Serving people accused of Medicare and Medicaid fraud in Wilmington, North Carolina and surrounding areas.
Medicare fraud involves fraudulent activities by healthcare providers or organizations participating in the Medicare program—a federal health insurance program for individuals aged 65 and older, as well as certain younger individuals with disabilities. Similarly, Medicaid fraud refers to deliberate acts by providers to defraud the Medicaid program, which offers health insurance to low-income individuals and families.
If you are looking for experienced lawyers to represent you in allegations of Medicare or Medicaid fraud, Blue LLP can help. Our attorneys have a proven track record of successfully defending clients against federal civil and criminal allegations of healthcare fraud.
Engaging in Medicare or Medicaid fraud can lead to severe consequences, including:
Civil Penalties: Under the False Claims Act, violators may face fines up to three times the government’s loss, plus monetary damages per false claim. Civil liability can occur even without specific intent to defraud.
Criminal Penalties: Convictions can result in imprisonment for up to 5 years and substantial fine. Other charges such as mail or wire fraud can lead to lengthier terms of imprisonment.
Examples of Fraudulent Activities
Common forms of Medicare and Medicaid fraud can include:
-Submitting claims for services not rendered
-Billing for unnecessary medical services
-Upcoding (billing for more expensive services than provided)
-Billing for services performed by excluded individuals
Successfully defending against healthcare fraud allegations requires an in-depth understanding of federal and state laws. An experienced lawyer can:
1. Analyze the evidence. Healthcare fraud cases often are dependent on extensive documentation and data analysis. A skilled attorney will scrutinize the substance and quantity of the government’s evidence of inaccuracies, inconsistencies, and unreliable sampling.
2. Challenge the Substance of the Evidence. All billing errors do not amount to fraud. An experienced attorney can argue that mistakes were unintentional, due to administrative errors, or otherwise fail to amount to deliberate or reckless misconduct.
3. Work With Multiple Prosecutors and Law Enforcement Agencies. Healthcare fraud cases often involve multiple government agencies such as the federal Department of Justice, the North Carolina Department of Justice, state Medicare and Medicare investigative units, the FBI, and others. By hiring an experienced attorney you can eliminate the burden of communicating directly with prosecutors and investigators and lessen the likelihood of unknowingly providing incriminating evidence.
4. Negotiate Fair Settlements. Depending on the nature of the alleged fraud, your attorney may be able to help you negotiate a reasonable monetary settlement.
5. Defend your reputation. Fraud allegations can damage your personal and professional reputation. A strong defense strategy can help preserve your standing in the community and among your peers.
If you are under investigation or facing charges for Medicare or Medicaid fraud, taking immediate action is crucial. Here are the steps you should follow:
1. Consult an Attorney: Do not speak to investigators or law enforcement without legal representation. Anything you say can be used against you.
2. Preserve Evidence: Keep records of all communications, billing practices, and financial documents. This information may be vital to your defense.
3. Avoid Retaliation: If the investigation involves whistleblowers, avoid taking retaliatory actions, as this could lead to additional legal issues.
4. Stay Informed: Work closely with your attorney to understand the allegations and your legal options.
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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