Atlanta Healthcare Fraud Attorney
Facing any criminal allegation is a serious challenge. At The Law Offices
of Howard J. Weintraub, P.C. you don't have to face this accusation
alone. Our law firm is dedicated to providing high-quality legal representation
in Atlanta and the surrounding areas. At the firm, we handle a wide variety
of criminal defense practice areas – including healthcare fraud.
Simply put, healthcare fraud refers to the intentional falsification of
any healthcare transaction. Healthcare fraud can be committed by a provider,
employer group, employee, or healthcare member. Persons might commit healthcare
fraud by billing for services that were not provided or performing unnecessary
medical services to collect payment.
Healthcare Fraud in the United States
According to the Federal bureau of Investigation (FBI), healthcare fraud
costs the United States approximately $80 billion every year. The U.S.
spends more than $2.7 trillion on healthcare every year. Unfortunately,
the cost of healthcare is outpacing inflation – making healthcare
fraud a growing threat to the integrity of the medical industry across
the country. The FBI reports that recent cases of healthcare fraud demonstrate
a rising trend among healthcare providers: a willingness to risk patient
harm in their schemes.
The FBI is dedicated to stopping healthcare fraud and protecting medical
patients across the country. With jurisdiction in private and federal
insurance programs, the FBI has a far-reaching influence in the healthcare
industry and uses undercover operations and coordinated initiatives to
disband harmful healthcare fraud schemes. Not every healthcare fraud suspect
is a criminal, though. In fact, overzealous initiatives and operations
can easily lead the FBI to accuse innocent persons of healthcare fraud.
If you've been wrongly accused of healthcare fraud, contact The Law
Offices of Howard J. Weintraub, P.C. today. We have more than 40 years
of combined legal experience fighting for clients like you: let us put
this experience to work for your healthcare fraud defense case! Our team
can create an effective and aggressive defense strategy to give you the
best chance of a favorable case outcome. Contact our office today to retain
the aggressive legal representation you need.
Healthcare Fraud in the Future
The FBI predicts that healthcare fraud will continue to grow in popularity
as advanced medical treatment allows people to live longer. As people
live longer, long-term and short-term medical treatment will be utilized
more, creating more and more opportunities for healthcare fraud. According
to the FBI, fraudulent healthcare schemes will become more complicated
in the future. Because of this, the government is prepared to implement
aggressive investigations against suspected healthcare fraud.
Types of Healthcare Fraud
Fraudulent billing occurs when a healthcare provider sends a bill for
medical services that were not actually provided. For example, a patient
might receive a bill after no medical service was rendered or after a
service was rendered, but descried differently on the claim for payment.
Sometimes, fraudulent billing occurs when the care provider charges the
patient twice for the same medical service.
Upcoding occurs when a care provider submits a bill with the wrong service
code. For example, a follow-up appointment might be upcoded to a comprehensive
office visit. Comprehensive visits cost more than follow-up appointments.
Thus, the care provider would receive extra payment for the service rendered.
Other types of upcoding involve: billing group therapy as individual therapy,
billing unilateral procedures as bilateral procedures, and billing a half-hour
session as a 50+ minute session.
This scheme involves billing a patient with multiple bills to collect
the highest-possible reimbursement for tests and other medical services.
If the medical provider could have billed the tests, etc. as one procedure
for less money, he/she might be accused of unbundling if the bill is sent
in fragments. For instance: some lab tests can be ordered individual or
in a panel. Doctors that bill them individually to collect more money
may be guilty of unbundling.
Excessive Medical Service
Sometimes, healthcare providers try to trick patients into thinking that
they need more medical attention than is actually necessary. For instance,
a doctor might prescribe dialing visits when monthly or weekly visits
are more appropriate for the patient's needs. A medical supply company
might bill a nursing home for 30 wound care kits every week when the facility
only needs one per day.
The term "kickback" refers to a specific type of healthcare
fraud. Kickbacks occur when a healthcare provider offers or accepts payment
in exchange for patient referral when the patient's medical needs
will be handled by Medicare or Medicaid. For instance, a doctor might
accept $100 for every patient that he/she refers to a specific laboratory
for testing. Kickbacks are usually paid in cash, paid vacations, jewelry,
or other valuables and are determined by a percentage of the Medicare/Medicaid coverage.
Contact an Atlanta Healthcare Fraud Attorney
The FBI reports 2,690 healthcare fraud investigations in 2011. These investigations
resulted in 1,676 indictments and 736 criminal convictions. As the healthcare
industry continues to expand, so will the FBI's aggressive pursuit
of fraudulent healthcare schemes. Since 2008, the number of pending healthcare
cases has grown from 2,434 to 2,690. If you are facing allegations of
healthcare fraud, contact The Law Offices of Howard J. Weintraub, P.C.
today. Fraud is a serious criminal accusation; don't risk your future,
freedom, career, and wellbeing by handling an accusation alone. Call our
team of Atlanta healthcare fraud lawyers today for the outstanding legal
service your case requires. The sooner we hear from you, the faster our
team can help, so take the first step toward a secure legal future and
contact us today.