Facing charges for medical fraud? Let our healthcare fraud lawyer in Miami take a look at your case and develop a strong defense strategy for you.
At Frank Schwartz, P.A., we are deeply invested in each of our clients. Our founding attorney will work directly with you at every single step of the way. With over 23 years of experience defending clients in state and federal court, as well as former prosecution work, our healthcare fraud lawyer is ready to fight tenaciously for you.
Turn to us for strong defense against federal healthcare fraud charges.
What Is Healthcare Fraud?
Healthcare fraud is the misuse of health insurance programs for personal gain. In most cases, that “personal gain” is a financial one.
What Are the Most Common Healthcare Fraud Crimes?
In general, there are three types of healthcare fraud.
Healthcare Fraud by Medical Providers
Medical providers and healthcare professionals may commit fraud by:
- Phantom billing: Charging for medical services that were never provided.
- Double billing: Charging twice for a single medical service.
- Upcoding: Charging for a more expensive service than what was provided.
- Unbundling: Billing bundled services that were supposed to be at a discounted rate individually.
Healthcare Fraud by Patients and Others
This type of medical fraud may involve:
- Identify theft or identity swapping: Using someone else’s health insurance to get medical care.
- Bogus marketing: Using another person’s health insurance information to enroll them in a fraudulent benefit plan or similar scam, steal their identity, etc.
- Impersonating a medical professional: Providing care or services to another person when you don’t have a medical license.
Prescription medication fraud often includes:
- Doctor shopping: Going from doctor to doctor to get prescriptions from multiple providers.
- Diversion: Selling your prescription medication to others or similar illegal or illicit acts.
- Forgery: Writing yourself forged prescriptions or using another’s forged prescriptions.
Federal Healthcare Fraud and Abuse Laws
According to 18 U.S.C. § 1347, it is illegal for anyone to knowingly and willfully execute, or attempt to execute, a scheme or artifice to:
- Defraud any healthcare 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 healthcare benefit program.
How Is Healthcare Fraud Prosecuted?
Prosecutors take healthcare fraud very seriously, especially when it involves government health insurance programs like Medicare and Medicaid. Such fraud can cost the government and taxpayers tens of billions of dollars every year.
Note that to bring forward a charge for healthcare fraud, the prosecution must prove the following 3 elements:
- The defendant executed a scheme to defraud any healthcare benefit program or attempted to do so;
- The fraud was in connection with the delivery or payment of healthcare benefits or services; and
- The defendant acted knowingly and willfully.
Federal Healthcare Fraud Penalties
Committing the above could result in up to 10 years in prison as well as a fine. If the violation results in serious bodily injury, the penalty may be up to 20 years in prison and a fine. In the case of death, the offender could face up to life in prison.
Healthcare fraud may also be prosecuted under the False Claims Act, which penalizes any individual who knowingly:
- Submits or causes another to submit a false claim to the government; or
- Makes a false record or statement to get a false claim paid by the government.
Charged with Healthcare Fraud in Florida? Call (305) 707-7770.
If you have been charged with healthcare fraud, contact Frank Schwartz, P.A. immediately for legal advice on your next steps.
As such an offense is fraud against the federal government, you could be facing decades in jail for defrauding a benefits program. Our healthcare fraud defense lawyer has handled more than 100 criminal trials before and can confidently guide you through the legal process.
Not only will we help you craft a strong defense against your federal charges, but we’ll do our best to help you get out of your legal mess.
Call (305) 707-7770 to learn more about your defense options with our Miami healthcare fraud attorney.
Frank Schwartz is a Miami attorney who concentrates his legal practice in the area of criminal defense. Mr. Schwartz is proud to have established a highly successful and effective criminal defense trial practice in South Florida.