When an individual, health care provider or company defrauds the federal government, insurers, or state or federal aid programs such as New York Medicaid, they have committed health care fraud. Persons convicted can receive years in prison with costly fines.
Federal agencies such as the FBI, which has jurisdiction over federal and private insurance programs, work with the DEA, the Internal Revenue Service Criminal Investigation Unit and state agencies such as Medicaid Fraud Control to prioritize health care fraud crimes. However, everyone is innocent until proven guilty in a court of law. If you have been indicted on a health care fraud charge, knowing your rights can help you defend against the charges.
Responding to a health care fraud indictment
A health care fraud indictment is severe and can be frightening, but the wisest decision is to listen carefully to what’s alleged and remain silent despite your desire to plead your case. You should know your rights, ask questions and gather evidence. You have the right to be represented by counsel.
Health care fraud indictments consist of money laundering, bribery, obstruction of justice and any combination of other charges. You can be charged as a co-conspirator by inadvertently signing medical documents. Ignorance of the law is no excuse, and the rulings can be harsh in these cases.
Indictable health care fraud examples
Health care fraud can range from improper billing to over-prescribing medications. You can be a coding specialist, nurse, records manager or physician and be charged with a health care crime. Ordering inappropriate or unnecessary labs and testing are also examples of health care fraud.
Always be vigilant when handling health care information. If you are accused of fraud, you have the right to mount a defense.