Health Care Fraud

Health care fraud is a serious criminal offense, and the Health Insurance Portability and Accountability Act of 1996 makes it a federal crime, punishable by up to 10 years in prison. If you are the target of an investigation or have been charged, you need a skilled criminal defense lawyer in your corner.

We represent health care practitioners, including doctors, nurse practitioners, counselors, speech pathologists, therapists and other professionals, as well as clinics, hospitals, providers of durable medical equipment and billing companies facing criminal issues with the federal government related to:

• Overbilling for services
• Billing for services or tests not performed
• Altering medical records or reports in order to increase reimbursement
• Referral kickbacks
• Prescribing unnecessary or additional services, prescriptions, durable medical equipment, genetic testing, and other items in order to bill more or receive kickbacks
• Incorrectly reporting diagnoses, treatments or procedures to increase payments
• Unbundling billed services
• Knowingly using false billing codes or “upcoding”
• Submitting duplicate claims, either purposefully (to attempt to obtain duplicate payment), or accidentally (this raises questions of poor recordkeeping)
• Changing dates, services or names of patients on claims
• Billing for clients in the hospital, hospice, or unable to receive services

We also represent individual members of health care plans facing criminal issues such as:

• Submitting false information on applications or for medical services
• Forging prescriptions
• Making false claims

We have a track record of success in federal court, and know what it takes to battle even the toughest prosecutors. Through each step of the process, whether through investigation, negotiation or trials, our attorneys fight for our clients and ensure that their best interests inform our strategies. No two clients are the same, which is why your defense should be customized to your situation.

Health care fraud can be investigated by many different agencies including the FBI, the state Attorney General’s office, U.S. Postal Service Investigators or the federal Office of the Inspector General. No matter what department is investigating your case, the allegations can lead to harsh punishments. Our expertise and professionalism ensure you receive the best possible resolution.

Whether for the allegations relate to billing, medical records, testing or prescription fraud, you could be facing up to 10 years in prison, heavy fines and restitution, job loss, an encumbered license, and a permanently damaged reputation. A criminal record will affect every aspect of your life and the reputation you’ve worked hard to build.

We take the time to understand how you got in this position, and we are prepared to help you resolve it reasonably and in your best interests. We are defense advocates, and we go to work for you right away.

Contact us today at (404) 816-5000 to speak with a lawyer who is fully capable of handling complex health care fraud issues. All conversations are confidential.