When we hear about federal healthcare fraud, we often think of Medicare and Medicaid fraud. After all, these are health care benefits programs funded by the federal government, and therefore, under federal jurisdiction. However, health care fraud involving private health care insurance providers is also a federal crime. A Virginia federal healthcare insurance fraud lawyer can provide effective defense to those accused of fraud in connection with health care matters. Call today to discuss your case with a Virginia federal healthcare fraud lawyer.
Understanding Health Care Insurance Fraud
Insurance fraud occurs as either an attempt by the insured to receive benefits he or she is not entitled to or as an attempt by the insurer to deny the benefits owed to the insured. Health care insurance fraud may be committed by a health care provider, an individual patient, or by an insurance company:
- A health care provider fraudulently bills the insurance company by overbilling through upcoding or unbundling, by billing for services and procedures that were never provided to the patient, or by billing non-covered elective services as medically necessary.
- An individual allows someone else to use his or her identity or insurance information to receive health care benefits or services. An individual may also commit health insurance fraud by using benefits to obtain non-covered or non-prescribed medications or services.
- Health care providers and patients may work together to waive co-pays or deductibles.
- An insurance company may commit fraud by claiming that covered services were not actually covered and denying a legitimate claim.
In terms of federal health care fraud cases, most medical insurance fraud prosecutions are of medical providers accused of fraudulently billing insurance companies.
The federal government takes allegations of health care insurance fraud seriously. A Virginia federal healthcare fraud attorney is your best ally fighting charges in federal court.
Federal Health Care Fraud Laws and Penalties
The United States Code contains several laws involving fraud in general as well as statutes pertaining specifically to health care fraud. While health care insurance fraud may be prosecuted under a number of federal statutes, most federal health care fraud cases include one or more of the following charges:
- Health Care Fraud (18 U.S. Code 1347) – penalties include a maximum sentence of 10 years in prison, up to 20 years for acts resulting in serious bodily injury, up to life for acts resulting in death
- Making False Statements Relating to Health Care Matters (18 U.S. Code 1035) – punishable by a maximum sentence of 5 years in prison
- Conspiracy (18 U.S. Code 371) – up to 5 years in prison for two or more people conspiring together in an attempt to defraud the United States
If you are accused of committing health care insurance fraud or of conspiring with another to commit health care fraud, the penalties you face are significant. Act quickly to secure defense representation from a Virginia federal health care insurance fraud attorney.
Federal Health Insurance Fraud Lawyer in Virginia
Whether federal health care insurance fraud charges are the result of a poor decision, a misunderstanding of the claims process, bad advice from a health care provider or insurer, or a wrongful allegation, a Virginia federal health insurance fraud lawyer can help. Your attorney can help you avoid the mistakes that can jeopardize your case, can speak to investigators on your behalf, and can ensure that your rights are protected during an investigation. A federal fraud lawyer can challenge the government’s evidence against you and uncover evidence to support your defense. Learn more by scheduling a free consultation with a federal health insurance fraud attorney.
