Defending Against Accusations of Healthcare Fraud

Posted by Joseph D. Lento | Oct 21, 2022 | 0 Comments

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.

About the Author

Joseph D. Lento

"I pride myself on having heart and driving hard to get results!" Attorney Joseph D. Lento has unparalleled experience fighting for the futures of his professional clients nationwide. With unparalleled experience occupying several roles in the justice system outside of being an attorney, Joseph D. Lento can give you valuable behind-the-scenes insight as to what is happening during all phases of the legal process. In the courtroom and in life, attorney Joseph D. Lento stands up when the bell rings!


There are no comments for this post. Be the first and Add your Comment below.

Leave a Comment


Attorney Joseph D. Lento and the Lento Law Firm are committed to answering your questions about Physician License Defense, Nursing License Defense, Pharmacist License Defense, Psychologist and Psychiatrist License Defense, Dental License Defense, Chiropractic License Defense, Real Estate License Defense, Professional Counseling License Defense, and Other Professional Licenses law issues nationwide.
The Lento Law Firm will gladly discuss your case with you at your convenience. Contact us today to schedule an appointment.

This website was created only for general information purposes. It is not intended to be construed as legal advice for any situation. Only a direct consultation with a licensed Pennsylvania, New Jersey, and New York attorney can provide you with formal legal counsel based on the unique details surrounding your situation. The pages on this website may contain links and contact information for third party organizations - the Lento Law Firm does not necessarily endorse these organizations nor the materials contained on their website. In Pennsylvania, Attorney Joseph D. Lento represents clients throughout Pennsylvania's 67 counties, including, but not limited to Philadelphia, Allegheny, Berks, Bucks, Carbon, Chester, Dauphin, Delaware, Lancaster, Lehigh, Monroe, Montgomery, Northampton, Schuylkill, and York County. In New Jersey, attorney Joseph D. Lento represents clients throughout New Jersey's 21 counties: Atlantic, Bergen, Burlington, Camden, Cape May, Cumberland, Essex, Gloucester, Hudson, Hunterdon, Mercer, Middlesex, Monmouth, Morris, Ocean, Passaic, Salem, Somerset, Sussex, Union, and Warren County, In New York, Attorney Joseph D. Lento represents clients throughout New York's 62 counties. Outside of Pennsylvania, New Jersey, and New York, unless attorney Joseph D. Lento is admitted pro hac vice if needed, his assistance may not constitute legal advice or the practice of law. The decision to hire an attorney in Philadelphia, the Pennsylvania counties, New Jersey, New York, or nationwide should not be made solely on the strength of an advertisement. We invite you to contact the Lento Law Firm directly to inquire about our specific qualifications and experience. Communicating with the Lento Law Firm by email, phone, or fax does not create an attorney-client relationship. The Lento Law Firm will serve as your official legal counsel upon a formal agreement from both parties. Any information sent to the Lento Law Firm before an attorney-client relationship is made is done on a non-confidential basis.