Medical Fraud

If you are facing charges for medical fraud, you will need an experienced criminal defense attorney on your side. Contact Brian Zeiger for a free consultation. Medical fraud is a category of health care fraud, which is a type of white-collar crime that involves the filing of dishonest health care claims in order to turn a profit.

Fraudulent medical schemes come in many forms. Practitioner schemes include: individuals obtaining subsidized or fully-covered prescription pills that are actually unneeded and then selling them on the black market for a profit; billing by practitioners for care that they never rendered; filing duplicate claims for the same service rendered; altering the dates, description of services, or identities of members or providers; billing for a non-covered service as a covered service; modifying medical records; intentional incorrect reporting of diagnoses or procedures to maximize payment; use of unlicensed staff; accepting or giving kickbacks for member referrals; waiving member co-pays; and prescribing additional or unnecessary treatment. Members can commit medical fraud by providing false information when applying for programs or services, forging or selling prescription drugs, using transportation benefits for non-medical related purposes, and loaning or using another’s insurance card.

When medical fraud is committed, the health care provider passes the costs along to its customers. Because of the pervasiveness of health care fraud, statistics now show that 10 cents of every dollar spent on health care goes toward paying for fraudulent health care claims.

The prosecution of a health care provider can end in a conviction that has serious consequences. The health care provider likely faces incarceration, fines, and possibly losing the right to practice in the medical industry.

 

Example of Medical Fraud

In one case, Kaiser Permanente posted a $15,000 reward for information leading to the conviction of the participants in a scam that bilked Kaiser of more than $8 million for medical transportation services for patients of kidney dialysis centers. The perpetrators allegedly obtained the names of seven physicians and a list of dialysis patients, sent letters on physicians’ letterhead verifying the need for transportation services and then billed Kaiser for services that were never provided.

 

Contact Brian Zeiger

When you need a Philadelphia, Pennsylvania attorney to defend you when arrested and charged with a with a white-collar crime, contact Brian Zeiger. It is critical to have an experienced attorney advocating on your behalf. Brian Zeiger is an experienced criminal defense attorney who will vigorously defend your rights.

An experienced criminal defense attorney can help you determine whether you have any grounds for dismissal of the charges, explore plea options, or represent you at trial. Only someone familiar with the criminal court system and cases like yours will know how good your chances are for a favorable outcome. A knowledgeable attorney will take all of this into consideration, assist you in making decisions about your case, and protect your rights.

Contact The Zeiger Firm today at (215) 546-0340 for a consultation, and let us help you.

 

Sources:

  1. https://www.law.cornell.edu/wex/white-collar_crime
  2. https://www.law.cornell.edu/wex/healthcare_fraud
  3. http://criminal.findlaw.com/criminal-charges/white-collar-crime.html
  4. https://www.nhcaa.org/resources/health-care-anti-fraud-resources/consumer-info-action.aspx
  5. http://www.nolo.com/dictionary/white-collar-crime-term.html