What is Medicaid fraud?
Medicaid fraud is a type of healthcare fraud that occurs when a provider or group practice exaggerates or fabricates the medical care being provided. A provider can fill out a claim form for an existing patient and add extra services that were never performed. Some scam artists who are not providers may contact Medicaid patients and ask for personal information, such as their name, address and ID number, then use this information to fabricate false claims in hopes of being reimbursed.
Besides billing for non-existent patients or services never rendered, other examples of Medicare fraud include:
- billing for medical services performed by unauthorized personnel;
- billing for services or testing that were medically unnecessary;
- accepting payment for referrals;
- exaggerating the length of a counseling session in order to bill for the most money possible;
- billing both Medicaid and another insurance company for the same services (double billing); and
- falsifying cost reports by including personal items on the claim form.
Providers who find themselves facing such accusations in Fort Lauderdale can contact fraud lawyers to formulate a plan for their defense.
Contacting a Fort Lauderdale Fraud Lawyer
According to the Office of Inspector General, in 2011, there were 649 Medicaid fraud investigations in Florida, with 60 convictions. This can be a serious crime and it’s not taken lightly, which is why many accused of such crimes often require legal assistance and representation from an attorney.
There are many state and federal healthcare regulations which providers must abide. Also, these regulations may change, leaving providers confused about what to do. Some may make a good-faith effort to follow the laws, but end up being accused of healthcare fraud anyway because they or their staff made mistakes in reporting claims, such as using the incorrect codes to bill for services rendered.
Getting a letter or a visit from a federal agent can be scary for any provider. That’s why hiring a Fort Lauderdale fraud lawyer can help when addressing any accusations of healthcare fraud. An attorney will evaluate the details of the accusations, can examine billing records to recognize the issue, and work towards a resolution or develop a defense against the charges.
Taking advantage of a federal government or insurance program can result in felony charges, which can result in hefty fines and prison time. Robert Malove is a Fort Lauderdale fraud lawyer who can help providers accused of healthcare and Medicaid fraud develop a defense against accusations or charges. Contact us today at 954-861-0384.