January 25, 2017
Did you know that over the last three years, the government has recovered almost $11 Billion from health care fraud investigations? When the Affordable Care Act was passed, the following changes drastically enhanced the government’s ability to punish and combat health care fraud:
- Increased penalties for federal offenders by 20-50 percent
- Enhanced screening for high risk abusers, including site visits
- Use of advanced predictive modeling technology to identify potential areas of fraud
- Increased funding over the next ten years specifically to combat health care fraud
Types of Health Care Fraud
Health care fraud occurs at various stages in the insurance process, and you may not be aware that you have been caught in a fraudulent scheme. If you are a healthcare provider, such as a doctor, nurse, or healthcare facility, it is considered fraud if you do any of the following:
- Bill for services not rendered
- Change billing codes to receive payment
- Change dates or the location of services to receive payment
- Misrepresent which provider rendered medical services
- Waive a deductible and/or co-payment
Occasionally, providers and billing companies may actually be trying to help a patient by changing certain key information in order to ensure his or her insurance will cover the services rendered. For example, if you have an insurance plan that does not take effect for two weeks, but you fall ill and end up at the hospital, rather than stick you with a substantial medical bill the hospital may indicate to the insurance company that your visit did not occur until a date after your insurance took effect. Although this is considered health care fraud, do not let the weight of the law crush you for your otherwise noble intentions.
Contact an Experienced Florida Health Care Fraud Attorney for More Information
If you have been blindsided by charges of health care fraud, either in Florida’s state or federal courts, be sure to contact a law firm that understands the complex motivations underlying the charges. Further, it is important to contact a firm familiar with the recent changes to the nation’s health care law and equipped with the resources to fight for you. The Khonsari Law Group has spent years serving as white-collar defense attorneys in the St. Petersburg and greater Tampa Bay area. If you have been charged with a health care related offense, contact them today for a FREE, no-risk consultation at (727) 269-5300.
1 https://www.justice.gov/criminal/criminal-fraud/2021-national-health-care-fraud-enforcement-action