As healthcare fraud defense lawyers, we understand how frightening it is to be charged with medical billing fraud. If you are charged with medical billing fraud, an attorney from Westfall Sellers can help you defend and protect your name and your practice against these claims.
Medical billing fraud is a very serious allegation that can affect your reputation, your livelihood, and your medical practice. Proper negotiations done early on by your attorney are more likely to prevent these charges from affecting your life’s work, so contact a lawyer as soon as possible.
In the meantime, it’s important to know how you can be charged with billing fraud and the tactics attorneys can use to defend your case. Learn more about medical billing fraud, and contact a healthcare fraud defense lawyer at Westfall Sellers today.
Common examples of medical billing fraud
There are many types of abuse in medical billing, most relating to government healthcare programs like Medicaid. Here are the most common examples of billing fraud that our healthcare fraud defense attorneys see and deal with:
- Lack of medical necessity: Billing for services that are unnecessary
- Prescription fraud in Texas: Altering or writing unnecessary drug prescriptions
- Upcoding: Billing for services at a higher price
- Falsifying diagnoses for higher payments
- Double billing for medical services
- Services not rendered: Billing for medical services that were not performed or for items that were not provided
How can you be charged with medical billing fraud?
Medical providers can be charged with medical billing fraud if they are suspected of partaking in unethical medical billing practices that result in financial loss for the federal government (typically for healthcare benefit programs like Medicaid).
When someone suspects a medical provider of abuse in medical billing, another healthcare provider or any other individual can file a qui tam lawsuit under the False Claims Act (FAC) to punish the provider. This lawsuit is under the whistleblower law that rewards those who expose types of fraud against the federal government. Qui tam lawsuits can award the plaintiff up to 30% of the total money owed from the defendant, which gives these individuals an incentive to make the claims.
The penalties under the false claims act vary by case but can result in a loss of tens of thousands to millions of dollars in penalties. You may also face asset forfeiture, loss of your practice and medical license, and even jail time if convicted.
What a healthcare fraud defense lawyer can do for you
The reality is, the healthcare legal system is complex and difficult to navigate, even if you’re familiar with it. If you’ve been charged with medical billing fraud, you need someone in your corner fighting against the harsh penalties of healthcare fraud. Through gathering efficient evidence and analyzing every angle of your case, an attorney can help refute these claims against you.
If you are accused of committing medical billing fraud, your healthcare defense attorney may use the following defenses, depending on the particulars of your case:
- Lack of intent: The defendant did not knowingly or intentionally commit the fraudulent action(s).
- Consent from the victim: Provide documentation that the party accusing you of fraud consented to the medical steps you took to treat them.
- Insufficient evidence: If there’s not enough evidence to prove your intent beyond a reasonable doubt, then there’s no case against you.
These allegations, whether true or false, can be detrimental to your medical practice. You’ve worked so hard to build up a trustworthy reputation in the medical industry. Don’t let one potential misunderstanding tarnish your achievements. The second you think you’re being suspected of healthcare fraud, hire a healthcare fraud defense lawyer that you can trust as soon as possible.
Accused of Medical Billing Fraud? Contact a Westfall Sellers Attorney ASAP!
With years of experience defending clients against healthcare fraud accusations, a Dallas Health Care Fraud Lawyer from Westfall Sellers has the expertise and knowledge to provide you with quality representation against medical billing fraud accusations. Our attorneys have the specialized knowledge of healthcare statutes, provider guidelines, and more to handle these types of cases.
You only get one shot at defending your reputation and your medical practice. Contact our team online today or call us at 817-928-4222 to request a free consultation.
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