Written and edited by our team of expert legal content writers and reviewed and approved by Attorney Mark O’Mara
Orlando Healthcare Fraud Lawyer
When people come to us for criminal defense, it is usually during the worst time in their lives; they are worried, confused and stressed.
Content last updated on: March 22, 2024
Usually, these offenses involve doctors who either charge for services they don’t perform or perform unnecessary services, then they bill an insurance company or Medicaid. Frequently, federal or state prosecutors show little interest in private insurance healthcare fraud. Medicaid fraud is a different matter. Government prosecutors at both the state and federal levels are very interested in Medicare or Medicaid fraud. And, they have a small army of investigators and other foot soldiers to help them obtain convictions in these cases. These bureaucrats have little regard for individual rights.
In contrast, the dedicated Orlando healthcare fraud lawyers at the O’Mara Law Group stand up for your Constitutional rights and protect them from government overreach. Such overreaches are common in healthcare fraud cases. Prosecutors are often willing to take shortcuts to obtain convictions in these areas. Such shortcuts often include obtaining evidence illegally and withholding critical proof before trial.
Types of Healthcare Fraud
Fraud is an umbrella term for any deceptive scheme intended to enrich a doctor or other person at the expense of an insurance company or another entity. Some specific kinds of healthcare fraud include:
- Kickbacks: Private companies, as opposed to individual doctors, often perpetrate these frauds. It’s illegal to offer anything of value to a doctor in exchange for making a certain decision or pushing a certain product.
- Unnecessary Services: These frauds usually involve diagnostic and other tests. It’s often difficult to distinguish among things like ordering an unnecessary test, being overly cautious, and covering all the bases. Only the first act is illegal, although it’s very similar to the other two.
- Improper Prescription Drug Charges: Many pharmacies offer informal, in-store discounts to people who don’t have Medicaid or Medicare. But they bill the government for the full price. Federal laws require Medicare/Medicaid and non-Medicare/Medicaid customers to pay the same price.
- Non-Physician Services: Government and private insurance companies usually require doctors to perform certain examinations and other services. It’s illegal to delegate these tasks to nurses or patient care technicians. These charges only hold up in court if the doctor intended to save money. They may not apply if the doctor intended to save time.
- Upcoding: Medical coders translate physician services to certain insurance codes. Sometimes, these coders intentionally enter the wrong data to enrich the medical practice. But sometimes, they simply make mistakes.
The stakes are high in these cases. A healthcare fraud conviction could mean up to thirty years in prison. There are collateral consequences to consider as well. Healthcare fraud convictions often follow professionals for the rest of their careers.
Possible Resolutions
Usually, an Orlando healthcare fraud lawyer can arrange for pretrial diversion or deferred disposition in these cases. These dispositions address the direct and collateral consequences of a fraud case.
Pretrial diversion means that prosecutors dismiss the case if the defendant completes all program requirements. After a pretrial dismissal, defendants might be eligible for record expungement. The government either destroys all law enforcement and judicial records or returns them to the defendant. So, no one will ever know about the arrest or the case.
Deferred disposition involves completing a period of probation. After the judge dismisses the case at the end of the probationary period, record sealing might be an option. The arrest and court records are still available, but only a few people, mostly law enforcement and judicial officers, can view them. As far as anyone else is concerned, they don’t exist.
Connect with a Dedicated Orange County Lawyer
Fraud accusations do not necessarily lead to fraud convictions. For a confidential consultation with an experienced healthcare fraud attorney in Orlando, contact the O’Mara Law Group, Attorneys at Law. Convenient payment plans are available.
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Orlando, FL 32804
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