A San Diego Healthcare Fraud Defense Lawyer Can Help You
The U.S. healthcare system has grown exponentially over the past few decades. In general, it has become complex and difficult to navigate, with multiple payers, huge administrative costs, and complex federal and state regulations. In an environment this dynamic and complex, the soil is fertile for the perpetuation of many different types of healthcare fraud. With the development of EMRs, or electronic medical records, tracking down healthcare fraud is more difficult than ever, and these records and other digital phenomena can lead fraud investigators to suspect those who are innocent or those who may have committed fraudulent acts unintentionally. For example, even a new person on the job who has only been trained a few weeks can make a mistake, that will actually be noted as healthcare fraud, when it was only an error in inputting data, not necessarily an “error in judgment.” The cost of fraud has been estimated to be around $300 billion annually in the United States. For this reason, those who investigate and prosecute healthcare fraud are aggressive in their search for this fraudulent activity and are likely to show no mercy when it comes to doling out punishments for people who are deemed as guilty actors. That’s why, if you’ve been charged with healthcare fraud, it’s extremely important to understand how a healthcare fraud defense lawyer can help you during these confusing times.
Medical Insurance Fraud and Medical Fraud
The types of medical insurance and medical fraud that exist are as unlimited as the creativity of the perpetrators. One common type of medical insurance fraud is called “upcoding.” Upcoding occurs when an insurance biller intentionally assigns a billing code to a diagnosis that is inaccurate, in order to get more insurance compensation for the treatment. Manipulating deductibles and insurance co-pays is another method of insurance fraud.
Medical fraud is also common and occurs when a patient’s diagnosis is falsified in order to justify tests or treatment that isn’t needed in order to increase billable revenue for the practitioner’s office. Billing for services that were never even rendered has also been accomplished by using false identities. Billing for various types of medical equipment that was never issued to the patient may also occur, especially in the case of home care or nursing home billing. However, many possible cases of medical or insurance fraud involve a true misunderstanding or are the result of a debatable diagnosis, in which no one really intended to commit fraud. That’s where a healthcare defense lawyer can be of great benefit and a definite advantage over trying to sort through potential discrepancies on your own if you have been accused of any one of these crimes regarding healthcare fraud.
Like medical and medical insurance fraud, Medicare fraud is also rampant in this country. Medicare fraud involves the inappropriate use of Medicare funds for financial gain. This type of fraud is also committed by upcoding services, by billing for unnecessary services, or even by billing for equipment as new when, in fact, it is used. Penalties for Medicare fraud are severe, as this type of fraud jeopardizes the healthcare of elderly citizens, and also costs the taxpayers billions of dollars. When you’re charged with Medicare fraud, hiring an expert healthcare fraud defense lawyer is the smart thing to do.
Call to Schedule a Free Consultation with a Healthcare Fraud Defense Lawyer Today
If you have been charged with healthcare fraud, call to schedule a free consultation with a federal criminal defense lawyer today. Healthcare fraud is a serious crime with serious penalties that can ruin a professional career and can lead to long prison sentences and very stiff fines. The expert legal professionals at the law offices of John D. Kirby have over forty years of combined experience and will fight to defend your rights and your freedom. We serve San Diego, La Jolla, Coronado, Carlsbad, La Mesa, Del Mar, San Marcos, Solana Beach and surrounding San Diego County communities. Call us at 619-557-0100 and let us give you legal guidance that you can trust.