In the ever-evolving landscape of healthcare, compliance with all relevant billing standards can prove to be an unending challenge for healthcare providers, especially those relying on benefit programs like Medicare, Medicaid, and Tricare. This compliance challenge often stems from myriad factors such as unclear regulations, frequent staff changes, and complex business relationships with other parties.
However, staying compliant is not just crucial, it’s obligatory. Breaches in billing practices can lead to severe consequences for healthcare professionals including physicians, pharmacists, and hospice operators. Penalties for billing fraud allegations are wide-ranging, from civil monetary penalties and exclusion from programs to the loss of licensure and even federal imprisonment.
As healthcare fraud enforcement remains a significant law enforcement objective, providers nationwide are dealing with investigations or worse. A large number of healthcare professionals are witnessing the repercussions of failing to adequately combat billing fraud allegations firsthand. Keep reading to learn more and then contact Chambers Law Firm at 714-760-4088 if you are facing this or other federal charges.
What is “Billing Fraud”?
When it comes to common allegations surrounding Medicare, Medicaid, and Tricare investigations, billing fraud is a broad term encompassing various breaches related to payment claims. These claims, submitted by healthcare providers to benefit programs, may be scrutinized under numerous laws. Predominantly, these breaches are pursued as civil or criminal offenses under the False Claims Act.
Potential Billing Fraud Charges
Key charges often levied during billing fraud investigations under these statutes include billing for kickbacks and referral fees, medically unnecessary treatments, non-allowable costs, and services, drugs, or equipment not provided. Further, charges may include billing for unlicensed or excluded services, making multiple reimbursement requests, failure to comply with payment conditions or secondary payer rules, unbundling services, up-coding, and using an incorrect billing code.
Contact a Federal Defense Attorney for Help
With such a wide array of potential allegations, it’s clear that if you’re facing accusations of insurance fraud or medical billing charges, expert legal assistance is crucial. The complexities of healthcare law and the severe implications of these charges necessitate the engagement of a knowledgeable and passionate attorney.
At Chambers Law Firm, we have extensive experience helping healthcare providers fight these charges. Our deep understanding of the intricacies of healthcare billing and fraud laws allows us to provide our clients with robust and comprehensive defense strategies. If you find yourself in the challenging position of facing fraud accusations, don’t hesitate to reach out to us at 714-760-4088 for a free consultation.
