Health care providers are in a position of trust. Their patients trust that they will do what is best for them. There are a select few medical professionals in South Carolina who take advantage of various opportunities to make more money — opportunities that are questionable in nature or even illegal. Health care fraud is damaging to the medical profession, insurance providers and, most importantly, patients. The federal government does not treat this issue lightly, and neither should you if you find yourself charged with committing this type of fraud.
Those accused of health care fraud are often thought to be members of organized crime groups or are just health care providers who stand accused of being dishonest. There are also those facing charges for crimes they did not commit. It does not matter which of these situations applies to your case; the consequences if prosecuting attorneys achieve a conviction can be severe, so how you approach the situation matters.
Types of health care fraud
There are several types of health care fraud that are commonly seen. A few of them include:
- Upcoding
- Unbundling
- Falsifying diagnoses
- Accepting kickbacks
- Performing unnecessary procedures
- Billing for services not performed
- Changing billing codes for non-covered treatments
The list goes on. The point is any of the above will result in patients having to pay more or being put through unnecessary procedures. All of the above may also result in insurance paying for things it usually wouldn’t.
When accused…
If an insurance provider or patient has questioned your actions when it comes to treatment and billing and you are now facing federal charges because of it, the next steps you take can make or break your case. You have the right to defend yourself. How you go about doing so depends on a number of factors.
Fight, but don’t fight alone
When facing federal health care fraud charges, it is easy to roll over and accept whatever prosecuting attorneys have in store for you. You do not have to do that though. You can fight federal charges, and you do not have to fight alone.
With the right assistance, you can come up with a defense strategy that will help you achieve the best possible outcome. Working toward a case dismissal is always the goal, but if that is not possible, seeking a reduction in charges, alternative sentencing or pursuing a plea agreement may be possible.