Orlando Healthcare Fraud Defense Attorney
Healthcare providers must navigate a complex and often confusing array of state and federal laws and regulations, many of which are aimed at preventing fraud. For doctors and other healthcare providers, this increases the chances of being targeted in an investigation or being charged with healthcare fraud. Regional and statewide Florida enforcement agencies collaborating with federal agencies such as the DOJ’s Health Care Fraud Unit, the FBI, and the Drug Enforcement Administration (DEA), investigate numerous healthcare providers in Florida and cast a wide net when they make arrests for healthcare fraud.
Unfortunately, their nets can catch innocent doctors and other healthcare providers along with the guilty. Indeed, merely being under suspicion for healthcare fraud can threaten your license and career. A conviction can destroy your career, threaten your freedom, and cost you thousands of dollars in fines.
If you have reason to believe you are being investigated for healthcare fraud or have been charged with a related crime, you should take steps right away to protect yourself and your future. Get the legal help you need to protect your career and your future by contacting an experienced Orlando healthcare fraud defense attorney. Attorney Jonathan Rose has more than twenty years’ experience as a lawyer and is committed to putting his experience and expertise in healthcare law to work protecting you during an investigation and defending you should charges be filed against you.
For the help you need to protect your future, call Jonathan Rose today at 407-894-4555 or submit the “Tell Us What Happened” form on our website.
What Is Healthcare Fraud?
Healthcare fraud is most often investigated and prosecuted by the federal government and is governed by 18 U.S. Code §1347. Under that statute, healthcare fraud is defined as knowingly and willfully executing, or attempting to execute, a scheme or artifice in connection with the delivery of or payment for healthcare benefits, items, or services 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.
The inherently complex nature of the healthcare system in the United States lends itself well to fraud schemes. Unfortunately, it can also make it easy for completely legitimate practices to be targeted in a much larger fraud investigation.
Some of the most common examples of healthcare fraud include:
- Upcoding. This involves billing for products or services that are more complex and expensive than the ones actually provided. While it can be done intentionally, it can also be the result of an honest mistake by healthcare providers or their administrative staff.
- Unbundling. Instead of using one code, unbundling occurs when a provider submits separate bills for medical procedures or tests to maximize reimbursement from an insurance company.
- Double billing. This involves submitting multiple identical claims for the same service or using multiple codes to bill more than once for the same service.
- Providing unnecessary services. This occurs when services are provided that are not medically necessary.
- Phantom billing. Conversely, phantom billing involves billing for a service visit or medical treatment that the patient never received.
- Kickbacks. Receiving “kickbacks” for patient referrals can be considered a type of healthcare fraud; however, it is governed by the Federal Anti-Kickback Statute.
- Doctor shopping. Doctor shopping involves a patient visiting multiple doctors and/or pharmacies to try and receive multiple controlled substance prescriptions. While there are numerous safeguards in place to avoid this type of fraud, healthcare providers must be vigilant to avoid inadvertently becoming involved in such a scheme.
If your medical practice is being investigated for any reason by state or federal agents, it is important to act immediately to try to prevent prosecution and its chilling effect on your career and livelihood. An experienced healthcare defense attorney like Jonathan Rose can intervene early and communicate with investigators on your behalf to avoid prosecution. If you are prosecuted, he will develop a powerful defense strategy to achieve the best possible outcome for you.
What Are the Penalties for a Federal Healthcare Fraud Conviction?
A conviction for federal healthcare fraud can subject you to a term of imprisonment of up to 10 years in prison and/or a fine of up to $250,000 for an individual or $500,000 for an organization. If the underlying circumstances involve serious bodily injury, the potential punishment increases to 20 years in prison and/or an increased fine. while you can be sentenced to life in prison if a death is related to healthcare fraud.
Along with the direct criminal penalties imposed for a healthcare fraud conviction, there are also related penalties. For example, as a doctor, pharmacist, nurse, or other healthcare professional, you will face disciplinary action from the state licensing board if you are convicted of healthcare fraud or a related offense. Even if you are not convicted, disciplinary action can be taken against your license, so having an attorney who is an experienced Florida license defense attorney advocating for you can be extremely beneficial.
Contact an Experienced Orlando Healthcare Defense Attorney
As a healthcare provider, you have dedicated your life to helping others. Suddenly finding yourself under suspicion or under arrest for a federal criminal offense involving healthcare fraud can be a frightening experience. The most important thing you can do under such circumstances is to contact an experienced Orlando healthcare defense attorney immediately.
As a former prosecuting attorney himself, attorney Jonathon Rose understands how the government builds and prosecutes cases. His extensive experience defending healthcare professionals coupled with his considerable resources and unwavering dedication make him the attorney you want on your side when the government is targeting you.
If you believe you are under investigation for, or you have already been charged with, healthcare fraud, do not hesitate to seek help from Orlando healthcare defense attorney, Jonathan Rose. Call 407-894-4555 or submit the “Tell Us What Happened” form on our website to get the expert legal advice and protection you need.