Written and edited by our team of expert legal content writers and reviewed and approved by Attorney Mark O’Mara
Orlando Federal 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
The United States healthcare system is not really a “system” at all. Instead, it is a loosely-connected chain of healthcare providers, medication and device suppliers, and insurance companies. Because the bureaucracy is so huge, Medicaid fraud is one of the most common types of cases. But there are many types of healthcare fraud, as outlined below. But they all have a few things in common, such as the provision of false information with the intent to deprive another person or entity of services or property.
The dedicated Orlando healthcare fraud lawyers at the O’Mara Law Group are committed to upholding your individual rights when aggressive police and prosecutors encroach on them. Our passion fuels our purpose. Because we believe in your rights so fervently, we do what it takes to protect them in court. That means building a strong defense and never taking the quick or easy way out. All the while, we proactively communicate with you, so you are never in the dark.
Types of Federal Healthcare Fraud
Federal law defines a healthcare fraudster as someone who “knowingly, and willfully executes or attempts to execute a scheme…to defraud any healthcare benefit program or to obtain by means of false or fraudulent pretenses, representations, or promises any of the money or property owned by…any healthcare benefit program.” Some specific types of healthcare fraud include:
- Incorrect CPT Codes: Some providers intentionally use the wrong Current Procedural Terminology codes to increase their reimbursements. But in many situations, the miscoding is an error. Not all medical procedures have accompanying CPT codes, so providers must use their best guesses. When they do so, they usually give themselves the benefit of the doubt.
- False Medical Records: This form of healthcare fraud is almost as common. As is the case with errant CPT codes, the intent element is often missing here. Most doctors reconstruct at least part of their charts from memory. Additionally, when these charts go to records clerks, information often gets lost in translation.
- Unnecessary Services: Occasionally, doctors provide services that are clearly unnecessary. Other times, however, doctors are overly-cautious, so they perform tests and other procedures which might not be necessary as far as prosecutors are concerned. This behavior is especially common in jurisdictions, like Florida, which have high medical malpractice litigation rates.
Other healthcare fraud cases include charging for services not provided and falsifying patient treatment and medical histories to support controversial charges.
How an Orlando Federal Healthcare Fraud Lawyer Can Help
Most people know about the strong advocacy that attorneys provide defendants. Many people overlook the advice these professionals give. Both contributions are equally important, and only experienced fraud attorneys can offer both.
As outlined above, healthcare fraud prosecutions have many elements and are difficult to prove in court. That’s especially true because the burden of proof, beyond any reasonable doubt, is so high in criminal cases. The best advocates identify weak spots and use them to undermine the prosecutor’s case.
The advice in a criminal case includes legal and nonlegal advice. Legal advice about your options helps you make the best possible choices. Nonlegal advice about the process helps take the fear out of these cases and reduce your stress level.
Reach Out to a Tough 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. Virtual, home, and after-hours visits are available.
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Our Orlando Office
221 NE Ivanhoe Blvd.
Suite 200
Orlando, FL 32804
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