One of the biggest mistakes people can make is witness tampering. Even innocent people want to have a coherent story, but that can look bad to investigators. An attorney will get witnesses together and will reveal the coherent story in an appropriate manner. If you do it yourself, it is a federal crime.
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View on GoogleThe False Claims Act
Under The False Claims Act, it is a federal offense to commit healthcare fraud. This fraud is defined as a health care provider knowingly and willingly filing false claims or defrauding a healthcare program. Many health care fraud charges under the False Claims Act deal with Medicare and Medicaid.
Anti-Kickback Statute
The Anti-Kickback statutes specify that it is illegal for medical professionals to “knowingly and willingly” accept bribes or remuneration for the referral of patients. This includes specifically targeting federal health care programs such as Medicare, Medicaid, and Tricare. Referrals are a significant aspect of the health care industry causing Anti-Kickback laws to place immense pressure on providers.
There are “safe harbors" or exceptions to the Anti-Kickback statutes, however, they require strict qualifications. A lapse in attention toward these qualifications could suddenly launch a criminal investigation. These investigations blanket individuals at all levels of the industry, independent of their involvement.
Why You Need A Defense Attorney
Health care fraud is an incredibly serious and complicated matter. While similar business practices may be acceptable in other fields, the healthcare industry is highly regulated and heavily scrutinized. If you have been contacted by federal investigators, you should contact an attorney right away.
Our Houston, TX, lawyers can help guide you through the complicated process and divert the serious criminal allegations that often follow a federal health care investigation by:
Building Your Case
Protecting Your Rights
Our healthcare fraud attorneys understand the intricacies of fraud law. When dealing with a conglomerate like the healthcare system, you will need someone in your corner who has the knowledge and experience to build your case and fight for your rights and freedom.
Limiting Client Exposure
The more information available, the stronger a case can be built. Therefore, it is important to have a lawyer who has the ability to digest what is alleged in detail in order to avoid and or limit the client’s exposure. Many times this translates to countless hours reviewing thousands of documents.
Lawyers You Can Trust To Protect Your Rights and Freedom
If you are a health care provider who has been accused of healthcare fraud, you need to hire an experienced, trusted attorney. Our attorneys Paul Doyle and Trevor Sharon have over ten years of experience practicing law. They understand what it takes to build a successful case to protect you and your freedom.
We offer free consultations for all our clients. During this consultation with our law firm, one of our lawyers will review the details of your case, be honest about their perceived outcome, and offer advice on the next steps.
If you have been charged with health care fraud, call our Houston, TX, law firm to request your free consultation.
(713) 228-9200
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"Despite the obstacles, Paul Doyle worked arduously and diligently resulting in my case being dismissed. I highly recommend Paul Doyle & Associates if you find yourself in need of an awesome Criminal Defense Attorney." Robby E. Alsbrooks, 5-Star Google Review
How Will I Know I'm Under Investigation?
Office Raid
One common way clients learn they are under investigation for fraud is when federal officials raid their place of work. Typically they will take documents and hold interviews, but make no arrests.
Medicare Audit
A medicare auditor could look into a group of your patients to see if the billed treatments and prescriptions were medically necessary. Anything fraudulent could lead to a loss of your Medicare or Medicaid number and prosecution.
Company Indictment
If a company that you have been working with has been indicted, it is possible they could find evidence that links you to their case and lead to you being under investigation.
The Importance of Having a Lawyer From the Start of a Medicare Fraud Case
Request Your Free Consultation
Paul Doyle is a former special crimes prosecutor who spent years investigating and winning fraud cases. He knows how the prosecution tries to obtain guilty verdicts for health care fraud – and how to fight against them. Call our law firm at (713) 228-9200 today.
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I have known Mr. Doyle for sometime now, and I can say without pause he is one of the best in Houston. Paul Mauro
A Conviction Can Destroy Your Career
The U.S. Department of Health and Human Services Office of Inspector General enforces the Exclusion Statute, which mandates severe punishments beyond financial penalties and prison time for anyone convicted of health care fraud.
If you are convicted of any of the offenses listed below, the Office of Inspector General has the right to exclude you from Federal health care programs, meaning any services or prescriptions you render will not be reimbursable through Medicare, Medicaid, or TRICARE, even if your services are billed indirectly through an employer or practice group.
- Medicare or Medicaid fraud
- Patient abuse or neglect
- Felony financial misconduct
- Felony convictions regarding controlled substances
Potential Defenses In Health Care Fraud Cases
Lack of Intent
A conviction for health care fraud requires the prosecution to prove that you had a clear intent to deceive insurance companies or government medical programs. We may be able to demonstrate that the actions that led to your charges were committed through honest mistakes or because of misunderstandings stemming from complex regulations or bad advice from colleagues.
Proof of Compliance
Some health care providers institute thorough compliance programs designed to ensure that they and their employees do not make any mistakes that may lead to health care fraud charges. If we can provide evidence of such a plan, we may be able to prove that you had no intention to commit fraud.
Records of Legitimate Services
You may be charged with fraud based upon false allegations of delivering health care services that were not really necessary. By conducting a thorough investigation of all available evidence, like medical records and bills, Mr. Doyle may be able to demonstrate that every service you rendered was legitimate and necessary. If applicable, he can hire a medical expert to attest to this fact.