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Los Angeles Federal Healthcare Fraud Attorney

What is Federal Healthcare Fraud?

The federal government aggressively investigates both providers and consumers of benefits under federal health care programs, including Medicare, to determine whether federal funds are being diverted or misused. Los Angeles is a target of federal scrutiny because of the high number of claims filed under federal healthcare programs, which increases the risk of fraudulent claims.

Healthcare providers including physicians, pharmacists, and home health care workers may be prosecuted for federal healthcare fraud if they are engaged in practices designed to take advantage of federal healthcare program funding, such as:

  • Billing patients for services not performed;
  • Intentionally misdiagnosing patients to justify unnecessary services;
  • Intentionally submitting incorrect billing codes for higher-rate services;
  • Soliciting or accepting “kickbacks” or referral fees;
  • Improperly filling prescriptions; OR
  • Falsifying patient records.

Healthcare consumers can also be prosecuted for federal healthcare fraud if they attempt to take advantage of federal benefits by:

  • Filing claims for services or prescriptions not received;
  • Filing claims under someone else’s insurance; OR
  • Forging or altering health care bills.

If you are under investigation for federal healthcare fraud, the government likely already has reason to believe that you have committed fraud. It is critical to hire an experienced Los Angeles federal healthcare fraud attorney as soon as you are aware that you might be under investigation. Early intervention by a skilled attorney could help you avoid serious consequences.

Penalties for Federal Healthcare Fraud

If you are convicted of federal healthcare fraud, you could face up to 10 years in federal prison for each count of fraud for which you are convicted. If you are a healthcare provider and your fraudulent activity contributed to bodily injury to a patient, this minimum sentence goes up to 20 years per count of fraud. You could face life in prison if you are responsible for the death of a patient due to federal healthcare fraud. You may also be required to pay hefty penalties and fines, in the hundreds of thousands of dollars.

Federal healthcare fraud allegations can also have civil penalties – in other words, penalties imposed in a civil trial in addition to criminal prosecution. Civil penalties could include a requirement to repay the federal benefits you fraudulently gained, as well as paying damages in the form of money to those you harmed. If you are a healthcare provider, you could also lose your professional license.

Defenses to Federal Healthcare Fraud Charges

To convict you of federal healthcare fraud, the prosecutor must prove beyond a reasonable doubt, that you (as a provider or consumer):

  • Intentionally submitted or caused a third party to submit false or misleading information; AND
  • Intended for that information to be used to determine the healthcare benefits payable to you.

If the government cannot make this case, you are not guilty of federal healthcare fraud.

The best action you can take when you know you are the target of a federal investigation is to hire an attorney to get involved early in the process before any charges are filed. A knowledgeable and experienced Los Angeles federal healthcare fraud attorney will contact the government agency in charge of the investigation to understand the facts and begin negotiating a resolution. Typically, the most common and most powerful defense to charges of federal healthcare fraud is that you did not act with the knowledge and intent of defrauding the government. Your attorney can help make this argument and potentially head off serious charges.

How Can a Los Angeles Federal Healthcare Fraud Attorney Help Me?

A criminal defense attorney with experience in healthcare fraud cases can help you understand your rights and your options, advise you on how to conduct yourself during an investigation, gather and present strong evidence in support of your case, and if necessary, represent you skillfully in court. With our firm’s extensive experience, the Law Offices of Adrian M. Baca can effectively intervene in the government’s investigation and help you avoid the worst consequences of federal charges.

Contact us today for a free evaluation of your case.