Medicaid/Medicare Fraud Lawyer Denver, CO
Healthcare Fraud Defense Lawyer in Colorado
Medicare and Medicaid fraud are very serious issues both on a statewide
and federal level. Both forms of fraud are considered
white collar crimes and charges may be lodged against consumers or providers of services.
Medicare fraud was determined to cost taxpayers approximately $60 billion
or about 10 percent of the annual budgeted amount while Medicaid fraud
is estimated to cost about $14.4 billion or nearly five percent of the
budgeted amount. Since the
Affordable Care Act was enacted and government healthcare coverage costs increased, a large
increase in healthcare fraud has occurred.
If you are facing charges for government medical insurance fraud, call
a Medicare or Medicaid fraud defense attorney at
(720) 548-2990 right away.
Who Can Face Medicaid & Medicare Fraud Charges in Colorado?
As previously stated, both beneficiaries and providers can face charges
of insurance fraud. Whether you are a medical care provider such as a
physician, nurse, or medical billing employee; or you are a patient charged
with fraud, you need to hire a Denver healthcare fraud lawyer immediately.
Some of the common reasons a provider can face charges are:
Overbilling of Services – providers who have not performed services and have billed for
them could face charges of fraud. These charges are very serious as they
could ultimately result in the provider being banned from receiving any
type of payment from these programs. False diagnosis is also another common
way providers have defrauded Medicaid and Medicare.
Violation of Stark and Anti-Kickback Laws – providers are strictly prohibited from referring patients to other
providers in return for any type of financial gain. This includes referrals
for any type of services including laboratory work, physical therapy,
second opinions, etc. All types of providers and medical billing companies
are bound by these rules.
Up Billing Patients – when a hospital, physician’s office or a billing company
improperly codes procedures or they bill services individually when they
are offered as a “bundle”. All submissions for reimbursement
must be properly coded and if a pattern of abuse is discovered the provider
could face fraud charges.
Beneficiaries of Medicare or Medicaid are not exempt from charges of fraud.
Some of the ways beneficiaries can defraud the system include:
Falsifying Application Information – understating income, overstating household size and hiding assets
have all been ways that beneficiaries have qualified for assistance under
these programs. Should they be discovered, they may be barred from receiving
these benefits as well as other federal or state benefits.
Improper Use of Medical Insurance – beneficiaries have been found guilty of allowing a non-eligible
person to use their insurance card for the purposes of obtaining services.
Doing so violates the law and also will result in the eligible beneficiary
losing their coverage.
Tampering With Receipts and Bills – beneficiaries who tamper with properly issued bills or receipts in order
to increase the amount they may be entitled to be reimbursed are violating
both state and federal laws and will face harsh penalties including the
loss of coverage.
Penalties for Consumer Medicaid & Medicare Fraud in Colorado
Insurance fraud laws in Colorado have been strengthened due to numerous
legislative changes. While providers may face state or federal charges,
in nearly all cases, Colorado counties handle the prosecution of insurance
fraud by consumers.
On a county and state level, beneficiaries could face up to one year in
jail, be required to pay steep fines and be prohibited from participating
in these programs permanently. Depending on the amount of benefits obtained
fraudulently, you could be facing Class 5 felony charges and face serious
jail time and probation for as long as 12 years. In addition, you will
have to deal with having a life-long felony record.
Medicare & Medicaid Provider Fraud Penalties
Provider fraud is handled far more harshly; providers will no longer be
able to get any reimbursements from either program if they are found guilty.
Generally, the charges are investigated and enforced by the US Department
of Justice, the Department of Health and Human Services and the Office
of the Inspector General. In addition to losing the right to bill any
further services to these programs, the person who is convicted of fraud
will also face a minimum of five years in federal prison, and fines ranging
from $250,000 to more than $1 million.
If you are a provider charged with fraud, call our Medicaid and Medicare
fraud lawyers right away so that we can start building your defense. It
is crucial to your case that you do not incriminate yourself by speaking
with investigators without an attorney.
Contact Denver Medicaid & Medicare Insurance Fraud Defense Attorney
Since Medicare and Medicaid fraud is normally only charged after an extensive
investigation, you will probably learn about your charge long before an
indictment can be filed against you. You need a Denver healthcare fraud
defense lawyer on your side ASAP if you are under investigation. The sooner
we get involved, the better the chances are that we can prevent an indictment
or when we are unable to stop the indictment, can better prepare your defense.
If you find you are under investigation for any insurance-related fraud charges,
contact the Law Office of Kevin Cahill at
(720) 548-2990 immediately.