Health Care Fraud Lawyer in Miami

Fraud in the health care industry takes various forms that may involve any one of a number of government programs. Some of the most common allegedly fraudulent claims involve popular government programs, such as Medicare or Medicaid.

Cases of fraud can be relatively simple submission of false claims or may involve more complex schemes in which other costs, figures, or data have been manipulated.

Some of the most common types of alleged health care fraud include, but are not limited to:

• Billing for services that were never rendered
• Billing for unnecessary services or items
• Co-pay inflation
• False claims
• Falsifying a diagnosis to unnecessary procedures
• Inadequate documentation
• Kickbacks
• Misrepresentation
• Off-label marketing of pharmaceuticals or medical devices
• Overbilling
• Self-referrals (Stark Law violations)
• Unbundling
• Up-coding
• Waiving co-pays or deductibles and over-billing the insurance carrier or benefit plan

Federal Penalties for Health Care Fraud

Alleged offenders accused of health care fraud can face civil and criminal penalties under various federal laws.

Some of the most common statutes that federal cases may be prosecuted under include:

• False, fictitious or fraudulent claims, 18 U.S. Code § 287: Making or presenting to any person, officer, department, or agency of the United States any claim for money or property knowing such claim to be false, fictitious, or fraudulent is punishable by up to five years in prison and a fine of up to $250,000 (or $500,000 for an organization) for a felony offense or up to $200,000 for a misdemeanor

• Statements or entries generally, 18 U.S. Code § 1001: Knowingly and willfully falsifying, concealing, or covering up by any trick, scheme, or device a material fact; making any materially false, fictitious, or fraudulent statement or representation; or making or using any false writing or document knowing the same to contain any materially false, fictitious, or fraudulent statement or entry is punishable by up to five years in prison and a fine of up to $10,000 per violation
• Health care fraud, 18 U.S. Code § 1347: Knowingly and willfully executing or attempting to execute a scheme or artifice to defraud any health care benefit program or obtain, by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any health care benefit program, in connection with the delivery of or payment for health care benefits, items, or services, is punishable by up to 10 years in prison and/or a fine of up to $250,000 (or $500,000 for an organization); if the violation resulted in serious bodily injury, the offense is punishable by up to 20 years in prison; if the violation resulted in death, the offense is punishable by up to life in prison

Additionally, 42 U.S. Code § 1320a–7b establishes criminal penalties for several other acts involving federal health care programs.

All of the following violations are punishable up to five years in prison and a fine of up to $25,000:

• Making or causing to be made false statements or representations
• Illegal remunerations
• False statements or representations with respect to condition or operation of institutions
• Illegal patient admittance and retention practices

Call The Hoffman Firm for a Free Consultation

If you or someone you care about has been accused of health care fraud, it is crucial that you contact an experienced and aggressive criminal defense attorney as soon as possible to discuss your legal rights and options. At The Hoffman Firm, we are prepared to put nearly 20 years of legal experience on your side. Our Miami health care fraud defense lawyer can begin immediately building a strong defense aimed at protecting your rights and your future.

If you reside in Miami call (305) 928-1669 now. If you reside in Broward County call 954-737-3004 now.