Top Spring Valley, CA Health Care Fraud Lawyers Near You
When Results Matter Most, Put 42 Years of Criminal Defense to Work For You! Open 24/7. Free Consultation.
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SoCal Super Lawyers 16 years in a row, AV rated. Criminal defense attorney offering experience, skill and personal attention.
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Our nationwide team of defense lawyers includes a former U.S. Attorney, four former Federal Prosecutors, two former FBI agents and two former Army JAGS.
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Certified Criminal Law Specialist and Attorney of the Year by the San Diego Transcript. Free Case Evaluation/Quote. Call Now!
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Award Winning Criminal Attorney. Fighting For Your Rights. Fighting For Your Future. Providing Thoughtful Support And Strong Advocacy For Your Complex Criminal Defense.
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Fed Trouble? Free Consult. Former Prosecutor & Team Former Federal Agents. Call/Text 24/7. Immediate Response Guaranteed!
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Former Prosecutor Fighting For You! Top Rated Federal Criminal Defense Law Frim.
400 S Melrose Dr., Suite 101, Vista, CA 92081-6632
If you need Health Care Fraud help in California, contact Christoph Law Offices, a local practice in Spring Valley, for legal representation.
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501 West Broadway, Suite 800, San Diego, CA 92101
Other Nearby Offices
Contact Bulldog Law in Spring Valley, California for experienced legal assistance in Health Care Fraud.
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750 B Street, Suite 2900, San Diego, CA 92101
2244 Faraday Ave, PMB, Carlsbad, CA 92008
402 W Broadway, Suite 400, San Diego, CA 92101
501 West Broadway, Suite 900, San Diego, CA 92101-3577
401 W A St, Suite 1150, San Diego, CA 92101
4747 Executive Drive, Suite 240, San Diego, CA 92121
550 West C Street, Suite 620, San Diego, CA 92101
4655 Executive Drive, Suite 350, San Diego, CA 92121
401 West A Street, Suite 1900, San Diego, CA 92101-8484
380 South Melrose Dr, Suite 301, Vista, CA 92081
109 W C St, Suite C, San Diego, CA 92101
600 West Broadway, Suite 1100, San Diego, CA 92101
8241 La Mesa Blvd, Suite A, La Mesa, CA 91942
655 West Broadway, Suite 1600, San Diego, CA 92101-8494
501 W. Broadway, Suite 1610, San Diego, CA 92101
501 W. Broadway, Suite 1100, San Diego, CA 92101
11440 West Bernardo Court, Ste 265, San Diego, CA 92127
3580 Carmel Mountain Road, Suite 200, San Diego, CA 92130
401 West A Street, Suite 2600, San Diego, CA 92101
12230 El Camino Real, Suite 300, San Diego, CA 92130
4655 Executive Drive, Suite 1500, San Diego, CA 92121
600 West Broadway, Suite 1060, San Diego, CA 92101
402 West Broadway, Suite 860, San Diego, CA 92101
Spring Valley Health Care Fraud Information
Lead Counsel independently verifies Health Care Fraud attorneys in Spring Valley and checks their standing with California bar associations.
Our Verification Process and Criteria
Ample Experience
Attorneys must meet stringent qualifications and prove they practice in the area of law they’re verified in.Good Standing
Be in good standing with their bar associations and maintain a clean disciplinary record.Annual Review
Submit to an annual review to retain their Lead Counsel Verified status.Client Commitment
Pledge to follow the highest quality client service and ethical standards.
What Qualifies as Health Care Fraud?
Health care fraud involves making false representations to gain money or benefits related to medical care, insurance, or government benefits. Health care fraud can be committed by anyone involved in the healthcare industry, including patients, doctors, insurance providers, and medical services companies.
State and federal law enforcement take health care fraud very seriously. The penalties can include years in prison for a felony conviction. However, some innocent people are caught up in false accusations of fraud and should consult with a criminal defense lawyer to understand their legal rights.
What Are the Types of Health Care Fraud?
There are several types of health care fraud. In some cases, fraud is committed by a prospective patient, including false statements on an insurance form. This could include using someone else’s insurance to get medical care.
More extensive healthcare fraud involves health care providers or medical services businesses. Medical providers and home health services may make a fraudulent claim to patients, insurance companies, or Medicare for compensation. Some examples of health care fraud may include:
- Unbundling, or charging separate billing codes for bundled services
- Double-billing or duplicate billing
- Billing for services that were never provided
- Fraudulent billing for medically unnecessary services
- Up-coding, or seeking reimbursement for services that should be billed at a lower rate
- Misrepresentation of the type of service provided
Kickback Fraud
Another type of fraud in health care involves kickbacks. Kickbacks are the referral fees, illegal remunerations, bribes, or rebates paid directly or indirectly for referrals in health care. Kickbacks are illegal in health care under the Anti-Kickback Statute. It is unlawful to pay for inducing or rewarding patient referrals for business involving any item or service payable by the federal healthcare programs, including drugs, supplies, or health care services.
Self-Referral Fraud
Physician self-referral laws prohibit physicians from referring patients with Medicare or Medicaid to facilities or services where the physician has a financial interest. This includes entities where the doctor’s immediate family member has a financial relationship. For example, if a doctor’s spouse is a co-owner of a radiology provider, the doctor cannot refer a patient to that provider, unless an exception applies.
Is Health Care Fraud a Felony?
Health care fraud can be charged as a misdemeanor or a felony. As a misdemeanor, a conviction could carry up to one year in jail and a fine. As a felony, health care fraud is punishable by more than a year in prison and thousands of dollars in fines.
The penalties associated with health care fraud depend on the specific facts involved. Some aggravating factors can increase the penalties, including where the fraud involved:
- Multiple incidents of fraud
- Medical identity theft
- Insurance fraud
- Money laundering
Is Health Care Fraud a Federal Crime?
Health care fraud can be a state-level crime in California or a federal offense, depending on the circumstances. It is federal crime for whoever knowingly and willfully executes a scheme to:
- Defraud any health care benefit program; or
- Obtain money, property, or health care benefits by fraudulent pretenses, representations, or promises.
The penalties for a federal government fraud conviction include up to 20 years in prison. If the fraud results in death, a conviction could result in life in prison.
How is Health Care Fraud Detected?
Healthcare fraud can be detected through computerized fraud prevention systems or reporting of potential fraud. The Centers for Medicare and Medicaid Services (CMS) uses a Fraud Prevention System (FPS) to analyze healthcare providers networks to detect patterns that represent a risk of fraudulent activity. The leads are then investigated by field office agents to identify possible fraud and refer the health care fraud cases for criminal prosecution.
Why Do I Need a Health Care Fraud Defense Lawyer?
There are severe penalties for a conviction of health care fraud. A felony conviction could result in a permanent criminal record, and make it more difficult for you to find a job in the future. With a lot at stake, a criminal defense lawyer can help you fight the charges for health care fraud to avoid a criminal record. An experienced criminal defense attorney can also negotiate to get a plea deal with reduced criminal charges or minimum sentencing. If you are accused of health care fraud, you may have several legal defense options. The prosecutor has the burden of proving every element of the offense beyond a reasonable doubt. Possible criminal defenses to fraud charges include:- No intent to commit fraud
- False claims were made by mistake
- Another person was responsible for making a false claim
- Incorrect claims were caused by computer error or operator error