Top Wilmington, DE Medicaid Fraud Lawyers Near You

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

222 Delaware Ave, Suite 1105, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

300 Delaware Avenue, Suite 1380, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

300 Delaware Ave, Suite 1015, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office

1201 N. Market Street, Suite 1407, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office

500 Delaware Avenue, Suite 1410, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office

600 N King St, Suite 901, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

500 Delaware Ave, Suite 730, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Centerville Office | Serving Wilmington, DE

5721 Kennett Pike, Centerville, DE 19807-1311

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

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

Medicaid Fraud Lawyers | Wilmington Office

1313 Market St, Suite 5100, Wilmington, DE 19801

Medicaid Fraud Lawyers | Wilmington Office

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

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.
  • 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 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.

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.

What to Expect from an Initial Consultation

  • Seek to determine whether the attorney can represent you. There is no one-size-fits-all legal solution and it may turn out your needs are better served by an attorney in a different specialization.
  • It’s important to find a legal ally who is both competent in the law and someone you can trust to protect your interests.
  • Discuss how the practice’s billing works and discuss possible additional charges or fees that may arise during or after the resolution of your case.

An attorney consultation should provide you with enough information so that you can make an informed decision on whether to proceed with legal help.

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

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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