Health Care Fraud

Health Care Fraud

Federal Health Care Fraud Charges

What is Health Care Fraud?

It’s a federal crime to knowingly and willfully execute, or attempt to execute, a scheme or artifice to defraud a health care benefit program, or to get any of the money or property owned by, or under the custody or control of, a health care benefit program by means of false or fraudulent pretenses, representations, or promises.

A Defendant can be found guilty of health care fraud only if all the following facts are proved beyond a reasonable doubt:

  1. The Defendant knowingly executed, or attempted to execute, a scheme or artifice to defraud a health-care benefit program, or to obtain money or property owned by, or under the custody or control of, a health-care benefit program by means of false or fraudulent pretenses, representations, or promises.
  2. The health care benefit program affected interstate commerce.
  3. The false or fraudulent pretenses, representations, or promises related to a material fact.
  4. The Defendant acted willfully and intended to defraud.
  5. The Defendant did so in connection with the delivery of or payment for health-care benefits, items, or services.

What Are Some Examples of Health Care Fraud?

  • Submitting false claims to CMS for payment
  • Billing for services that were not provided
  • Kickbacks
  • Lack of medical necessity
  • Upcoding

What Are The Penalties For Healthcare Fraud?
The maximum penalty in a health care fraud case is 10 years imprisonment.  The maximum fine is $250,000, or twice the value of the property involved, whichever is greater.

However, if the fraud causes a person serious bodily injury the maximum penalty is 20 years imprisonment.  If the fraud causes a person’s death, the maximum penalty is life in prison.

Are you looking for the best federal criminal defense lawyer in Tampa Florida? Contact Attorney David C. Hardy.

Tampa Attorney David C. Hardy is a former prosecutor that now represents people in matters related to federal criminal offenses.

Attorney Hardy is Board Certified by the Florida Bar and the National Board of Trial Advocacy as an Expert in Criminal Trial Law. In the Federal Courts, he has handled a wide variety of cases including international extradition, drug trafficking, bank fraud, health care fraud, immigration offenses, aggravated identity theft, racketeering, the misbranding of drugs, and firearms offenses.  He has represented clients in Federal Trial and Appellate Courts in Florida, Texas, and Georgia.

Attorney Hardy has the knowledge, skills, and experience to guide you through this process and obtain the best possible results.  Contact Attorney Hardy for a free consultation.