Medicare fraud entails deceptive practices carried out by healthcare providers or organizations involved in the Medicare program, a federal health insurance initiative for those aged 65 and older, along with certain younger individuals with disabilities. Likewise, Medicaid fraud involves intentional actions by providers regarding the Medicaid program, which provides health insurance for low-income individuals and families.
Blue LLP represents people accused in civil and criminal Medicare and Medicaid fraud cases. If you need help, call us at (919) 833-1931. Although we are based in Raleigh, we represent people throughout North Carolina.
Fraudulent practices in the healthcare sector can occur in various ways, including:
Billing for Nonexistent Services: Submitting claims for medical procedures or treatments that were never performed.
Upcoding Services: Charging for more expensive services than were actually provided.
Unnecessary Procedures: Billing for tests or treatments that are not medically necessary.
Kickback Schemes: Accepting or offering financial incentives for patient referrals, violating anti-kickback laws.
Misrepresentation of Costs: Falsely reporting operational expenses to increase reimbursement amounts.
Using Another Provider’s Credentials: Submitting claims under the name of a provider eligible for Medicare or Medicaid, even if they didn’t provide the service.
We understand the challenge of defending against fraud allegations. Our legal team has the experience to provide a thorough, customized approach to your defense. As experienced attorneys, we can help you:
1. Thoroughly examine the evidence. Healthcare fraud cases often involve extensive records. As skilled attorneys, we can help you analyze the evidence and explore potential defenses.
2. Challenge the Substance of the Allegations. Many billing errors are unintentional. We can help uncover whether the errors resulted from administrative issues rather than intentional or reckless misconduct.
3. Manage Interaction With Prosecutors and Law Enforcement Agencies. Medicare and Medicaid fraud cases often involve multiple government agencies including the federal Department of Justice, the North Carolina Department of Justice, state Medicare and Medicare investigative units, the FBI, and others. We will help you manage your personal interactions with these agencies while you are under investigation to ensure that your rights are protected.
4. Negotiate Settlements. In some cases, resolving health care fraud allegations through settlement may be the best course of action. When possible, we can help you negotiate terms that minimize penalties.
5. Protect your reputation. Fraud accusations can destroy your personal and professional standing. A robust legal defense might help you preserve your reputation and career.
If you find yourself facing healthcare fraud allegations, taking immediate action is essential to protect your rights. As such, you should consider the following:
1. Seek Legal Counsel Immediately: Avoid speaking to investigators or law enforcement without an attorney. Anything you say can be used against you.
2. Preserve Important Documents Including Electronic Data: Retain all relevant records, including communications, billing details, and financial reports. These materials could be critical to your defense.
3. Avoid Retaliation: If a whistleblower is involved in your case, avoid taking actions that could be interpreted as retaliation.
4. Stay Proactive: Work closely with your legal team to understand the nature of the allegations and develop a comprehensive defense strategy.
If you are concerned about Medicare or Medicaid fraud, call us today to see how we can help. The call is free and confidential. We only take on clients who we believe we can help.
Complete the form below or call (919) 833-1931 for a free consultation.
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