Fort Lauderdale Health Care Fraud Attorney
Health care fraud covers a broad spectrum of fraud that takes place within the health care industry. Specifically, health care fraud is the act of make false claims to a health insurance company or government health care organization like medicare. Fraud can be medical identity theft, medical billing for unnecessary items or medical procedures, overbilling (or upcoding), accepting kickbacks, and more. Companies, doctors, insurers, and individuals are all guilty of committing health care fraud, which costs the U.S. taxpayers billions of dollars annually. According to an article in the Economist, Andrew Hackbarth of RAND Corporation and Donald Berwick, former director of the Centres for Medicare and Medicaid Services estimated that in 2012, health care fraud put a $272 billion dent in the healthcare system in losses and resources spent fighting fraud. As such, there are huge disincentives in the form of punishments for those that think about or have committed health care fraud. Companies face major whistleblower lawsuits under the False Claims Act, while individuals face hefty fines and prison time. Contact an experienced Fort Lauderdale health care fraud attorney immediately.
Major Types of Health Care Fraud According to the National Health Care Anti-Fraud Association
According to the National Health Care Anti-Fraud Association, the following types of health care fraud are some of the most prevalent:
- Billing for services that never occurred;
- Overbilling (or upcoding) for services or procedures. Charging for more than they actually cost;
- Performing services that are not medically necessary in order to earn insurance payments;
- Misrepresenting or falsifying non-insurance-covered treatments as being necessary, when in fact they are not necessary and would therefore not be covered by insurance;
- Falsifying patient diagnosis in order to perform unnecessary tests or procedures;
- Billing each part of a procedure as though each were separate procedures, which is called unbundling;
- Overbilling a patient’s co-pay;
- Taking kickbacks (monetary rewards) for patient referrals; and
- Not charging a patient for co-pay or deductibles and then overbilling the insurance provider.
In addition to the types of fraud listed above, patient identity theft is a growing type of health care fraud, in which a schemester steals a person’s medical, insurance, and billing information. Health care fraud is punishable in Florida state court as well as federal court, and the fines and imprisonment times vary depending on the type of fraud and how much financial damage was caused. Florida medicare or medicaid fraudsters can be fined up to $250,000 and face three years of incarceration, and more if multiple laws were broken and dozens of individuals were negatively affected. If the crime falls under RICO, an act that discourages and punishes those involved in racketeering, the prison penalties can be even more severe.
If you have been charged with health care fraud because you simply made a paperwork mistake or for some other reason, take no chances with your future. Contact an experienced Fort Lauderdale health care fraud attorney immediately. Call Deric Zacca, P.A. at 954-450-4848 today.