If you are a health care provider or a patient who has been accused of Medicare/Medicaid fraud for phantom billing, you face serious criminal charges and penalties. However, just because you face charges in the New York City metro area does not mean that you do not have options.
Phantom billing
Phantom billing is a type of health care fraud that involves submitting false or inflated claims to Medicare/Medicaid for services or supplies that were never provided, were not necessary or were more expensive than what was actually delivered. Phantom billing can also involve billing for patients who do not exist, using stolen or forged Medicare/Medicaid numbers or paying kickbacks to patients or other providers to participate in the scheme.
Federal offense with local consequences
Medicare/Medicaid fraud is a federal offense that can result in fines, restitution, exclusion from federal healthcare programs and imprisonment. In addition, you may face civil lawsuits from the government or private insurers who were defrauded, as well as professional sanctions from your licensing board or employer. The government has dedicated significant resources and agencies to investigate and prosecute health care fraud cases, such as the Health Care Fraud Prevention and Enforcement Action Team, the Medicare Fraud Strike Force and the Office of the Inspector General.
Take the charges seriously
If you are under investigation or have been charged with Medicare/Medicaid fraud for phantom billing, you need to act quickly and begin crafting your defense immediately. This defense includes challenging the evidence against you, negotiating with the prosecutors and preparing a strong defense strategy for your case. However, you may need an attorney.
Defenses
First, you can show that you did not act with fraudulent intent or knowingly submit false claims. You can also prove that you provided the services or supplies that you billed for or demonstrate that you followed the Medicare/Medicaid rules and regulations. You can also dispute the amount or value of the alleged fraud, seek a reduction or dismissal of the charges or arrange a plea bargain or a pretrial diversion program. It is important to advocate for a lenient sentence or an alternative to incarceration and provide justification.
Medicare/Medicaid fraud for phantom billing is a serious allegation that can have devastating consequences for your personal and professional life. You should not take any chances with your future and freedom.