Healthcare Fraud Charges
Healthcare fraud is a crime involving the intentional submission of false or misleading information to healthcare providers, insurers, or government healthcare programs to obtain unauthorized financial gain.
Common examples include billing for services not rendered, upcoding (charging for more expensive procedures), and accepting kickbacks for patient referrals.
Federal statutes governing health care fraud include the False Claims Act (31 U.S.C. §§ 3729-3733), the Anti-Kickback Statute (42 U.S.C. § 1320a-7b), and the Health care Fraud Statute (18 U.S.C. § 1347).
As a defendant facing healthcare fraud charges, it is essential to understand these statutes and their implications.
Healthcare Fraud Investigations
These agencies work together to identify and prosecute health care fraud, using various tools and techniques:
- Reviewing billing records, patient charts, and electronic medical records.
- Conducting interviews with patients, employees, and other witnesses.
- Utilizing undercover operations, such as “sting” operations, to gather evidence.
Healthcare Fraud Sentencing
The U.S. Sentencing Guidelines provide a framework for determining appropriate punishments for healthcare fraud offenses.
Factors influencing sentencing include the nature and extent of the fraudulent scheme, the financial loss incurred, and the defendant’s criminal history.
Health care fraud convictions can result in severe penalties, including imprisonment, fines, and restitution.
Under 18 U.S.C. § 1347, the maximum prison sentence for health care fraud is ten years.
However, if serious bodily injury or death results from the fraudulent conduct, the maximum prison sentence increases to 20 years or life, respectively.
Fines can range up to $250,000 for individuals or $500,000 for organizations.
Navigating the complexities of a healthcare fraud case is challenging.
Engaging the services of Wall Street Prison Consultants can be crucial in understanding the legal process, the ramifications of going to trial versus taking a plea, and exploring early release options or sentence reductions.
With their expertise, they can help prepare for sentencing hearings and guide you in understanding what you are facing.
By partnering with Wall Street Prison Consultants, you can work towards the best possible outcome in your healthcare fraud case.