Federal healthcare fraud costs taxpayers billions each year, and recent prosecutions reveal several persistent schemes. Federal law prohibits knowingly submitting false claims to Medicare, Medicaid, or other government health programs, paying or receiving kickbacks, and exploiting patients for financial gain.

Common Types of Federal Healthcare Fraud

Unfortunately, healthcare fraud comes in many forms, including the following:

• Billing for services not rendered: Providers bill for procedures, exams, or medications that were never given to patients.
• Kickback schemes: Physicians and other professionals receive payments or compensation for referring patients or ordering unnecessary tests and equipment, violating the Anti-Kickback Statute.
• Upcoding and overbilling: Medical staff submit claims for more expensive procedures or longer hospital stays than actually provided.
• Pharmacy prescription fraud: Pharmacies submit Medicaid and Medicare claims for costly medications that aren't dispensed, or pay individuals to bring in prescriptions for fraudulent reimbursement.
• Unnecessary and harmful treatments: Allegations include performing excessive scans, therapy sessions, or inducing early medical procedures just to receive higher payments.
• Fake patient records and referrals: Falsifying documents or paying for patient leads to being billed for services not required or performed.
• Genetic and lab testing fraud: Ordering tests and equipment for patients who were never examined, all to maximize false claims.

Penalties for Federal Healthcare Fraud

Penalties for federal healthcare fraud can be incredibly devastating for any person. In fact, it can include years in federal prison, steep fines, asset forfeiture, restitution requirements, and exclusion from Medicare or Medicaid. Convictions often lead to sentence enhancements if the scheme targeted seniors, vulnerable patients, or involved significant financial loss.

Sigal Law Group's Defense Approach

Sigal Law Group challenges the evidence at every turn, scrutinizing billing practices, auditing patient records, and consulting medical experts.  Our attorneys distinguish clerical errors from intentional fraud, arguing for reduced charges or dismissal, and will leverage negotiation skills to secure settlements and protect professional licenses.

Experienced, thorough defense is essential in federal healthcare fraud cases. Contact our offices today for a free consultation.