Top Wilmington, DE Medicaid Fraud Lawyers Near You

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

222 Delaware Ave, Suite 1105, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office

824 N. Market Street, Suite 710, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

1313 Market St, Suite 5100, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

1106 West 10th Street, Wilmington, DE 19806

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

222 Delaware Avenue, Suite 1101, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office

300 Delaware Ave, Suite 1015, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office

500 Delaware Avenue, Suite 1410, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

1000 N. West Street, Suite 1244, Wilmington, DE 19801

Medicaid Fraud Lawyers | Centerville Office | Serving Wilmington, DE

5721 Kennett Pike, Centerville, DE 19807-1311

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

300 Delaware Avenue, Suite 1010, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office

1523 Concord Pike, Suite 200, Wilmington, DE 19803

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

300 Delaware Avenue, Suite 770, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office

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

Wilmington Medicaid Fraud Information

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Lead Counsel Verified Attorneys In Wilmington

Lead Counsel independently verifies Medicaid Fraud attorneys in Wilmington 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.
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Find a Medicaid Fraud Attorney near Wilmington

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.

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.

Tips on Approaching an Initial Attorney Consultation

  • Use the consultation as a means of gaining a better understanding of your legal situation.
  • Ask the attorney how many cases similar to yours he/she has handled. An attorney’s experience and knowledge can speak to their expertise (or lack of) in addressing your situation.
  • Your attorney should be able to articulate roughly how long a case like yours will take to resolve and what sort of procedures to expect.
  • Determine how comfortable you are working with the lawyer and/or law firm.

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

Personal jurisdiction – Requirement that a particular court have authority over a person, in order to bind that person to the judgment of the court, based on minimum contacts. International Shoe Co v. Washington is a landmark Supreme Court case outlining the scope of a state court’s reach in personal jurisdiction.

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