Health care fraud is most commonly charged when the government believes a health care provider has intentionally deceived or misrepresented medical claims to the government. Healthcare law is complicated and puts a burden on medical providers to navigate a tremendous amount of law in order to navigate both criminal and civil charges for fraud, kickbacks, referrals, and false claims. Running afoul of any of these laws can result in prison, loss of a medical license, and even prison.
Most often, the charges involve a healthcare provider allegedly charging for goods or services that in actuality were not provided or were not medically necessary. Cases often rely on false bills submitted to Medicare, Medicaid, or private insurance companies.
Contact a Colorado criminal defense lawyer representing clients in Denver, CO today to schedule your initial consultation.
Cases Commonly Include the Following Federal Statutes:
- Criminal Health Care Fraud (18 U.S.C. § 1347)– This statute is charged when the government is able to show the defendant knowingly executed a scheme to defraud a health care benefit program, or used false statements to obtain funds held by federal health care programs (Medicare, Medicaid).
- Anti-Kickback Statute (42 U.S.C. § 1320a-7b)– This statute is charged when the government is able to show the defendant knowingly offered or received anything of value and induced or rewarded referral of Medicare or Medicaid business.
- False Claims Act (18 U.S.C. § 287)– This statute is charged when the government is able to show the defendant knowingly made a claim or statement to get the government to pay money on a claim, and that the claim or statement was false or fraudulent.
- Health Care Fraud Conspiracy (18 U.S.C. § 1349)– This statute is charged when the government is able to prove two or more people agreed to a common plan or scheme, and the defendant knew the unlawful purpose, and joined willingly with the intent to further the unlawful purpose.
- Wire and Mail Fraud (18 U.S.C. § 1341, 18 U.S.C. § 1343) – This statute is charged when the government is able to show there is a scheme to defraud, and that U.S. mail was used in the scheme or interstate telephone or electronic communications were used to further the scheme.
If you would like to schedule an initial consultation, contact a Colorado criminal defense attorney, we represent clients in Denver, Colorado, and the surrounding area. The Savela Law Firm, P.C. Give us a call at (720) 821-1001 or complete our inquiry form.
Health care fraud cases can be defended. The cases require the government to prove intent, that the defendant intended to defraud the government or a private insurance company. If the act was done by accident then there cannot be a conviction. Nor can be you be convicted if the alleged victim in the case consented to the action. In addition to the absence of intent and consent, federal health care law provides “safe harbor” provisions for several equipment rentals, personal services, practice sales, recruitments, insurance subsidies, and in other instances.
If you have been charged with healthcare fraud a skilled Denver healthcare fraud defense attorney is essential. Get in touch with experienced Denver healthcare fraud defense attorney Jason Savela by calling (720) 821-1001.