Being accused of Medicare/Medicaid fraud is a serious legal matter and one of the most troubling charges brought against a provider. If found guilty, you’ll be facing civil or criminal charges that may result in fines or worse, a jail sentence.
The Law Offices of Seth Kretzer says any Medicare or Medicaid provider may be charged with fraud. This includes doctors, pharmacies, dentists, and 4care facilities.
If You’re Accused
Investigations usually begin with a letter from an investigator asking you to turn over documents and schedule an “interview.” You are expected to give all information you have regarding the dates and services in question, and answer all questions completely and honestly.
Here’s the thing: it’s not so much an interview as it is an ambush. Government agencies only open an investigation when they’re sure they can get incriminating information out of it. Going there alone and providing documents without a lawyer is a huge mistake. Before agreeing to any “meeting,” make sure you have a Medicare/Medicaid attorney to accompany you.
What’s the Best Defense?
Several activities and practices cause red flags that catch the attention of government auditors, including an abnormally high number of healthcare claims or a whistleblower hoping to get a financial reward.
Legal professionals say the best defense is to make sure you’re above scrutiny. For one, when filing reports to Medicaid or Medicare, make sure all information about the services and products are 100% accurate.
Knowledge is another important defense. Know why you’re being investigated, know your rights, and know what the potential penalties are.
What’s the Next Best Move?
Hire a lawyer. Not just any lawyer, but an experienced, real healthcare fraud attorney who can effectively engage the formidable legal system. There’s no going around this prerequisite.
It’s essential in preventing fraud charges from tearing your profession and life apart. With a good lawyer, you won’t have to pay for the entire pie when you’re only responsible for a single crumb.