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Clearwater Medicare Fraud Attorney

Medicare is a vital tool for millions of older Americans. Part A medicare covers hospital costs, doctor visits, blood work, skilled nursing facilities, and hospice costs. Part B medicare can also cover some home health care costs such as medical equipment, outpatient care, and other preventative services. U.S. citizens are automatically enrolled in medicare when they reach the age of 65 if they or their spouse worked for at least 10 years and, during that time, paid medicare taxes, according to the Department of Health and Human Services. We all pay into it over the course of our careers, and without this government-run medical insurance program, millions would be left without adequate healthcare at a time in their lives when they need it most. As such, the criminal justice system cracks down hard upon those who are convicted of defrauding medicare. Depending on the amount of financial damage caused, and what specific laws were violated, those convicted of medicare fraud can face years to decades behind bars. The stakes for committing medicare fraud may be high, but that does not stop it from occurring on a pandemic level. Medicare loses billions of dollars annually to fraud schemes, which are employed by both individuals and corporations alike. Fraudsters are subject to fines of hundreds of thousands of dollars in addition to prison time. Contact the Clearwater law office of Roman & Roman today to speak with one of our Clearwater Medicare fraud attorneys.

Laws that Govern Medicare Fraud

The federal laws that regulate medicare fraud include the False Claims Act, the Physician Self-Referral Law, the Anti-Kickback Statute, the Social Security Act; and the United States Criminal Code, according to the Department of Health and Human Services. Often, more than one law is violated when fraud is committed, and the defendant may be facing multiple accounts of wrongdoing, which adds to their prison sentence and fines.

Doctors Use Patients to Help them Commit Fraud

Physicians will even employ the help of patients, the homeless, or drug and alcohol addicted people to aid them in defrauding medicare. They charge medicare for procedures that were not performed and offer the person a kickback as a reward. Both parties, in this circumstance, will be held accountable for fraud.

Types of Medicare Fraud

There are other types of medicare fraud that physicians and medical facilities use to line their pockets with Medicare funds, according to the Centers for Medicare and Medicaid Services.

  • Billing for medical procedures, medications, and lab tests that were not actually administered to the patient;
  • Upcoding, which is the use of a billing code to increase the cost of a procedure that was not performed;
  • Unbundling, which is the practice of charging for each step of medical work, which drives the cost up;
  • Poor record keeping;
  • Phantom billing for a non-existent employees hourly wage; and
  • Charging for brand name medications when generics were prescribed.

If you have been charged with any type of medicare fraud, you need to act quickly to begin building your case. Do not take this matter lightly. Contact Roman & Roman today at our Clearwater law office at 877-767-1032 to speak with one of our Clearwater Medicare fraud defense attorneys.

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