Health Care Fraud

Health Care Fraud

If you have been charged with health care fraud, you will want to contact a New Jersey health care fraud defense attorney. The penalties for health care fraud can be very severe. However, this crime may be difficult to prove and your attorney can help explain your defenses and options.

Types of Health Care Fraud

There are many types of health care fraud that a New Jersey health care fraud defense attorney can explain to you. Some common types include:

  • Physician. Fraud committed by a physician can include submitting bills for services that were not provided, seeking compensation for uncovered services and seeking kickbacks for referrals.
  • Patients. Fraud committed by a patient can include obtaining prescription drugs for illegal or recreational purposes, seeking false reimbursements and forging medical documents.
  • Hospital. Hospitals may engage in fraud by not using proper staff, performing unnecessary services and submitting inaccurate claims.

False Claims Act

One key federal law related to health care fraud is the False Claims Act. This act makes it illegal to submit false claims to the government. Your attorney can explain that to prove this claim, federal prosecutors will generally have to show:

  • Intent. A person must have had the intent and knowledge to engage in fraud. So a simple mistake would not be considered a federal crime.
  • Claim Made. A person must have taken an affirmative step by submitting an actual claim to the federal government.
  • Misrepresentation. A person’s misrepresentation must have been material, meaning that it influenced the government to take some act.

Sentencing and Penalties for Health Care Fraud

The penalties for health care fraud can be very severe:

  • Prison. A person could face up to 20 years or more in federal prison for the most severe health care fraud cases. In addition, there are other sentencing guidelines depending upon who the person allegedly defrauded, e.g. Medicaid and Medicare.
  • Fines. If a person is accused of engaging in an ongoing health care fraud scheme, they could face monetary penalties in the millions of dollars.
  • Restitution. If the person allegedly benefited from the fraud, they may be ordered to pay back the amount that allegedly was improperly obtained.

Contact a New Jersey Health Care Fraud Defense Lawyer

If you are facing such charges, contact experienced New Jersey health care fraud defense attorney, Tim Anderson, by calling 732-212-2812.