Miami Medicare Fraud Defense lawyer
Fighting Federal Charges for Presenting False Medicare Claims
Medicare is a national insurance program that is administered by the U.S. federal government. It guarantees access to health insurance for Americans aged 65 and older and for younger Americans with disabilities.
Medicare fraud is a general term that refers to an individual or a corporation seeking to collect Medicare healthcare reimbursement under false pretenses. People commit Medicare fraud to illegally collect money from the Medicare program.
Medicare fraud typically involves:
- Phantom billing
- The act of billing for products and/or services that were never provided
- Patient billing, where the patient provides his or her patient number in exchange for kickbacks
- An upcoding scheme and unbundling, where bills are inflated using a billing code that indicates the patient needs expensive procedures
If you’re facing criminal charges for Medicare fraud, put The Law Offices of Joel DeFabio on your side. We can help you craft an effective defense and fight to protect your rights.
Medicare Fraud Penalties
Under Section 1128A of the Social Security Act [U.S.C §1320a-7a(a)], healthcare professionals—including organizations, agencies, and other entities—are prohibited from presenting claims for services that the individual or entity knew or should have known were not provided as claimed. This includes any person who engages in a pattern of presenting an item or service that is based on a code the person knows will result in a higher payment than the code that was applicable for the actual service provided.
Healthcare professionals and entities are prohibited from presenting a claim for a medical service that is false or fraudulent and from filing a claim for a service that was not medically necessary. The fines under this section can be severe. For example, any physician who knowingly accepts an overpayment and fails to report and return the overpayment is subject to civil penalties of up to $10,000 for each item or service or up to $50,000 for each false record or misrepresentation of material fact.
According to the American Medical Association, individuals who are convicted of a program-related crime or a felony offense related to healthcare fraud must be excluded from Medicare for a minimum of five years. If the offender has a prior conviction, the exclusion is for 10 years. If the offender has two prior convictions, the exclusion is permanent. However, with misdemeanor healthcare fraud offenses, exclusion is discretionary.
Call The Law Offices of Joel DeFabio Today
If you are a physician facing Medicare fraud charges, you cannot afford to forego a strong defense. We urge you to contact Attorney Joel DeFabio right away for aggressive legal representation. With more than 35 years of experience handling various forms of healthcare fraud, we can fight to protect your reputation and your ability to file Medicare claims.
Call our Miami Medicare fraud attorney at (305) 851-5581 today.
Joel was especially great. I was able to meet with him when I needed to and he called me all the time to give me an update. Really professional lawyer and team.- Emilia
I was represented by Mr. Joel DeFabio, and I am very satisfied with the courtesy and professionalism he provided. He is a very sensitive, clever and resourceful attorney. The staff is excellent as well. I am glad I found them. Excellent team in general, I highly recommend them.- Hilario
It was a pleasure working with Mr. DeFabio and his legal team. Remarkable work ethic and superior legal knowledge. It was a very pleasant experience having them on my team.- Former Client
CHARGES DISMISSED Aggravated Identity Theft
CHARGES DISMISSED Assault of a Federal Officer
ALL CHARGES WERE DISMISSED Charged with refusing to comply
NOT GUILTY Conspiracy
CHARGES DISMISSED Conspiracy to Commit Bank Fraud
NO JAIL Conspiracy to Commit Fraud