Defending Against Accusations of Healthcare Fraud

 Posted on August 18, 2021 in Medical License Defense

The shutdowns of the COVID-19 pandemic resulted in multiple federal programs to help businesses and individuals survive financially. Some of these resources included the Economic Injury Disaster Loan program, Paycheck Protection Program, and the Pandemic Emergency Unemployment Compensation. Over the last several months, the U.S. Department of Justice (DOJ) has announced indictments of multiple cases of fraud against parties who allegedly benefitted from these programs illegally. Recently, the DOJ announced another area of pandemic fraud they will be targeting – healthcare fraud.

Multiple Indictments

The DOJ issued their warning to all healthcare providers across the country that submitting claims for COVID-19-related testing and healthcare services that are false could result in criminal charges. Over the past couple of months, the DOJ has filed criminal charges against more than a dozen people in multiple states for submitting false claims. The total amount of these alleged false claims totals more than $143 million. Some of the alleged criminal acts charged in these indictments include fake testing, money laundering, and wire fraud.

In one case, a medical doctor was one of the people charged in an alleged scheme involving COVID-19 testing for Medicare recipients. The doctor is alleged to have taken the personal information of individuals receiving COVID tests, along with blood or saliva samples, and submitted them to Medicare for unrelated, unnecessary, and expensive laboratory testing. Some of the conditions allegedly submitted falsely for testing included cancer, allergy testing, respiratory pathogen panel tests, and genetic testing.

The DOJ also charged multiple defendants with allegedly filing fraudulent claims to Medicare for sham telemedicine appointments that they say never occurred. Some of these cases also include accusations of paid bribes for the medical professional’s referral of diagnostic testing that was unnecessary.

Accusations of Submitting False Claims

It is a well-known fact of people working in the healthcare field how complicated and confusing medical billing can be, with all the different abbreviations and codes. Billing mistakes can and do happen. Billing errors can cause headaches for the medical provider, however, there is a major difference between billing errors and healthcare fraud. Billing for services never received is deemed healthcare fraud because there is an “intent” to defraud the insurance provider.

A criminal conviction of healthcare fraud not only can mean a loss of the defendant’s medical license, but a conviction for filing false claims with Medicare or Medicaid can also mean up to five years in prison and hefty fines.  

Contact an Illinois Medical License Defense Attorney

If you are a medical provider who is currently being investigated or have been accused of healthcare fraud, do not delay contacting a skilled Illinois medical license defense lawyer to defend you against these charges. These accusations could have a significant impact not only on your practice, but also on your future. Call The Law Offices of Joseph J. Bogdan, Inc. at 630-310-1267 to schedule a free and confidential consultation.

Source:

https://www.justice.gov/opa/pr/doj-announces-coordinated-law-enforcement-action-combat-health-care-fraud-related-covid-19