Top Umatilla, FL Medicare Fraud Lawyers Near You
We Are Zealous Advocates For Those Accused Of Violating Federal Or State Law. Protect Your Future, Call Now. Hablamos Espanol.
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Fed Trouble? Free Consult. Former Prosecutor & Team Former Federal Agents. Call/Text 24/7. Immediate Response Guaranteed!
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Top-Rated, Highly-Experienced, LOCAL Federal Criminal Defense Attorneys. 150+ Yrs. Combined Experience. A+ by the BBB, Super Lawyers, Superb 10 AVVO, Top 100 Trial Lawyers
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Defending your rights since 1974. Nationally recognized experts in Federal and White Collar offenses. Highly qualified with the experience necessary to WIN. Call now!
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We FIGHT To Get Results. Over 40 Years Of Experience Defending Those Accused Of Serious State And Federal Charges
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Federal Defender with 25 years trial experience. Assisting those accused of drug crimes, white collar and any federal criminal defense matters. You speak to me directly!
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Our nationwide team of defense lawyers includes a former U.S. Attorney, four former Federal Prosecutors, two former FBI agents and two former Army JAGS.
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121 South Orange Avenue, Suite 1500, Orlando, FL 32801
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If you need Medicare Fraud help in Florida, contact O’Brien Hatfield, PA, a local practice in Umatilla, for legal representation.
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3708 S. John Young Pkwy, Suite D, Orlando, FL 32839
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Musca Law has experience helping clients with their Medicare Fraud needs in Umatilla, Florida.
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510 Co Rd 466, Suite 203W, The Villages, FL 32159
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Those seeking legal help with Medicare Fraud can reach out to Whittel & Melton, LLC, a local practice representing people in Umatilla, Florida.
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111 North Orange Ave, Suite 1200, Orlando, FL 32801
200 S. Orange Avenue, Suite 2300, Orlando, FL 32801-3432
111 N Orange Ave, Suite 1750, Orlando, FL 32801
1217 East Robinson Street, Orlando, FL 32801
390 N Orange Avenue, Suite 2300, Orlando, FL 32801
201 East Pine Street, Suite 500, Orlando, FL 32801
200 S. Orange Ave, Suite 800, Orlando, FL 32801
1115 E Livingston Street, Orlando, FL 32803
315 East Robinson Street, Suite 550, Orlando, FL 32801
300 South Orange Avenue, Suite 1600, Orlando, FL 32801
800 North Magnolia Ave, Suite 450, Orlando, FL 32803
1945 E. Michigan Street, Orlando, FL 32806
5323 Millenia Lakes Blvd, Suite 300, Orlando, FL 32839
200 E Robinson Street, Suite 1150, Orlando, FL 32801
1420 Edgewater Dr, Orlando, FL 32804
200 S. Orange Avenue, Suite 2600, Orlando, FL 32801
1220 Commerce Park Drive, Suite 207, Longwood, FL 32779
225 E Robinson St, Suite 600, Orlando, FL 32801
450 South Orange Avenue, Suite 650, Orlando, FL 32801
941 West Morse Blvd, Suite 100, Winter Park, FL 32789
200 South Orange Avenue, Suite 2900, Orlando, FL 32801
221 NE Ivanhoe Blvd, Suite 200, Orlando, FL 32804
Umatilla Medicare Fraud Information
Lead Counsel independently verifies Medicare Fraud attorneys in Umatilla and checks their standing with Florida 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.
What Constitutes Medicare Fraud?
Medicare is a national health insurance program, administered under the Centers for Medicare and Medicaid Services (CMS). Medicare covers many of the healthcare expenses of enrollees. Uncovered services and remaining costs may be covered by private insurance or other government benefit programs. To be eligible under Medicare, the individual has to meet one of the following requirements:
- Age 65 or older and a U.S. citizen, or LPR for 5 continuous years with a qualifying spouse or ex-spouse
- Under 65 with a disability and have been receiving SSDI or other disability benefits for a qualifying period of time
- People with End-Stage Renal Disease (ESRD) receiving continuing dialysis
Medicare fraud involves making false claims or fraudulent misrepresentations for Medicare health care benefit reimbursement. According to the Government Accountability Office, Medicare is vulnerable to fraud, with a low rate of Medicare claim audits. People accused of Medicare fraud can involve anyone involved in government healthcare benefit program, including:
- Doctors and medical providers
- Billing professionals
- Health care professionals
- Health care services companies
- Insurance companies
- Pharmaceutical companies
What Are Examples of Medicare Fraud?
Medicare fraud generally occurs between medical care providers and patients, vendors, or other doctors. There are several examples of medical billing fraud, anti-kickback violations, and financial gain through improper self-referral. Some common examples of Medicare fraud include:
- Billing for services that are not necessary
- Health care provider treatment for an undiagnosed condition
- Charging for an unnecessary expensive service
- Paying kickbacks for referrals
- Unbundling medical procedures
- Double billing or duplicate claims
- Up-coding
- Billing for medical services never provided
How is Medicare Fraud Determined?
There are several ways Medicare fraud can be identified. Suspected fraud can be reported by patients, healthcare providers, or even employees. Health care fraud cases can also be identified through computer analysis. CMS uses a Fraud Prevention System (FPS) to identify possible fraud. According to CMS, the FPS is a “state-of-the-art predictive analytics technology.”
The system assesses all Medicare fee-for-service claims to identify fraudulent claims and take administrative action. When patterns of inappropriate billing are identified, investigators conduct site visits, interview patients, and review medical records to identify fraud.
The Office of Inspector General (OIG) has a hotline for reporting potential fraud and Medicare abuse. Patients, co-workers, or employees may have an incentive for reporting fraudulent billing and may be eligible for whistleblower awards under some federal programs.
Is Medicare Fraud Civil or Criminal?
Medicare fraud charges can involve both civil and criminal laws and penalties. Federal health care fraud carries felony criminal charges. The penalties for a conviction of federal government fraud include up to 10 years in federal prison, or up to 20 if it resulted in serious bodily injury.
When a doctor refers a Medicare patient to another business or provider where the doctor has a financial interest, it may be a violation of the Physician Self-Referral Law, or the Stark Law. Civil penalties for illegal patient referrals include civil penalties, treble damages, and Medicare program exclusion.
The Anti-Kickback Statute is a criminal statute, with penalties including possible imprisonment for up to five years, fines, and exclusion from federal benefit programs.
The False Claims Act (FCA) provides for civil penalties where a doctor defrauds the federal government. The FCA also provides a reward system, and whistleblowers can recover up to 30% of the money recovered by the government.
Other penalties may include restitution, or paying back the victims of fraud. After a conviction for Medicare fraud, a doctor could also lose their medical license or be excluded from participating in Medicare or Medicaid. Medicare fraud may also involve other criminal violations, including:
- Identity theft
- Forgery
- Money laundering
- Wire fraud
- Insurance fraud
What if You Are Accused of Medicare Fraud?
Not all Medicare fraud criminal investigations involve criminal intent. There are a number of possible explanations or legal defenses when a doctor faces fraud allegations. In many cases, suspected fraud may be caused by simple mistakes or unclear rules, without any intention of fraud. A fraud attorney can review your case for a strategic defense, with possible defenses including:
- Accidentally putting in the wrong billing code
- Accidentally ordering extra diagnostic tests
- Billing employees did not have the proper training
- Patient claimed they did not already have a procedure or test
- Misspellings or unclear handwriting