18 U.S.C. 1347, 42 U.S.C. §1320a–7b
If you have been arrested for health care fraud, you need a Miami health care fraud attorney. Unbeknownst to the public, health care fraud is one of the most common crimes prosecuted in Florida. It is also referred to as Medicare Fraud or Medicaid Fraud. In 2011, the U.S. Sentencing Commission reported that 9.8% of offenders were prosecuted for a fraud related offense. In Florida, this number is almost twice the national average where 18.4% of all offenders were prosecuted for a fraud related offense.
What Am I Facing for Health Care Fraud Charges?
Penalties for Health Care Fraud – Medicare Fraud in Florida
A typical indictment for health care fraud in Florida will usually contain multiple counts. A Miami health care fraud attorney needs to be prepared to defend against a multi-count indictment or complaint. Under Federal law, you can be charged with a different count for every distinct act of health care fraud alleged. For example, if prosecutors accuse you of committing health care fraud by filing a different fraudulent claim with Medicare every day for 30 days, prosecutors have the power to charge you with 30 counts of health care fraud.
Alternatively, prosecutors can also charge you with one single count of health care fraud that identifies the entire period of time as one ongoing act of health care fraud.
Additionally, it is common to find allegations of other criminal conduct included in the same indictment for health care fraud. The following lists some of the most common offenses charged in a health care fraud case:
Health Care Fraud
- Up to 10 Years Prison, per count.
Conspiracy to Commit Health Care Fraud
- Up to 10 Years Prison, per count.
Payment of Kickbacks
- Up to 5 Years Prison, per count.
Receipt of Kickbacks
- Up to 5 Years Prison, per count.
Conspiracy to Pay Kickbacks
- Up to 5 Years Prison, per count.
Conspiracy to Receive Kickbacks
- Up to 20 Years Prison, per count.
Money Laundering
- Up to 20 Years Prison, per count.
Asset Forfeiture
- Loss of Assets, No Prison
Common Targets of Health Care Fraud (Medicare Fraud) Investigations in Florida
As a Miami health care fraud attorney, I can tell you there are typical targets of health care fraud prosecutions that occur in most cases. The following list contains common groups of people and entities that are targeted for health care fraud – Medicare fraud enforcement:
- Doctors and Health Care Providers
- Clinics, Treatment Centers, Rehab Centers, and Hospitals
- Home Health Care Providers
- AIDS Infusion Therapy Clinics
- Durable Medical Equipment Providers (DME’s)
- Medical Billing and Coding Companies
Health care fraud (Medicare Fraud) is considered a white collar crime, but is also one that is punished very severely. Even though it is a non-violent and non-sexually motivated offense, there is a strong push by the Government to deter health care fraud. According to one statistic, 10% of all monies paid by the U.S. Government in regards to health care were fraudulently obtained. In reality, this figure is much higher, because many health care fraud schemes go undetected.
Types of Health Care Fraud in Florida
Health care fraud can be charged following a number of different types of illegal conduct. In most cases, health care fraud involves the coordination of many people. It can involve doctors, health clinic staff, patient brokers, patients, and a number of other people.
The most common types of health care fraud schemes include one or more of the following:
- Doctors and clinics who bill for services never rendered
- Billing for non-covered services as covered services
- Filing duplicate billing for the same one service
- Payment of kickbacks to “patient brokers”
- Prescription of unnecessary medication that is diverted to the black market
- Billing the insurance card of someone other than the covered person
- Filing claim forms that contain fraudulent information
- Intentional reporting of false diagnoses or unnecessary procedures to inflate payment
In the next section, we will address how a criminal attorney can help you defend against health care fraud charges.