Michigan Health Care Fraud Defense Attorney

Health care fraud not only undermines the financial stability of both public and private health insurance systems but also questions the integrity of health care providers and even patients involved. Such allegations are taken seriously at the federal level, where the battle against health care fraud is fought with determination, armed with strict laws and the collaboration of various enforcement agencies. If you are facing these charges, it is essential to understand the legal environment around health care fraud and secure representation from an experienced attorney.

Understanding Health Care Fraud

At its core, health care fraud involves illegal activities designed to deceitfully extract financial gains from health insurance programs. This could be through billing for unprovided services, inflating the costs of services (known as upcoding) or fabricating patient records to justify unnecessary medical procedures. The illegal distribution of prescription medications, especially opioids, is also a critical concern, actively pursued by federal agencies.

The consequences of being implicated in health care fraud are far-reaching, with the possibility of facing substantial fines, repaying stolen funds and enduring prison time. Given what’s at stake, partnering with an experienced white collar defense attorney becomes crucial. Anjali Prasad brings insight as a former federal prosecutor for 15 years to her clients. Now, with more than 25 years of legal experience, Ms. Prasad delivers depth in federal criminal law and a proactive defense strategy tailored to meet the needs of your case.

Forms Of Health Care Fraud

Health care fraud manifests in various ways, and recognizing these forms is the first step for an effective defense:

• Billing fraud: Submitting claims for services not rendered or supplies not provided.
• Upcoding and unbundling: Misrepresenting the services rendered to receive higher reimbursements or billing each stage of a procedure as if it were a separate procedure.
• Kickbacks and bribery: Accepting or offering something of value in exchange for referrals or the prescribing of certain medications.
• Prescription fraud: Forgery, alteration or unauthorized prescription of pharmaceuticals, especially controlled substances.
• Identity theft: Using another person’s insurance information without their consent to receive services.
• Wire fraud: Wire fraud involves the use of electronic communication or transactions to deceitfully obtain money or property. This can include the electronic submission of fraudulent claims, transferring funds acquired through deceitful means, or communicating false information over the internet or telephone to execute a scheme. Due to the widespread use of electronic billing and communication in health care, wire fraud is a common charge in these cases.

Do not hesitate to reach out to Prasad Legal, PLLC, if you are being investigated for health care fraud and suspect you may be soon facing charges.

Legal Consequences Of Health Care Fraud

The consequences of health care fraud are severe, reflecting the government’s commitment to upholding the integrity of health care systems. Punishments can include:

• Imprisonment: Convicted individuals may face lengthy sentences, especially in cases involving significant financial loss or risk to patient health.
• Fines and restitution: Financial penalties often exceed the amounts fraudulently obtained, intending to deter future offenses.
• Probation: Probationary sentences may include compliance with strict conditions, regular monitoring and restrictions on professional practice.
• Loss of professional licenses: Health care providers may face the revocation of their licenses, effectively ending their careers.
• Exclusion from Medicare/Medicaid: Conviction can lead to exclusion from participating in federal health care programs, a devastating blow for professionals and facilities reliant on these reimbursements.

Through legal support and defense efforts, it’s possible to challenge the allegations, minimize the penalties or even secure a dismissal. In matters of health care fraud, the right legal representation is not just advantageous – it’s indispensable.

Defending Against Health Care Fraud Charges

Mounting a defense against health care fraud charges requires a lawyer who is not only well-versed in federal law but also deeply familiar with the intricacies of health care billing and regulations. Defense strategies can vary, but common defenses include:

• Lack of knowledge and intent: Asserting that the accused did not knowingly or intentionally commit fraud. This can include demonstrating that any incorrect billing was due to an error or misunderstanding rather than a deliberate attempt to deceive.
• Insufficient evidence: Challenging the sufficiency and reliability of the evidence presented by the prosecution. This might involve questioning the accuracy of audit findings or the interpretation of billing data.
• Compliance with existing regulations: Demonstrating that the actions under scrutiny were in compliance with relevant health care laws and regulations. This could involve providing documentation of adherence to billing procedures or showing that the services billed were medically necessary.
• Mistake of fact: Arguing that any misrepresentation was based on a mistake of fact rather than an intent to commit fraud. For example, billing errors could result from incorrect information supplied by patients or other health care providers.
• Entrapment: Suggesting that the defendant was induced by government agents to commit a crime they would not have otherwise engaged in. Although less common, this defense might be applicable in certain sting operations conducted by law enforcement.
• Coercion or duress: Claiming that the defendant was forced into committing the fraudulent activity due to threats or pressure from a third party.

Each of these defense strategies is catered to the specific circumstances of the allegations, seeking to challenge the prosecution’s case by refuting the evidence of fraudulent intent or actions. Ms. Prasad can evaluate the details of the accusation to build the most effective defense.

The Role Of An Attorney In Health Care Fraud Cases

When facing fraud allegations, Ms. Prasad can be your guide and protector, dispensing legal knowledge and strategic defense tactics against the charges you face. From dissecting the details of your case to engaging with prosecutors for charge reduction or dismissal and advising you through crucial decision-making, Ms. Prasad will stand by you every step of the way.

Federal defense attorney Anjali Prasad helps those in Oakland County, Michigan, who have been accused of health care fraud. Recognized for her aggressive advocacy and attentive service, she also serves clients across numerous locations including West Bloomfield, Macomb, Clinton Township, Sterling Heights, Bloomfield Township, Farmington Hills, Detroit, Rochester and Troy. Don’t face this journey alone. Reach out today to schedule a consultation.

Michigan Health Care Fraud Attorney

Confronting health care fraud allegations can be intimidating, but you’re not in this alone. Anjali Prasad will help you craft solid defenses tailored to the specifics of your case. Committed to guiding you through these challenging times, Ms. Prasad is here to secure an amicable resolution to your case. If you’re facing charges of health care fraud, take that pivotal step toward safeguarding your future. Contact Prasad Legal, PLLC, today at 248-221-2247, or fill out the online contact form.