Learning you've been accused of committing fraud on a federal or state healthcare program can be shocking. Before you realize it, your reputation is irreparably damaged. Your livelihood is on the line. Your freedom may even be in jeopardy. Given how seriously the government takes claims of healthcare fraud, it's important to take such allegations seriously. More than $60 billion of taxpayer funds are lost each year due to fraud. The government is throwing the book at defendants as a way to recoup those funds.
The term healthcare fraud can apply to a wide range of activities. Medicare fraud, for instance, may include double billing, phantom billing, excessive testing, pharmaceutical fraud, or inflating bills via upcoding.
Defense Strategies to Consider
There's no singular defense strategy that physicians accused of healthcare fraud can employ across the board. These cases are often won or lost based on the experience of the defense attorneys, experts, and the strength of the prosecution's case. Still, a proper investigation and passionate advocacy in the courtroom can shift the odds in favor of the defendant. When over-utilization or medical necessity is in question, defense experts are some of the most important witnesses. A thorough knowledge of Medicare guidelines and standards of care can also prove vital – our government frequently proffers guidelines and regulations that internally contradict one another in terms of utilization and billing.
Defense experts should be reliable, vetted, and knowledgeable enough to stand up to attacks on the stand. Retaining and preparing these experts should be a priority. Expert advice should be sought as early in the proceedings as possible. Character witnesses are also important. They can paint a picture of a law-abiding citizen wrongfully accused of fraud. Many individual defendants are facing first-time allegations of criminal wrongdoing. They are often upstanding citizens with strong reputations in their communities. Character witnesses can prove instrumental in defending against allegations of fraud.
The Importance of Compliance Plans
Perhaps the best form of defense against claims of healthcare fraud is a comprehensive compliance plan initiated before the alleged fraud occurred. Even the most careful healthcare providers are concerned about healthcare fraud accusations these days. A person may be charged with healthcare fraud even if they didn't know they were committing fraud. Creating a compliance plan can help you detect fraudulent behavior in your organization. Evidence of a compliance plan can be used as evidence that you lacked the intent necessary to engage in fraudulent practices.
Don't Face Allegations of Fraud Alone
While learning you're the subject of healthcare fraud allegations can be overwhelming, facing such accusations alone is never a good idea. With your entire career and livelihood on the line, you can't allow a misunderstanding to put your future in jeopardy. Don't take unnecessary risks with your reputation. Instead, turn to attorney Joseph D. Lento and the Lento Law Firm for support. Attorney Lento and his expert team have helped countless clients protect their good names and come out the other side of allegations unscathed. Every minute counts when such allegations are flying. Take control today – call the Lento Law Firm at (888) 535-3686 today to discuss your case and evaluate your options.
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