum of five years in prison for every claim
  • Treble damages, which triple the amount of civil damages the government will receive
  • Exclusion from Medicare and Medicaid
  • Suspension or complete revocation of a professional license

Our Medicaid/Medicare Health Care Fraud Lawyer in Orlando will Protect Your Rights

If you are being audited by Medicaid or Medicare, or you are under federal investigation, you need the help of an experienced Orlando Medicaid/Medicare health care fraud lawyer. At Joshi Law Firm, P.A., we know the challenges that arise in these complex cases and we have the experience to overcome them. Call us now at 407-661-1109 or contact us online to schedule a free consultation.

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