by | last updated on January 20, 2016

Medical providers, facilities and organizations can face healthcare fraud charges for a number of reasons. Whether they’re billing the government or insurance companies for services that weren’t actually performed, getting kickbacks, or making false claims, the charges they can face for these acts are severe.

Anyone facing charges of this caliber should talk to an insurance fraud lawyer in Fort Lauderdale to begin discussing their legal options.

Penalties for Healthcare Fraud Charges

There are a number of federal laws and acts that pertain to healthcare fraud charges and falsified medical claims. Those convicted of medical fraud may be penalized under one or all of these acts, depending on the exact specifics of the medical fraud committed.

Federal laws that pertain to medical fraud include:

  • False Claims Act – When a person makes a false statement or tries to conceal information in a Medicaid, Medicare or other healthcare claim, they can face up to five years in prison and a maximum $10,000 fine.
  • Social Security Act, Anti-Kickback Provision – Medical providers who are found to be accepting kickbacks, bribes, refunds or other types of compensation in exchange for making false health insurance claim can be penalized with a fine of up to $25,000 and maximum jail time of five years.
  • Social Security Act, Physician Self-Referral Law – Physicians may not make referrals for designated health services (physical therapy, laboratory services, radiation therapy, etc.) reimbursed by Medicare to a facility with which the physician has a financial relationship (save for some exceptions). Violations may lead to fines and prohibition from participation in government health programs.
  • Racketeering Influenced and Corrupt Organization Act – If an organization is found to be committing healthcare fraud, those involved could face up to 20 years in prison or be forced to forfeit assets.
  • Civil Monetary Law – If a practitioner is found guilty of making a false statement or claim or violating the anti-kickback statute, they can face significant fines of up to $10,000 for each false claim or up to $50,000 for a violation of the anti-kickback statute for each improper act.
  • Health Insurance Portability Act – This establishes the crime of Health Care Fraud for anyone who intentionally defrauds health care programs or makes fraudulent representations in regards to a claim. Those convicted of this crime can be penalized with 10 years in prison or, if the fraud resulted in serious bodily injury or death, they could face up to 20 years in prison or a life sentence, respectively.

In addition to these laws, if an organization, provider or facility is found to be committing medical fraud, the Department of Health Services may choose to exclude them from federal programs, such as Medicare. Allegations, therefore, can be quite serious and may require assistance from an insurance fraud lawyer in Fort Lauderdale.

Help with Healthcare Fraud Charges from an Insurance Fraud Lawyer in Fort Lauderdale

According to a 2009 report from the National Health Care Anti-Fraud Association, healthcare fraud cost America between $67 and $224 billion in 2007. Those convicted of medical fraud could face thousands of dollars in fines and be sentenced to years in prison. Anyone facing these charges should call 888-744-8225 to speak to an insurance fraud lawyer in Fort Lauderdale at the Law Offices of Robert David Malove. Defendants should begin building their defense against healthcare fraud charges right away.