by | last updated on January 20, 2016

Medicare fraud is a particularly common form of health fraud. It can include a variety of fraudulent practices, though in some cases, doctors may find themselves wrongfully accused or having committed a mistake that may be deemed fraudulent. Miscommunication with medical staff and even simple errors can cause a doctor to be heavily scrutinized and/or accused of fraud.

According to the government’s Stop Medicare Fraud website, anti-fraud efforts implemented since 2008 have resulted in a recovery of more than $10 billion. Because fraud prevention is such a top priority, medical providers should implement their own steps to prevent fraud, such as internal audit programs, proper staff training, and more. If accused of fraud, proper documentation and internal processes can help a fraud lawyer in Fort Lauderdale build a defense.

Types of Medicare Fraud

Health fraud can come in many forms.

Some common fraudulent practices involving the Medicare system include:

  • Phantom billing for services — When a doctor bills Medicare for services or tests that were never rendered.
  • Billing for equipment never received — Billing Medicare for equipment that the patient never receives or does not need.
  • Performing unnecessary tests or procedures — Some doctors may perform tests that are unnecessary for the sole purpose of billing Medicare.
  • Upcoding — When a provider renders an inexpensive service (such as follow-up visit) but charges for a more comprehensive and expensive service instead (such as a new patient visit).

Doctors should be sure to implement certain antifraud practices to avoid allegations. Keeping accurate records and ensuring proper procedures are followed by staff may help a fraud lawyer in Fort Lauderdale demonstrate that allegations of health fraud are false.

How to Prevent Medicare Fraud Charges

The FBI and antifraud agencies are constantly checking for discrepancies or inaccuracies in billing and reimbursement for Medicare claims. Even if a provider did not purposely mean to commit fraud, he or she may still be questioned.

Therefore, here are some tips that providers should keep in mind to avoid allegations of health fraud:

  • Make sure billing staff is properly trained. Lack of training can lead to inaccuracies such as use of the wrong codes, duplicate billing and other errors that point to fraud.
  • Keep proper documentation. If a doctor has no proof of medical services performed, then that’s a red flag to authorities. Keep thorough documentation of everything. An audit can happen at any time and it’s best to be prepared.
  • Conduct frequent monitoring. Doctors should audit their own records periodically to ensure that proper billing and recordkeeping practices are being followed.

Contacting a Fraud Lawyer in Fort Lauderdale

Fraud is a serious charge that can affect a doctor’s ability to practice medicine and may result in penalties. Robert Malove is a fraud lawyer in Fort Lauderdale who can help doctors accused of fraud review their legal rights and take action to fight allegations of health fraud. Contact Robert Malove today at 954-861-0384 schedule a consultation regarding accusations of Medicare fraud.