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Former Assistant District Attorney
Former Assistant U.S. Attorney

Are you a suspect in a health care fraud investigation?

On Behalf of | Aug 24, 2020 | Uncategorized

When you became a medical professional, you likely had aspirations of helping people and doing whatever you could to better the health of others. Though the years may have dulled your enthusiasm, you still want to do what you can to be a good doctor. Because of this desire, you may have felt surprised when you came under investigation for fraud.

Though learning of the investigation can leave you feeling shocked, you would be wise not to let that shock put you in a state of inaction. Even if no formal charges for health care fraud have come against you yet, you can still start looking into your legal options to learn what could happen in the event that charges do result.

What may have triggered an investigation?

Health care fraud falls into the category of white-collar crime because it is a financial crime. Federal charges can result from this and other types of fraud, which means that you face the risk of serious consequences if charges come against you. Of course, you may still feel blindsided by the idea of anyone thinking you did something wrong to such a degree, so you may wonder what actions constitute health care fraud. Those actions include the following:

  • Providing a false diagnosis to a patient in order to perform unnecessary tests and procedures
  • Receiving kickbacks or incentives for patient referrals
  • Billing steps in a procedure individually rather than as a single procedure
  • Presenting procedures not covered by insurance policies as coverable procedures, such as presenting a cosmetic facial surgery as a surgically necessary facial repair
  • Over-billing patients or insurance companies
  • Billing for more expensive procedures than the ones actually performed
  • Billing for services that never took place
  • Carrying out tests or procedures that patients do not need in order to bill for them

You may look at this list and think that you have not carried out any of those actions, but even so, that does not mean that investigators will consider you innocent.

What can you do?

As soon as you learn of an investigation into health care fraud, you want to protect your interests. Contacting a Mississippi attorney experienced in helping individuals defend against federal charges could help you gain information on what the investigation could entail, what might happen if you face charges and how you could move forward in the event that charges do come against you.