Medicare is a federally-administered health insurance program that provides medical benefits primarily to individuals who are retired. Healthcare providers who offer medical care to individuals with Medicare are responsible for filing claims for reimbursement from Medicare for the services that they provided. In some cases, however, medical providers or facilities knowingly overbill or fraudulently bill Medicare for services that it did not provide, or for services that it provide, but that were medically unnecessary. Another common form of Medicare fraud is for a medical provider to offer financial incentives for patient referrals in order to collect additional Medicare reimbursement funds.
When these situations occur, these individuals or entities could face Medicare fraud charges under federal law. Conviction on federal Medicare fraud charges could result in fines and up to ten years of imprisonment, or both. However, if the fraud results in serious bodily injury, the potential imprisonment increases to 20 years, and if the fraud results in death, the potential imprisonment increases to any number of years, or life in prison.
Additionally, making any sort of false statement or claim associated with Medicaid or Medicare can result in a five-year prison sentence and fines of as much as $250,000 per offense. An organization who makes a false statement or claim with respect to Medicaid or Medicare can be fined $500,00 per offense.
The federal government also has stepped up its prosecutions of Medicare fraud. In June of this year, a federal jury convicted two Texas nurses and one doctor of federal healthcare fraud and conspiracy to commit fraud from their home healthcare scheme, which is estimated to have netted them as much as $11.3 million. This is just one example of the increased prosecutions of these crimes by the federal government.
An experienced Texas white collar crime attorney can help build a strong defense against criminal charges, regardless of the type of criminal offense involved. Taking steps to get you released from incarceration and fight for your rights at the beginning of your case is typically easier than waiting until it may be too late to remedy your situation. Contact Peek & Toland at (512) 474-4445 today and see how we can help.