HealthCare & Insurance Fraud Charges Defense in Houston, TX

A Healthcare and Insurance Fraud Charges Defense Attorney
in Texas Can Help You

The issue of healthcare fraud has received significant publicity become a popular one and is often in the public eye as the topic of media coverage. Because healthcare fraud costs the U.S. government nearly $68 billion annually, anti-fraud agencies are more active than ever and are eager to catch perpetrators in the act. That is just one reason why, if you’ve been charged with healthcare fraud, you need to get the best legal representation you can find, and you need to do it right away. It is crucial that you find an attorney to defend you who is familiar with the many complex laws that regulate healthcare fraud and who understands the workings of the federal local court systems. Penalties for healthcare fraud are harsh and having such a charge on your record can be very damaging professionally as well.

HealthCare Fraud Charges Defense - Insurance Fraud Defense

The False Claims Act

The False Claims Act was first made law in 1863 and was often referred to as the “Lincoln Law” because fraud was common at the time, which was during the Civil War. This law was expanded in 1986, and then later, during the 1990’s, it also began to apply to healthcare in the U.S. Provisions were also made for financial rewards, called Qui Tam bounties, to be paid to those who helped uncover healthcare fraud by exposing fraudulent behavior to agencies like the Centers for Medicare and Medicaid Services, or CMS. Common types of healthcare fraud that are penalized under the False Claims Act are claims made for healthcare services that were never given or exaggerated claims for the costs of various services. Penalties for healthcare fraud are severe and can often involve thousands of dollars in fines and many years of imprisonment.

Billing and Prescription Fraud

In the medical billing world, patients and insurance companies are billed for services by using an international coding system that summarizes the services being billed for in a type of specialized code. One type of billing fraud that is not uncommon is called “upcoding.” This means that the biller or coder writes code for the service that is a code for a service that is more expensive than the one that was actually rendered and submits the higher paying code for reimbursement. Billing also happens for services that were never given, and unfortunately, this happens a lot in home care and hospice services. Billing has even occurred for services provided to patients who do not exist or who may have died long ago, which is another type of fraudulent billing that is does often investigated happens in this system.

Fraud also occurs in the area of prescriptions and filling of prescription drugs. There have been cases in which providers have prescribed narcotics in larger amounts than needed so that they can later be sold on the street at a higher price. All of these types of fraud carry serious penalties and can result in the loss of a professional license.

Examples of Insurance Fraud

There are many examples of insurance fraud, limited only by the creativity of the perpetrators. Insurance fraud is rampant in the field of health care, and it is unfortunately not uncommon for insurance companies and for Medicare and Medicaid to be billed for procedures or services that were never actually given to a patient, or for the cost of these services to be exaggerated on a claim. Insurance fraud also occurs in matters of property ownership. For example, the owner of a failing business may, on one night decide to illegally set fire to the business that he owns, to collect an insurance payment for the property. Penalties for insurance fraud may be misdemeanors or felonies, but when the crime involves significant amounts of much money or the intentional destruction of property, it is usually a felony and can have very severe penalties.

Call to Schedule a Consultation with a Healthcare Fraud Charges Defense Attorney in Houston, Texas Today

If you’ve been charged with any type of healthcare fraud or are suspected being investigated for of any actions related to fraud in the healthcare system, you will want to call to schedule a consultation with a healthcare fraud charges defense attorney in Houston, Texas today. The legal professionals at the Law Office of Mervyn M. Mosbacker, Jr. are dedicated to thoroughly investigating your case to deliver the best defense possible. We serve Houston and all the surrounding communities, and we are eager to help you. Call us at 713-526-2246 to schedule a free initial consultation and let us be your legal advocates.