Articles Posted in Fraud

In 2019, the nonprofit news service, ProPublica, published a story about health care fraud. The story, which included reporting about a Texas-based personal trainer, shows how easy it can be to bill health insurance providers for services despite lacking any legal basis for doing so.

Unfortunately, as the ProPublica report points out, there are some problems with the current health care billing system. The Medical License Verification Act would change that.

Obtaining a National Provider Identifier number

Just as in every state, people in Georgia utilize the USPS on a daily basis. While it is generally a very ordinary activity, sometimes the mail is used as a venue to facilitate a crime. Charges for mail fraud are very serious and a conviction can come with stiff financial penalties and prison time. But why might just a small aspect of crime be considered so seriously? 

According to the United States Postal Service, mail fraud is any kind of fraud that uses the mail. It does not matter whether it begins on the telephone, online or through the mail. Once any part of the commission of a crime goes through the mail system it is considered a federal offense known as mail fraud. The most common categories of mail fraud are financial, employment, telemarketing, sweepstakes, telemarketing and fraud against veterans or the elderly. 

In fact, The New York Times reported that mail fraud charges were included in a list of criminal charges in the recent college bribery admissions scandal involving actresses Lori Loughlin and Felicity Huffman. Fifty people were charged with various crimes in this complicated criminality. In addition to the television stars, others implicated were college consultants, parents and college athletic coaches. Although the sheer sum of money made bribery appear to be the most important aspect of the scandal, the list of criminal charges included conspiracy to commit mail fraud and honest services mail fraud. 

Issues of fraud most often arise from business transactions in Atlanta. Thus, if and when you find yourself in the position of acting as a broker or agent of another in such a transaction, you should be aware that your actions will be highly scrutinized by those who entrusted you with assets. Any losses (accompanied by your profits) may immediately be met with skepticism and accusations. Defending yourself from allegations of fraud requires that you understand how Georgia defines this offense. 

Section 16-8-3 of Georgia’s Code of Crimes and Offenses states that obtaining property by deceitful means or artful practice with the intention of depriving another of that property constitutes fraud. Notice the inclusion of the words “with the intention of.” Per the law, you cannot accidently commit fraud. Rather, you must have intended to secure a business partner’s property through your actions. 

Proving intent might seem difficult given that it is seemingly so subjective. Fortunately, the state has provided a well-defined explanation of what it views as intent. It includes: 

In any fraud case in Atlanta, the central issue may be the establishment of intent. Proving that one committed fraud may require establishing that they engaged in their actions knowing full well of that what they were doing was unlawful and likely to cause harm. Thus, those who perform any sort of financial service may want to maintain meticulous records as the review of such documents may go a long way in establishing that they might have been operating in good faith all along. Conversely, poor record keeping may be seen by some as evidence that one was wanting to conceal their actions from others. 

It was question about potentially falsified records that led authorities to investigate a Louisiana man who was recently arrested and accused of Medicaid fraud. Among the many businesses linked to the man was a transportation company targeted exclusively at Medicaid patients. Authorities say that the driving logs for this company were purposefully doctored and included forged signatures, which prompted the fraud charges being filed against the man and one of his employees. The man is also accused of falsifying his financial records so that he himself could qualify for Medicaid, even though him being a Medicaid service provider disqualified him from coverage. 

In some cases, evidence supporting the falsification of records may be clear. In others, there may be doubt. In such cases, being able to produce legitimate records proving one’s innocent intentions may be the key to escaping from having to face criminal charges. Having an experienced attorney on one’s side may also prove to be a benefit worth having during such a time. 

There are aspects of paying taxes that may reveal illegal activities, and if your tax return prompts questions, you could find yourself the subject of an IRS investigation. According to the IRS, the federal agency conducts investigations, not only into possible tax fraud, but also when there is a suspicion of money laundering and other fraudulent activities.

Your tax returns may not be the trigger of an investigation. The IRS also investigates based on information provided by the public, by law enforcement agencies and by U.S. Attorneys offices all over the country.

Before an official federal criminal investigation is launched, the agency requires certain steps to be taken. A special agent analyzes relevant information during a primary investigation. Next, the special agent’s supervisor evaluates the results of the preliminary investigation and approves or declines a further investigation. If approved, the information goes before the head of the office, who may then approve a criminal investigation.

If you are facing charges of mail fraud in Georgia, it is important you understand the seriousness of the crime. A conviction can result in harsh penalties such as fines and/or jail time, so it is imperative you get legal help right away. Because mail fraud is so broad, there may be some confusion, so it is good to take a look at what constitutes this type of fraud. 

According to FindLaw, mail fraud occurs when someone uses the postal system to send or receive documents or other correspondence that relates to fraudulent activity such as selling counterfeit items or conning others out of money. This fraud becomes a federal offense when the mail crosses from one state to another, and certain circumstances may result in up to 30 years in prison and/or up to $1 million in fines.

The United States Postal Inspection Service gives numerous examples of mail fraud. They fall into general categories such as: