Medicare fraud refers to fraudulent activities aimed at disproportionately high compensation from healthcare services sponsored by the government. This is an article prepared by lawyer James Bell.
Medicare fraud may be conducted by medical practitioners, medical facilities, patients, and those who appear to be one such group. Famous examples of fraud include paying for services not rendered, carrying out excessive testing, and receiving advantages if you are not eligible.
Medicare and Medicaid fraud can be committed by physicians, health facilities, patients, or participants in the program and by outside parties who may pretend to be a party.
Common Medicare Healthcare Fraud
When they do the following, providers commit fraud.
- Submit bills or unnecessary services for services not provided. A “gang tour” is a common scam when a provider visits a nursing home and charges care as if he handled most of his residents. Alternatively, a provider should provide a service if each resident requests it.
- Upcode a department. This is when a provider charges Medicare for a service that is more costly than provided. For example, if only a bandage is put over a cut, a provider can bill for surgery.
- Payment services are not provided as covered services. This happens if an operator charges a service like routine toenail clipping (not covered service) for foot surgery (covered service).
Hiring a Defense Lawyer
It can be scary and distressing to be accused of a crime, whether you are guilty or innocent. It can be much more disturbing if the other party is unable to send you to jail and has government resources to do so. Also, legal and criminal proceedings can be quite confusing and overwhelming.
There is plenty of paperwork to file, police officers’ questions to answer, and evidence to collect. Any small mistake in these processes can put your case at risk and result in a higher sentence, fine or severe charge. You need not take risks.
Hiring a lawyer will remove undue stress from you and significantly improve the chances of winning the case. Unless you know how to move around the legal system, it is dangerous and not advised to go alone in a criminal court.
A criminal lawyer will evaluate your case, build the best defense to support it, and protect your rights. Here are the main reasons why it is beneficial to hire Medical License Defense Attorney – Healthcare Fraud Group:
1. They have extensive legal system knowledge.
If you want to win a fight, you bring soldiers to the field, not teachers. Why? Just because they understand a war environment!
Good criminal defense attorneys such as the Medical License Defense Attorney – are criminal law experts and are familiar of Federal Health Care Fraud Statute – 18 USC 1347 | Healthcare Fraud Group LLC. For several years, they have studied and practiced criminal law. You know the legal system’s ins and outs and, therefore, have a better chance of setting up a strong case against your complainant.
They will assess the facts of the case, analyze all the evidence, and find ways to work for you. If you don’t know anything about crime and legal matters, you probably won’t even understand what your charges say, let alone what they say.
For someone with a knowledge of criminal justice, experience, and a good reputation, you improve your chances of developing a successful defense.
2. They are familiar with people and strategies to follow the law.
Part of winning a war is to recognize who the battlefield participants are. The chances of winning are better if you grasp how the battlefield is organized. Under the criminal procedure, the people involved, including prosecutors and judges, need to be recognized.
If you decide to defend yourself, you will probably be in turbulent waters if you do not know one of the parties you have to deal with. If you know you are unrepresented, the prosecutor will consider you an easy target.
Criminal attorneys, on the other hand, also consult with prosecutors and judges to better understand their working conditions. They are aware of what reasons and their greatest dislikes work best for them. There is nothing tragic about these findings being used for their benefit. After all, prosecutors and judges are just individuals who have their own peculiarities.
With this knowledge, criminal lawyers can plan an intelligent defense strategy and know if to enter into a plea agreement or to take action.
3. You are protected against heavy penalties.
In a fight, your enemies will undoubtedly come down to you to make sure you lose and give up. The lawyers are the greatest rivals in a criminal case. They will want to smash you as much as possible and add a victory to their “completion list.”
If you are wrongly convicted of a crime, it can be alarming to get a fine for something that you have not done. A trial lawyer is your shield from stern prosecutors. They help you demonstrate your case and avoid severe sanctions.
Yet if you are found guilty (even if innocent), the prosecutor must ensure you obtain a reasonable punishment.