How physicians can avoid Medicare fraud charges

| Jul 31, 2020 | Criminal Defense |

Medicare provides a means by which older residents in South Carolina can procure a significant amount of health care coverage. Unfortunately, cases of health care fraud reveal that not every claim is legitimate. Some health care providers may deliberately commit fraud while others accidentally wander into it. Learning how to avoid critical mistakes becomes vital.

Poor billing practices and improper accounting can lead a physician into a fraud investigation. Many legitimate cases of Medicare fraud have involved billing patients for services never rendered. When the health care facility’s records aren’t reliably maintained, the perception of fraud may arise. The accused must then mount a defense to prove that sloppiness is the issue and not fraud.

Another common error involves billing after a license expires. Unfortunately, when avoidable errors occur, violations of the law might exist. Therefore, it becomes necessary to make sure every step follows appropriate rules. Poor oversight could create legal nightmares.

Poor supervision might also get physicians in trouble. Did the doctor supervise via telemedicine? If so, how does this impact Medicare billing? Alternatively, did the doctor appropriately supervise the care of a patient but failed to log performance effectively? Becoming too casual with proper documentation could lead to legal consequences.

Did the patient receive his or her medication? If not, then Medicare shouldn’t receive a bill for the prescriptions. Errors can occur where Medicare gets billed, and this type of faulty billing may lead a physician into a fraud claim.

Meeting with a criminal defense attorney might prove helpful when an individual is accused of health care fraud. An attorney may explain what is necessary to prove fraud beyond a reasonable doubt and then discuss defense tactics. If no fraud exists, an attorney may seek a dismissal. In other cases, the attorney might work a plea bargain deal. Doing so may lead to a lesser sentence on reduced charges.