Top Bear, DE Medicaid Fraud Lawyers Near You

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

1523 Concord Pike, Suite 200, Wilmington, DE 19803

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

1201 North Market Street, Suite 2100, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

222 Delaware Avenue, Suite 1101, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

300 Delaware Avenue, Suite 770, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

1201 North Market Street, Suite 800, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

1106 West 10th Street, Wilmington, DE 19806

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

1201 North Market Street, Suite 1500, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

405 North King Street, Suite 500, Wilmington, DE 19801-3700

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

222 Delaware Ave, Suite 1105, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

1105 North Market Street, Suite 1700, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

500 Delaware Ave, Suite 730, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

1105 North Market Street, Suite 600, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving Bear, DE

1000 N. West St, Ste 1200, Wilmington, DE 19801

Bear Medicaid Fraud Information

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Lead Counsel Verified Attorneys In Bear

Lead Counsel independently verifies Medicaid Fraud attorneys in Bear 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 Medicaid Fraud Attorney near Bear

The Average Total Federal Prison Sentence for Medicaid 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 Is Medicaid Fraud?

Medicare and Medicaid are national medical health insurance programs that provide healthcare coverage. Medicare covers many of the healthcare expenses of people who are age 65 or older, people with a disability, or renal disease. Medicaid provides health care costs to people with low incomes. In most states, adults and dependent children are qualified to receive Medicaid with incomes up to 138% of the federal poverty line.

Medicaid and Medicare are subject to waste, abuse, and fraud. When fraud is involved, it can lead to criminal charges. Medicaid fraud involves making false representations or statements in order to obtain some benefit or payment that would not otherwise be provided. Fraud generally involves misrepresenting facts or concealing material facts. Medicare abuse usually involves practices that result in unnecessary cost or expense, and can also be the basis for criminal penalties.

What Are Some Examples of Medicaid Fraud?

Healthcare in the United States can be expensive and complicated. Billing government care providers, like Medicaid, requires following standard protocols. However, because of the size and scope of Medicaid, it can be subject to fraud or abuse. Common examples of Medicaid fraud may include:

  • Billing for services that are never performed
  • Billing for medical equipment that is not medically necessary
  • Unlawfully paying for patient referrals or provider kickbacks
  • Changing for a more expensive service than what was provided
  • Unbundling a combined medical procedure to charge as multiple procedures
  • Double billing or duplicate claims

Who Investigates Medicaid Fraud?

Medicaid is operated by a combination of federal and state agencies. Suspected Medicaid fraud can be investigated by multiple agencies or law enforcement agencies, including:

  • State health department fraud investigators
  • Office of Inspector General (OIG)
  • Centers for Medicare & Medicaid Services (CMS)
  • Internal Revenue Service (IRS)
  • Federal Bureau of Investigation (FBI)
  • Medicaid Fraud Control Unit

Financial fraud is often flagged by computer analysis that reviews health care records submitted to Medicaid. The CMS Fraud Prevention System (FPS) can look for suspicious activity or suspected patterns of fraud. After identifying suspicious activity, an investigation will further look into the health care providers involved to determine if there is evidence of provider fraud, including site visits, talking to patients, and reviewing the provider’s medical and billing records.

Can You Go To Jail for Medicaid Fraud?

Medicaid fraud can involve criminal and civil penalties. Health care fraud involving federal government healthcare agencies or programs is a felony offense. Under federal law, the penalties for federal health care fraud can include up to 10 years in federal prison time. If the fraud resulted in serious bodily harm to a patient, the penalties could increase to 20 years imprisonment. Felony convictions can harm your future job opportunities.

Healthcare providers are also prohibited from paying or accepting kickbacks for health care services. Violation of the Anti-Kickback Statute can result in up to 5 years in jail, thousands of dollars in fines, and Medicaid exclusion.

Unlawful self-referral involves a doctor referring a patient to medical services where the doctor has a financial interest. Violation of the Stark Law against physician self-referral can result in fines, restitution, punitive damages, and make the doctor ineligible for Medicare and Medicaid programs in the future.

What Happens If Someone Reports Me for Medicaid Fraud in Delaware?

If patients suspect their doctor has been improperly billing Medicaid for care, they may have an interest in reporting the doctor. Other doctors, health care workers, or family members may also report suspected Medicaid fraud. Under the False Claims Act (FCA), whistleblowers can recover up to 30% of the civil penalties recovered for fraud against the government.

What if You Are Accused of Medicaid Fraud?

If you are facing fraud allegations it does not necessarily mean you will be found guilty of any crime. You have legal defenses and constitutional protections to challenge the criminal charges in court with the right to legal counsel. There may be several viable defenses to a fraud charge, including improper billing caused by clerical errors or computer problems.

How Health Care Fraud Defense Lawyers Can Help

A federal fraud lawyer can help as soon as you learn about a fraud investigation. Legal representation can protect you from saying the wrong thing during a fraud interview. An experienced attorney can also inform you of your legal rights and the potential consequences of a plea agreement. A fraud attorney can also help negotiate favorable settlements to get the best possible resolution and avoid jail time or other severe penalties.

Top Questions to Ask When Hiring an Attorney

  • How many years have you been practicing law? How long have you practiced law in the local area?
  • How many cases similar to mine have you handled in the past?
  • What is the likely outcome for my case?

In legal practice, experience matters. An experienced attorney will likely have handled issues similar to yours many, many times. Therefore, after listening to your situation, the attorney should have a reasonable idea of the time line for a case like yours and the likely resolution.

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.

Types of legal fees:

Bill by the hour: Many attorneys bill by the hour. How much an attorney bills you per hour will vary based on a number of factors. For instance, an attorney’s hourly fee may fluctuate based on whether that hour is spent representing you in court or doing research on your case. Attorneys in one practice area may bill you more than attorneys in a different practice area.

Contingent fee: Some lawyers will accept payment via contingent fee. In this arrangement, the lawyer receives a percentage of the total monetary recovery if you win your lawsuit. In sum, the lawyer only gets paid if you win. Contingent fee agreements are limited to specific practice areas in civil law.

Flat fee: For “routine” legal work where the attorney generally knows the amount of time and resources necessary to complete the task, he/she may be willing to bill you a flat fee for services performed.

Common legal terms explained

Plaintiff – a person or party who brings a lawsuit against another person(s) or party/parties in a court of law. Private persons or parties can only file suit in civil court.

Judgment – A decision of the court. Also known as a decree or order. Judgments handed down by the court are usually binding on the parties before the court.

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