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Preventing health care fraud from leading to criminal charges

| Oct 11, 2020 | Uncategorized |

As a medical provider, filing reimbursement claims for Medicaid and Medicare is probably a routine act. Sometimes, mistakes will be made when it comes to the cost of medical equipment, services and medication, or with respect to a patient’s personal details.

If you make a genuine mistake on a Medicare or Medicaid reimbursement form and this is identified, it may alert the attention of the federal government. In recent years, the federal government has been engaging in an aggressive war against health care fraud. Therefore, if you give an address for a patient that is identified to be false, this may alert the attention of investigators, and you may find yourself needing to defend yourself against accusations of fraud. The following are things that you can do to prevent the situation from escalating.

Stop the government from proceeding

When you learn that the government has put you under investigation, several federal agencies could already be at work trying to incriminate you. You need to act quickly to stop them in their tracks. As soon as you contact legal services to support you in creating a defense strategy, the government’s process will slow down.

Dispute the assumptions and methods of the investigation

An auditor can easily come to false conclusions because they have misinterpreted the information they have found. It is important that you are able to swiftly and aggressively dispute assumptions and methods.

Understand the laws in place to protect you

The False Claims Act requires that evidence of “specific intent to violate the law” is found. The federal government has the burden of proof to show that you acted intentionally. You can argue that you made an honest mistake and that you never had any intention of breaking the law until they can prove otherwise.

If you are worried about being accused of health care fraud in Michigan, it is important that you take immediate action to form your defense strategy.