Whether you or a loved one has been arrested or are under investigation for healthcare fraud, it is critical to consult with an experienced Miami health care fraud attorney as soon as possible to ensure that your rights are protected. You need the counsel of an experienced lawyer to guide you through the process and maximize your chances of resolving your case with a favorable outcome.
Types of Healthcare Fraud Cases
Health care fraud cases in Florida are diverse and vary in complexity, targeting both public and private health insurance plans. They can be charged as state crimes or federal crimes, although the major health care fraud prosecutions tend to take place in federal court.
Common Healthcare Fraud Schemes
- Billing for services not rendered
- Billing for services not medically necessary
- Double billing for services provided
- Upcoding (e.g., billing for a more highly reimbursed service or product than the one provided)
- Unbundling (e.g., billing separately for groups of laboratory tests performed together in order to get a higher reimbursement)
- Fraudulent cost reporting by institutional providers
Kickbacks in return for referring patients or influencing the provision of health care are other common schemes. The anti-kickback statute prohibits the payment of kickbacks for the purpose of inducing the referral of services which are paid for by federal health care programs. Kickbacks corrupt the decision making of medical providers, placing profit above patient welfare. They can lead to grossly inappropriate medical care, including unnecessary hospitalization, surgery, tests, and equipment.
Other Fraudulent Healthcare Schemes
Other types of schemes include providing services by untrained personnel, failing to supervise unlicensed personnel, distributing unapproved devices or drugs and creating phony health insurance companies or employee benefits plans.
Agencies that Investigate Healthcare Fraud
The following law enforcement agencies investigate health care fraud:
- City, County, State and Federal Law Enforcement Agencies
- Justice Department through the Assistant
- U.S. Attorney Generals Office
- Federal Bureau of Investigation (FBI)
- Postal Inspectors
- Department of Health and Human Services (HHS)
- Food and Drug Administration (FDA)
- Offices of Inspectors General (OIG)
- U.S. Department of Labor
Contact an Experienced Miami Health Care Fraud Attorney
Whether you or a loved one has been arrested or are under investigation for healthcare fraud, it is critical to consult with an experienced Miami attorney as soon as possible to ensure that your rights are protected. You need the counsel of an experienced lawyer to guide you through the process and maximize your chances of resolving your case with a favorable outcome.
Over the years, we have represented hundreds of clients in a wide range of cases. There is a good chance that we have dealt with your type of case and have represented clients who shared similar needs and concerns that you may have. Feel free to browse through the results section of our site for a representative sample of some of our past cases, and the results we have achieved for our clients.
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