Dallas Healthcare Fraud Defense Lawyer
When a healthcare fraud investigation jeopardizes your reputation and future, protect yourself immediately. This is particularly important in the Dallas region, as this area is among the targets of the federal government’s Medicare Fraud Strike Force. Keen-eyed investigators and prosecutors man the Strike Force, scrutinizing potentially fraudulent claims. Their work has led to 70 convictions. And they are continuing.
If you are charged with healthcare fraud in Dallas, Fort Worth or surrounding counties, it’s crucial to consult with an experienced Federal criminal defense attorney before speaking to investigators or law enforcement. By enlisting the right defense attorney early on, you’ll get stronger protection against possible prosecution.
Acclaimed attorney David Finn provides a solid defense for those accused of healthcare fraud in the Dallas area. If you are charged with or are being investigated for this crime, see how Mr. Finn can help you.
Call David Finn, P.C. today at (214) 974-3457 to discuss your charge and legal options.
What Healthcare Fraud Means
Healthcare fraud is an intentional deception or misrepresentation to benefit from any federal healthcare program or insurer. Medicare, Medicaid, federal workers’ compensation, and Tricare are some common government programs where fraud happens. This may be committed by patients, doctors, or even businesses such as clinics and hospitals.
These are some ways individual consumers commit healthcare fraud:
- Providing false information in an insurance claim to maximize the benefits
- Forging or altering a receipt or invoice
- Using coverage of another individual
- Using the insurance card of another individual
- Filing of a claim for a medication or service not received.
Professionals and businesses commit healthcare fraud as well, such as by:
- Billing and coding errors
- Billing for unnecessary supplies, equipment, or services
- Billing for supplies, equipment, or services that were not provided
- Faking a patient’s diagnosis to justify unnecessary tests and procedures
- Upcoding – billing for a service that costs more than what was performed
- Unbundling – driving up costs by billing each stage of a procedure separately
- Accepting kickbacks for patient referrals
- Self-referrals – referring patients to service entities where the doctor has ownership or investment
- Fraudulent certifications.
Although many healthcare fraud investigations start out as civil matters, they can quickly escalate into criminal cases. It is vital to have legal protection as early as possible in the investigation.
Healthcare Fraud Penalties
Numerous cases of healthcare fraud are the result of simple mistakes. However, they could just as easily lead to serious legal consequences.
A civil case of healthcare fraud can result in forced repayment of claims or the denial of future claims. A patient may be barred from government healthcare programs, while a healthcare professional could face a state’s disciplinary board and lose their license.
A criminal healthcare fraud criminal case involves heavier penalties. At the state level, Texas healthcare fraud can range from a misdemeanor to a felony, and penalties vary according to the severity of the crime.
For instance, if the value of the claim was less than $100, then the crime is deemed a Class C misdemeanor and is punishable by a $500 fine. On the other end of the spectrum, if the individual’s claim was more than $30,000, or if their actions resulted in injury or death to another person, that outcome could be a first-degree felony conviction, with five to 99 years in a Texas prison plus fines of up to $10,000.
At the federal level, criminal penalties for healthcare fraud depend on which law was violated. To name some:
- Under the False Claims Act, penalties may include a maximum of five years in federal prison, a maximum fine of $250,000, recoupment, licensing action, and/or program exclusion.
- Under the Anti-Kickback Statute, violators may be jailed up to five years and fined up to $75,000 per violation.
Criminal consequences may increase in certain circumstances. For example, if the act resulted in injury to another person, it could be punishable by 20 years of federal prison time for each count of fraud. If it resulted in a patient’s death, the penalty could be lengthened to a life sentence.
Whether a healthcare fraud accusation is a civil matter or a serious criminal charge, it greatly impacts life. Your reputation could be damaged, your career halted, and your social connections ruined. Before any healthcare allegation escalate, seek Attorney David Finn to find your legal recourse.
Defense Against a Healthcare Fraud Charge
Key to a successful healthcare fraud defense is maintaining the lack of intent. The prosecution must prove that you acted knowingly and wilfully in the alleged crime. Without an intention to deceive, you cannot be convicted of healthcare fraud.
With this, Attorney David Finn uses strategic arguments tailor-made for your specific situation. There are many ways that the alleged fraud could be attributed to a simple mistake and not an intentional act. For instance, an action could be due to:
- Billing or payment mistakes
- Delegation errors
- Unqualified workers
- Lack of worker oversight
- Constantly changing rules in healthcare.
Additionally, your defense may be bolstered by factors such as the lack of evidence from the prosecution or the credibility of a witness’ testimonies.
David Finn works diligently and creatively to protect you at every step of your case, not just during trial. His effective steps include:
- Advising you on how to avoid additional charges
- Efficiently navigating the voluminous paperwork in discovery
- Assisting initial investigations to obtain a lenient sentence
- Crafting the most favorable plea bargains
- Tactically presenting your case during trial
- Challenging sentencing recommendations.
As a former criminal trial judge and an experienced trial attorney, Mr. Finn is thoroughly familiar with the Texas criminal justice system. This extensive experience, combined with his fearlessness, his tremendously benefited his defense clients over the decades.
Call David Finn, P.C. Today
If you or a loved one is accused of healthcare fraud, contact the law firm of David Finn, P.C. With his experience, resources, and aggressiveness, Attorney Finn handles even the most complex federal healthcare fraud cases, and he can fight for you. Your initial consultation is absolutely free and confidential. Call David Finn, P.C. at (214) 974-3457 today.
Office: (214) 871-1112
David Cell: (214) 538-6629
Kathy: (214) 738-4703 (Paralegal Kathy Archuletta)