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Health care fraud is a serious crime and it takes many forms, including submitting exaggerated or erroneous claims for health care services, prescribing unneeded medications or treatments, modifying medical records, accepting kickbacks, providing false information when applying for programs or services, and using unlicensed staff.
Health care fraud is rampant. Statistics show that 10 percent of every dollar spent on health care pays for fraudulent claims submitted by medical practitioners and patients.
Punishment for committing health care fraud carries significant prison terms and fines. So, if you are accused, or even suspected, of committing health care fraud, it is in your best interests to consult and hire an attorney who is well-versed in federal health care fraud law and state law and experienced in defending health care fraud cases.
Your health care fraud attorney will discuss with you the facts and circumstances of the alleged fraudulent act and explain the applicable criminal laws at an initial consultation, which most attorneys provide at no charge.
Several defenses are available to you and your attorney will discuss those with you and recommend the best course of action.
To defend you, your attorney will evaluate the evidence against you to assess its strength and validity and search for gaps, errors, and misrepresentations that may have occurred during the investigation. Your attorney also will work to develop mitigating evidence, which is evidence that favors you.
Your attorney will challenge the admissibility of evidence against you, such as evidence illegally obtained, retain expert witnesses to testify on your behalf, and develop evidence proving that the alleged fraudulent act was unintentional, if possible.
If a plea bargain is necessary, your attorney, with your consent, will negotiate with the prosecution to reduce the severity of the offense and reduce any prison time and fines.
If your case goes to trial, your attorney will aggressively defend you by challenging the government’s witnesses and establishing a “reasonable doubt” as to your guilt.
If you are convicted, your attorney will bring witnesses to testify about your good character and raise other mitigating factors in an attempt to reduce the severity of the punishment.
Finally, your attorney can file an appeal, which means your attorney believes an error in law or court procedure occurred.