Top Cheltenham, PA Medicaid Fraud Lawyers Near You
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1600 Locust Street, Philadelphia, PA 19103
Clients needing legal solutions for Medicaid Fraud can connect with Brennan Law Offices, a local Pennsylvania practice.
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1760 Market Street, Suite 600, Philadelphia, PA 19103
1700 Market St, Suite 1005, Philadelphia, PA 19103
1735 Market St, Suite 3300, Philadelphia, PA 19103
Three Parkway, 1601 Cherry Street, Suite 1400, Philadelphia, PA 19102
Two Commerce Square, 2001 Market Street, Suite 3100, Philadelphia, PA 19103
2005 Market St, 29th Floor, Philadelphia, PA 19103
1315 Walnut Street, 12th Floor, Philadelphia, PA 19107
1800 JFK Blvd, Suite 403, Philadelphia, PA 19103
123 S. Board Street, Suite 1030, Philadelphia, PA 19109
One Liberty Place, 1650 Market Street, Philadelphia, PA 19103
21 West Third Street, Media, PA 19063
One Logan Square, Suite 2000, Philadelphia, PA 19103-6996
1500 Market Street, 12th Floor, East Tower, Philadelphia, PA 19102
2000 Market Street, Suite 2300, Philadelphia, PA 19103
Centre Square West, 1500 Market St, Suite 3400, Philadelphia, PA 19102
2000 Market Street, 20th Floor, Philadelphia, PA 19103
30 South 17th Street, Philadelphia, PA 19103
1700 Market Street, Suite 1418, Philadelphia, PA 19103-3907
15 St. Asaphs Road, Bala Cynwyd, PA 19004
PO Box 22615, Philadelphia, PA 19110
2000 Market Street, Suite 2803, Philadelphia, PA 19103
1500 Walnut Street, Suite 900, Philadelphia, PA 19102
1500 Chestnut St, Ste 1520, Philadelphia, PA 19102
1617 John F Kennedy Blvd, Suite 2005, Philadelphia, PA 19103
Cheltenham Medicaid Fraud Information
Lead Counsel independently verifies Medicaid Fraud attorneys in Cheltenham and checks their standing with Pennsylvania 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 Is Medicaid Fraud?
Medicare and Medicaid are national medical health insurance programs that provide healthcare coverage. Medicare covers many of the healthcare expenses of people who are age 65 or older, people with a disability, or renal disease. Medicaid provides health care costs to people with low incomes. In most states, adults and dependent children are qualified to receive Medicaid with incomes up to 138% of the federal poverty line.
Medicaid and Medicare are subject to waste, abuse, and fraud. When fraud is involved, it can lead to criminal charges. Medicaid fraud involves making false representations or statements in order to obtain some benefit or payment that would not otherwise be provided. Fraud generally involves misrepresenting facts or concealing material facts. Medicare abuse usually involves practices that result in unnecessary cost or expense, and can also be the basis for criminal penalties.
What Are Some Examples of Medicaid Fraud?
Healthcare in the United States can be expensive and complicated. Billing government care providers, like Medicaid, requires following standard protocols. However, because of the size and scope of Medicaid, it can be subject to fraud or abuse. Common examples of Medicaid fraud may include:
- Billing for services that are never performed
- Billing for medical equipment that is not medically necessary
- Unlawfully paying for patient referrals or provider kickbacks
- Changing for a more expensive service than what was provided
- Unbundling a combined medical procedure to charge as multiple procedures
- Double billing or duplicate claims
Who Investigates Medicaid Fraud?
Medicaid is operated by a combination of federal and state agencies. Suspected Medicaid fraud can be investigated by multiple agencies or law enforcement agencies, including:
- State health department fraud investigators
- Office of Inspector General (OIG)
- Centers for Medicare & Medicaid Services (CMS)
- Internal Revenue Service (IRS)
- Federal Bureau of Investigation (FBI)
- Medicaid Fraud Control Unit
Financial fraud is often flagged by computer analysis that reviews health care records submitted to Medicaid. The CMS Fraud Prevention System (FPS) can look for suspicious activity or suspected patterns of fraud. After identifying suspicious activity, an investigation will further look into the health care providers involved to determine if there is evidence of provider fraud, including site visits, talking to patients, and reviewing the provider’s medical and billing records.
Can You Go To Jail for Medicaid Fraud?
Medicaid fraud can involve criminal and civil penalties. Health care fraud involving federal government healthcare agencies or programs is a felony offense. Under federal law, the penalties for federal health care fraud can include up to 10 years in federal prison time. If the fraud resulted in serious bodily harm to a patient, the penalties could increase to 20 years imprisonment. Felony convictions can harm your future job opportunities.
Healthcare providers are also prohibited from paying or accepting kickbacks for health care services. Violation of the Anti-Kickback Statute can result in up to 5 years in jail, thousands of dollars in fines, and Medicaid exclusion.
Unlawful self-referral involves a doctor referring a patient to medical services where the doctor has a financial interest. Violation of the Stark Law against physician self-referral can result in fines, restitution, punitive damages, and make the doctor ineligible for Medicare and Medicaid programs in the future.
What Happens If Someone Reports Me for Medicaid Fraud in Pennsylvania?
If patients suspect their doctor has been improperly billing Medicaid for care, they may have an interest in reporting the doctor. Other doctors, health care workers, or family members may also report suspected Medicaid fraud. Under the False Claims Act (FCA), whistleblowers can recover up to 30% of the civil penalties recovered for fraud against the government.
What if You Are Accused of Medicaid Fraud?
If you are facing fraud allegations it does not necessarily mean you will be found guilty of any crime. You have legal defenses and constitutional protections to challenge the criminal charges in court with the right to legal counsel. There may be several viable defenses to a fraud charge, including improper billing caused by clerical errors or computer problems.
How Health Care Fraud Defense Lawyers Can Help
A federal fraud lawyer can help as soon as you learn about a fraud investigation. Legal representation can protect you from saying the wrong thing during a fraud interview. An experienced attorney can also inform you of your legal rights and the potential consequences of a plea agreement. A fraud attorney can also help negotiate favorable settlements to get the best possible resolution and avoid jail time or other severe penalties.