Top New Castle, DE Medicaid Fraud Lawyers Near You

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

300 Delaware Ave, Suite 1015, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

500 Delaware Avenue, Suite 1410, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

Renaissance Centre, 405 N. King Street, 8th Flr., Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

1201 N Market St, Suite 1406, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

300 Delaware Ave, Suite 210, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

1201-A King Street, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

222 Delaware Avenue, Suite 1101, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

1106 West 10th Street, Wilmington, DE 19806

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

1313 Market St, Suite 5100, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

1313 N Market St, Suite 1201, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

1201 King Street, Suite B, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

222 Delaware Avenue, Suite 800, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

1523 Concord Pike, Suite 200, Wilmington, DE 19803

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

1201 N. Market Street, Suite 2300, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

919 North Market Street, 11th Floor, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

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

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

1201 N Market St, Suite 1001, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office | Serving New Castle, DE

919 North Market Street, Suite 1000, Wilmington, DE 19801

New Castle Medicaid Fraud Information

Lead Counsel Badge

Lead Counsel Verified Attorneys In New Castle

Lead Counsel independently verifies Medicaid Fraud attorneys in New Castle 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 New Castle

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.

How an Attorney Can Help

An attorney can often resolve your particular legal issue faster and better than trying to do it alone. A lawyer can help you navigate the legal system, while avoiding costly mistakes or procedural errors. You should seek out an attorney whose practice focuses on the area of law most relevant to your issue.

The Importance of a Good Consultation

The goal of an initial consultation is to find an attorney you are comfortable working with and someone who can help you understand your options under the law. Seek to understand the relevant legal experience the attorney brings to your case. While it is not realistic to expect an attorney to resolve your legal issue during an initial consultation, you should gain a level of comfort with his/her ability to do so. A good consultation can clarify issues, raise pertinent questions and considerations for your case, and help you make an informed decision towards resolving your legal issue.

Tips on Hiring an Experienced Lawyer with Medicaid Fraud Cases

The more experienced a lawyer is in legal practice, the more likely he/she will be able to bring about a successful resolution to your issue. Since experience matters, lawyers who’ve been practicing law for many years (with a successful track record) tend to be in high demand. You should look for information about a lawyer’s experience and ask questions during the initial meeting. It’s a very good idea to ask the lawyer how many years he/she has been practicing law and the expected outcome of your case.

Common legal terms explained

Pro se – This Latin term refers to representing yourself in court instead of hiring professional legal counsel. Pro se representation can occur in either criminal or civil cases.

Statute – Refers to a law created by a legislative body. For example, the laws enacted by Congress are statutes.

Subject matter jurisdiction – Requirement that a particular court have authority to hear the claim based on the specific type of issue brought to the court. For example, the U.S. Bankruptcy Court only has subject matter jurisdiction over bankruptcy filings, therefore it does not have the authority to render binding judgment over other types of cases, such as divorce.

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