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Fraud and the healthcare system

On Behalf of | Aug 2, 2021 | Blog, White Collar Crimes |

If you need medical treatment in Michigan, you expect that the doctor and other workers in the office or the hospital are professional in nature. However, some providers could be charged with health care fraud that could result in the practice being closed. Individuals can also commit this type of fraud, resulting in jail time or paying high fines.

Providers

One of the common types of white-collar crimes is billing for services that aren’t performed. A provider could be charged with a crime if medical statements show that procedures have been completed that really weren’t or that equipment and drugs were used for patients when the patient didn’t need them. Another way that this can occur would be if a pharmacy charges your insurance company for a certain medication and then dispenses one that’s less expensive.

Individuals

When you complete an application for health care assistance, there are certain details that you need to include. If you leave out information or give false information in order to obtain assistance, then you could be charged with a misdemeanor. Another way that you could commit this type of crime is by using someone else’s identity to get the assistance that you need. You might use a different income or even a different name on the application.

Consequences

In most situations, health care fraud is punishable by fines or a jail sentence. Depending on the circumstances, this type of fraud could lead to federal charges, which usually result in spending up to 10 years in prison. If the fraud results in an injury, then you or the provider could be sentenced to spend up to 20 years in prison. Fines could range from $10,000 to $50,000 or higher depending on the details of the case.