Any number of witnesses could become part of a healthcare fraud case.
One example is a medical expert witness, who can provide testimony regarding:
- claim submissions;
- billing discrepancies; and
- the types of services provided to a patient.
Although testimony from this type of witness could help a healthcare fraud defense case, there are circumstances in which a medical expert can end up hurting the case.
How a Healthcare Fraud Case May Be Impacted by a Medical Expert Witness
One way a healthcare fraud case may be hurt by this type of witness is that it could show how a patient’s diagnostic or treatment codes reflect a condition that is much more serious than the patient’s true diagnosis. This could support accusations that the healthcare professional submitted claims for treatments that were unnecessary in order to recover more compensation from insurance.
An examination by an independent medical expert could reveal the patient’s true diagnosis. In some cases the patient might have actually been put through procedures that weren’t necessary – and possibly dangerous – because other physicians were basing treatment on the false diagnosis.
On the other hand, a medical expert could help a case by showing that the incorrect diagnosis wasn’t intentional. It may be proven that although it wasn’t correct, another healthcare provider in the same set of circumstances might have come up with the same conclusion.
Or it could be that the expert shows a misdiagnosis was based on someone else’s mistake, such as a lab technician. Diverting responsibility away from the physician could aid in justifying any billing discrepancies.
Seeking Legal Counsel if Facing Healthcare Fraud Allegations
These cases can be very complicated with numerous issues that impact the direction of the case. Witnesses of all kinds could be utilized that either help a defendant or end up causing significant harm. The reality is that anyone who is facing charges of healthcare fraud needs strong, knowledgeable legal representation.
Talking with an attorney is essential in order to understand one’s rights and how they can be protected. Additionally, defendants should discuss what steps should be taken in order to defend against charges of fraud. By securing legal representation, defendants can secure access to medical and other expert witnesses that may provide valuable assistance.
An attorney can also explain some of the strengths and weaknesses of the case that could impact the outcome. For help defending against charges of this nature, contact The Law Offices of Robert David Malove.