Healthcare Fraud

By definition, healthcare fraud is the intentional deception or misinterpretation of healthcare transactions for the purpose of financial gain or the use of unauthorized benefits. It may be committed by a healthcare provider, an employer or an individual. The consequences of a conviction of healthcare fraud could result in harsh penalties, even imprisonment.

Healthcare providers such as doctors, therapists, billing offices and others may be held accountable for healthcare fraud if they are involved in unorthodox processes when billing insurance companies. They can also be charged with fraud if they misrepresent themselves as healthcare providers or distribute unapproved medical devices and services to patients

Other acts that can be filed as healthcare fraud include:

  • Billing for services and procedures that were not provided
  • Billing for services not covered by changing the code
  • Billing for duplicate payments
  • Falsifying dates and types of services provided
  • Performing and billing for unnecessary services

An individual who is insured may face healthcare fraud charges if he pursues compensation for something which he believes he is covered for. Other acts that can be filed as healthcare fraud by individuals include:

  • Using someone else's insurance card
  • Filing for services not received
  • Forging bills or obtaining multiple prescriptions by going to various doctors

Employers may also find themselves facing healthcare fraud charges if they fail to properly enroll their employees in medical coverage plans. Other acts that can be filed as healthcare fraud by employers include:

  • Presenting a false picture of their group in order to obtain better coverage
  • Enrolling employees who are not eligible
  • Changing employee hire and termination dates to expand coverage dates

If you find yourself being accused of healthcare fraud, you need to obtain the services of a Los Angeles healthcare fraud attorney. Our attorneys can help resolve your case and reduce the likelihood of prosecution. Attorneys at the Joe Shemaria Law Firm can meet with your accusers' lawyers at each stage and explain any unsupported charges or violations. Our lawyers are able to resolve healthcare fraud cases satisfactorily and minimize many negative consequences. Call now for a free consultation.

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