There has been a significant rise in healthcare fraud cases in the last five years, receiving increased attention from the federal government and prosecutors. According to the Federal Bureau of Investigation (FBI), tens of billions of dollars are stolen due to healthcare fraud every year. Fraudulent schemes can occur in one of many ways. The most typical kind occurs when doctors or health professionals receive more money by lying to insurance companies about false medical procedures.
Healthcare Fraud can be divided by the following:
- Employer Healthcare Fraud
- Creating fake health insurance companies or employee benefit plans
- Falsifying the hire or termination dates to expand coverage dates
- Enrolling ineligible employees for health care coverage
- Insured Member Healthcare Fraud
- Use of false information on health program applications
- Filing claims for services, treatment, medication not received
- Use of another person’s coverage or insurance to acquire services
- Provider (Doctors and Therapists) Healthcare Fraud
- Billing for services not provided
- Doubling billing
- Fabricating dates, description of services, or identities of members or providers
- Distributing non-approved drugs or devices
- Maximizing payment by reporting intentionally incorrect diagnoses or procedures
- Medical equipment fraud
- Failure to oversee unlicensed personnel
Arizona and Federal Healthcare Fraud Violation Penalties
Healthcare fraud is classified as a white-collar crime which involves the filing of falsified healthcare claims in order to make a profit. Due to the aggressive response by the U.S. government, what were once observed as simple billing errors are now regarded as fraud. Federal law provides for both criminal and civil penalties for health care fraud. While civil penalties only require restitution to be paid, state and federal criminal charges can lead to significant consequences.
These Federal penalties include the following:
- Lying in regard to Medicaid or Medicare claims is punishable by five years in prison per offense.
- Federal healthcare fraud is punishable by a 10-year prison sentence per offense.
- Healthcare fraud causing serious bodily injury is punishable by 20 years in prison.
- Healthcare fraud causing death carries a possible life sentence.
- Lying in regard to Medicaid or Medicare claims can carry a fine up to $250,000 per offense (singular offender), or up to $500,000 per offense (organization).
- Organizations that commit ongoing fraud can face fines in the millions or even billions of dollars.
Get Started With a Confidential Case Evaluation
If you are being investigated or have been charged with healthcare fraud, it is imperative that you speak with a Phoenix criminal defense attorney. Our founder, Jason Lamm, has more than 20 years of legal experience and has an exceptional track record in successfully defending his clients. He is prepared to conduct a thorough investigation in order to develop the most solid defense strategy on your behalf.
Our Clients Share Their Experiences
"We just prevailed in an important hearing, all thanks to Jason Lamm. Jason gets it - this is your life, and it's as important to him that you prevail in your case as it is to you."
"Thanks to Superman, Jason D. Lamm, I see the light in the darkness around me. There are no words available in English to describe how pungent, brilliant, and tactical Jason is. When anyone is in a situation where it appears that there is no hope, no avenue"
"He was very knowledgeable, upfront, and direct about the things that might come up and about the things that did come up. However, he always took the time to explain things thoroughly in a way that I could understand since I am not familiar with the langua"
You Have Questions, We Have Answers
Watch Jason D. Lamm in Action
Thousands of Cases Successfully Handled
Insight From a Former Major Felony Prosecutor
Relentless Investigation and Access to Resources
Committed to Obtaining Real Results for Clients
Aggressive and Personalized Defense Strategies
Over Two Decades of Proven Legal Experience