Top Edgemoor, DE Health Care Fraud Lawyers Near You

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

123 S Justison Street, Suite 100, Wilmington, DE 19801

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

222 Delaware Ave, Suite 1410, Wilmington, DE 19801-1621

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

Nemours Building, 1007 N. Orange Street, Suite 600, Wilmington, DE 19801

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

919 North Market Street, Suite 1300, Wilmington, DE 19801

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

1201 North Market Street, Suite 1001, Wilmington, DE 19801

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

222 Delaware Ave, Suite 1105, Wilmington, DE 19801

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

300 Delaware Ave, Suite 1015, Wilmington, DE 19801

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

One Rodney Square, PO Box 636, Wilmington, DE 19899

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

1523 Concord Pike, Suite 200, Wilmington, DE 19803

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

1201 N Market St, Suite 1400, Wilmington, DE 19801

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

1313 North Market Street, Suite 1200, Wilmington, DE 19801

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

1313 Market St, Suite 5100, Wilmington, DE 19801

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

500 Delaware Avenue, Suite 200, PO Box 32, Wilmington, DE 19899

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

1000 N. West Street, Suite 1500, Wilmington, DE 19801-1050

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

1007 North Orange Street, Suite 1200, Wilmington, DE 19801

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

1007 North Orange Street, Suite 711, Wilmington, DE 19801

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

222 Delaware Ave, Suite 1600, Wilmington, DE 19801

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

704 King Street, Suite 500, PO Box 1031, Wilmington, DE 19801

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

1201 North Market Street, Suite 1402, Wilmington, DE 19801

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

222 Delaware Avenue, 7th Floor, Wilmington, DE 19801

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

919 N. Market Street, Suite 300, PO Box 2323, Wilmington, DE 19899

Health Care Fraud Lawyers | Centerville Office | Serving Edgemoor, DE

5721 Kennett Pike, Centerville, DE 19807-1311

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

1007 N Orange Street, 4th Floor, Wilmington, DE 19801

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

222 Delaware Avenue, 17th FL, 17th Floor, Box 1114, Wilmington, DE 19899

Health Care Fraud Lawyers | Wilmington Office | Serving Edgemoor, DE

919 North Market St, Suite 1500, Wilmington, DE 19801

Edgemoor Health Care Fraud Information

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Lead Counsel Verified Attorneys In Edgemoor

Lead Counsel independently verifies Health Care Fraud attorneys in Edgemoor and checks their standing with Delaware bar associations.

Our Verification Process and Criteria
  • Ample Experience Attorneys must meet stringent qualifications and prove they practice in the area of law they’re verified in.
  • Good Standing Be in good standing with their bar associations and maintain a clean disciplinary record.
  • Annual Review Submit to an annual review to retain their Lead Counsel Verified status.
  • Client Commitment Pledge to follow the highest quality client service and ethical standards.

Find a Health Care Fraud Attorney near Edgemoor

The Average Total Federal Prison Sentence for Health Care Fraud in Delaware

36.53 months*

* based on 2019 Individual Offenders - Federal Court sentencing in Delaware federal courts. See Sentencing Data Information for complete details.

What Qualifies as Health Care Fraud?

Health care fraud involves making false representations to gain money or benefits related to medical care, insurance, or government benefits. Health care fraud can be committed by anyone involved in the healthcare industry, including patients, doctors, insurance providers, and medical services companies.

State and federal law enforcement take health care fraud very seriously. The penalties can include years in prison for a felony conviction. However, some innocent people are caught up in false accusations of fraud and should consult with a criminal defense lawyer to understand their legal rights.

What Are the Types of Health Care Fraud?

There are several types of health care fraud. In some cases, fraud is committed by a prospective patient, including false statements on an insurance form. This could include using someone else’s insurance to get medical care.

More extensive healthcare fraud involves health care providers or medical services businesses. Medical providers and home health services may make a fraudulent claim to patients, insurance companies, or Medicare for compensation. Some examples of health care fraud may include:

  • Unbundling, or charging separate billing codes for bundled services
  • Double-billing or duplicate billing
  • Billing for services that were never provided
  • Fraudulent billing for medically unnecessary services
  • Up-coding, or seeking reimbursement for services that should be billed at a lower rate
  • Misrepresentation of the type of service provided

Kickback Fraud

Another type of fraud in health care involves kickbacks. Kickbacks are the referral fees, illegal remunerations, bribes, or rebates paid directly or indirectly for referrals in health care. Kickbacks are illegal in health care under the Anti-Kickback Statute. It is unlawful to pay for inducing or rewarding patient referrals for business involving any item or service payable by the federal healthcare programs, including drugs, supplies, or health care services.

Self-Referral Fraud

Physician self-referral laws prohibit physicians from referring patients with Medicare or Medicaid to facilities or services where the physician has a financial interest. This includes entities where the doctor’s immediate family member has a financial relationship. For example, if a doctor’s spouse is a co-owner of a radiology provider, the doctor cannot refer a patient to that provider, unless an exception applies.

Is Healthcare Fraud a Felony?

Health care fraud can be charged as a misdemeanor or a felony. As a misdemeanor, a conviction could carry up to one year in jail and a fine. As a felony, health care fraud is punishable by more than a year in prison and thousands of dollars in fines.

The penalties associated with health care fraud depend on the specific facts involved. Some aggravating factors can increase the penalties, including where the fraud involved:

  • Multiple incidents of fraud
  • Medical identity theft
  • Insurance fraud
  • Money laundering

Is Healthcare Fraud a Federal Crime?

Health care fraud can be a state-level crime in Delaware or a federal offense, depending on the circumstances. It is federal crime for whoever knowingly and willfully executes a scheme to:

  • Defraud any health care benefit program; or
  • Obtain money, property, or health care benefits by fraudulent pretenses, representations, or promises.

The penalties for a federal government fraud conviction include up to 20 years in prison. If the fraud results in death, a conviction could result in life in prison.

How is Health Care Fraud Detected?

Healthcare fraud can be detected through computerized fraud prevention systems or reporting of potential fraud. The Centers for Medicare and Medicaid Services (CMS) uses a Fraud Prevention System (FPS) to analyze healthcare providers networks to detect patterns that represent a risk of fraudulent activity. The leads are then investigated by field office agents to identify possible fraud and refer the health care fraud cases for criminal prosecution.

Why Do I Need a Healthcare Fraud Defense Lawyer?

There are severe penalties for a conviction of health care fraud. A felony conviction could result in a permanent criminal record, and make it more difficult for you to find a job in the future. With a lot at stake, a criminal defense lawyer can help you fight the charges for health care fraud to avoid a criminal record. An experienced criminal defense attorney can also negotiate to get a plea deal with reduced criminal charges or minimum sentencing.

If you are accused of health care fraud, you may have several legal defense options. The prosecutor has the burden of proving every element of the offense beyond a reasonable doubt. Possible criminal defenses to fraud charges include:

  • No intent to commit fraud
  • False claims were made by mistake
  • Another person was responsible for making a false claim
  • Incorrect claims were caused by computer error or operator error

Health care fraud may also include related charges, which could increase the penalties and consequences of a conviction. Some related charges to health care fraud may include forgery, insurance fraud, or identity theft.

Best Time to Seek Legal Help

No matter what your legal issue may be, it is always best to seek legal help early in the process. An attorney can help secure what is likely to be the best possible outcome for your situation and avoid both unnecessary complications or errors.

How to Prepare for Your Initial Consultation

Prepare for your consultation by writing down notes of your understanding of the case, jot down questions and concerns for the attorney, and gather your documents. Remember that you are trying to get a sense of whether the attorney has your trust and can help you address your legal issues. Questions should include how the attorney intends to resolve your issue, how many years he/she has been practicing law and specifically practicing in your area, as well as how many cases similar to yours the attorney has handled. It can also be helpful to broach the subject of fees so that you understand the likely cost and structure of your representation by a specific attorney and/or legal team.

How much does it cost to hire an attorney?

In general, how much an attorney costs will often depend on these four factors: billing method and pricing structure, type of legal work performed, law firm prestige, and attorney experience. Depending on the legal issue you are facing, an attorney may bill you by the hour, settle on a flat fee, or enter into a contingency fee agreement. The type of legal work you need help with will also play a role in cost incurred.

Common legal terms explained

Affidavit – A sworn written statement made under oath. An affidavit is meant to be a supporting document to the court assisting in the verification of certain facts. An affidavit may or may not require notarization.

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