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Grand Rapids Billing Fraud Lawyer

Federal government statistics indicate that health care providers submit as much $50 billion in false or fraudulent Medicare claims each year. With these extraordinarily high numbers, the risk of federal scrutiny of your billing practices is substantial.

Accusations of federal billing fraud can be devastating to the medical practice that you have worked so hard to build. Whether the allegation involves Medicare, Medicaid, Tricare, or other health insurance claims, you may be subject to hefty fines and penalties, restitution orders, and even lengthy prison sentences.

Given the potential severity of the accusations against you, retaining the services of a Grand Rapids billing fraud lawyer may be essential to your ability to regain your life and continue to operate your medical practice. A qualified health care fraud attorney can help defuse federal investigations and work toward an acceptable resolution of your case.

Fraudulent Billing Practices in Grand Rapids

Billing fraud is a broad category of misconduct that relates to the filing of reimbursement of claims for payment by federal benefits programs like Medicare, Medicaid, and Tricare. For example, billing fraud may include billing for:

  • Medically unnecessary services, equipment, and supplies
  • Multiple duplicate claims
  • Non-allowable costs or those ineligible for reimbursement
  • Services provided to patients not covered by federal healthcare programs
  • Services, equipment, or supplies that the claimant never provided
  • Unlicensed or excluded services that are not reimbursable under benefit programs

This type of fraud might also entail failing to comply with payment eligibility conditions. As a billing fraud lawyer in Grand Rapids could advise, all these fraudulent billing activities routinely result in federal prosecutions for health care providers found guilty of participating in them.

For medical providers that depend primarily on Medicare, Medicaid, and Tricare benefits programs for patient revenue, remaining compliant with all billing guidelines can be complicated and confusing. Ever-changing rules, policy changes, and contracts with third parties all can contribute to difficulties in maintaining appropriate billing practices. Individuals should note, however, that compliance with these guidelines is crucial, as the penalties for failing to do so could be severe. Therefore, it is critical for defendants to seek the services of a knowledgeable lawyer.

Federal Laws Governing Billing Fraud

A variety of federal laws govern billing practices for providers seeking reimbursement from Medicare, Medicaid, and other federal benefits programs. As an example, the False Claims Act prohibits medical providers from intentionally making false statements or misrepresentations to obtain federal health care payments to which they are not entitled.

Similarly, 18 U.S.C. §1347 makes intentionally defrauding any health care benefit program or obtaining money or benefits from a health care program via false or fraudulent pretenses, a federal criminal offense. Those who violate this statute can face fines and up to ten years in federal prison.

Moreover, under 42 U.S.C. §1320a-7b, fraudulent claims for payment from federal health care benefits might result in monetary penalties of thousands of dollars per false claim and three times the amount claimed for each item or service, or up to three times the amount of the money received. A billing fraud attorney in Grand Rapids can assist medical providers whom federal investigators are targeting on allegations of healthcare fraud.

Contact a Grand Rapids Billing Fraud Attorney Today

Prosecution for federal billing fraud allegations can be intimidating and stressful. These matters are complicated and document-intensive, especially when you are up against federal prosecutors who devote all their time to investigating and prosecuting health care fraud matters. In this situation, contacting a Grand Rapids billing fraud lawyer could highly beneficial to you.

Seeking out legal advice and representation as soon as you become aware of a pending investigation can be the most effective means of fighting the allegations against you. Take control of the situation by enlisting the help of legal counsel right away.