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What constitutes Medicare fraud?

| Dec 23, 2020 | White Collar Crimes |

People in Michigan understand how important Medicare is to America’s senior citizens. Programs like Medicare and Medicaid make it possible for Americans with fixed or low incomes to receive healthcare services. Anyone charged with committing fraud against one of those systems needs to secure effective representation. There are many grey areas when it comes to Medicare fraud accusations.

Types of Medicare fraud

Medicare fraud can be committed in a number of different ways. Sometimes, a person who’s not authorized to use those benefits pretends they can claim them. At other times, providers will bill Medicare for services they didn’t actually provide. If a provider orders tests that aren’t necessary, that can also be considered Medicare fraud.

There can be innocent explanations for some of these charges. For example, a physician may order additional tests to rule out certain conditions. They may have a gut feeling about what’s causing problems for their patient that’s prompted them to order an unusual test.

Another issue is that Medicare regulations and requirements change all the time. One example of this is the recent expansion of Medicare services provided under the CARES Act. Under these changes, Medicare can be used to cover telemedicine services. Home healthcare providers can also be certified as providers now. It’s easy to see how someone could miss an important piece of information and make a mistake when billing.

Whatever the fraud accusation is, it’s important for anyone accused of white collar crimes to have effective representation. Under the Constitution, everyone is entitled to a zealous defense in court. Finding an experienced lawyer who understands fraud accusations is the first step in building a solid defense.