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Dallas Healthcare Fraud Defense Attorney
Healthcare fraud is a crime resulting from an intentional deception or misrepresentation about any form of healthcare that benefits an individual or entity in some way. An individual or entity may also be charged with healthcare fraud if there is an intent to defraud the insurer.
A healthcare fraud conviction is based on the fact that the crime was intentionally committed, and so an individual who has been charged with healthcare fraud can utilize a number of defense strategies. The act, after all, may not classify as healthcare fraud if there was a lack of intent to defraud or deceive.
In many instances, cases of healthcare fraud are a result of simple mistakes. If you are being investigated for healthcare fraud, it is crucial that you consult an experienced attorney before providing a statement to law enforcement officers or investigators. Contact David Finn, P.C. at (214) 871-1112 today to discuss your legal options.
Types of Healthcare Fraud
While healthcare fraud is just one type of fraud, an individual can commit many different forms of healthcare fraud. The most common instance of healthcare fraud occurs when an individual provides false information on their insurance claim to maximize the received benefits.
Some other common healthcare fraud charges include:
- 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 performance of tests and procedures not needed
- Upcoding or billing for a service that costs more than what was performed
- Unbundling or driving up the cost by billing each stage of a procedure separately
- Accepting kickbacks for patient referrals
Consumers can commit healthcare fraud as well. Common examples include:
- Forging or altering a receipt or bill
- Using coverage of another individual or using the insurance card of another
- Filing of a claim for a medication or service not received
Healthcare Fraud Penalties
Healthcare fraud, like all other types of fraud, is deemed a white collar crime, bringing with it numerous penalties. These penalties largely depend on two factors: the severity of the crime and the amount of the claim involved.
In Texas, healthcare fraud charges can range from a misdemeanor to a felony. If the value of the claim was less than $100, for instance, then the crime is deemed a Class C misdemeanor and is punishable by a $500 fine. If the value of the claim is lower than $2,500, then a Class B and Class A misdemeanor is possible—also punishable by a corresponding fine.
A state jail felony automatically occurs when the value of the claim is above $2,500 but below $30,000. This is punishable by a $10,000 fine, 180 days to two years of jail, or both.
If the value of the claim is $30,000 or greater, a person may be charged with a third-degree, second-degree, or first-degree felony. If the value of the claim was above $300,000 or if the act resulted in another person’s injury or death, then a first-degree felony may be charged. A first-degree penalty is punishable by a fine of up to $10,000, anywhere from five to 99 years in prison, or both.
Call David Finn, P.C. Today
If you or a loved one are accused of healthcare fraud, it is imperative that you hire a reputable criminal defense lawyer as soon as possible. You may risk losing your business to false charges. David Finn, P.C. has the experience, knowledge, and resources to handle even the most complex federal health care fraud cases. He will protect your rights, fight the allegations against you, and create the strongest defense possible. Call David Finn, P.C. at (214) 871-1112 today.
Office: (214) 871-1112
Cel 1: (214) 538-6629
Cel 2: (214) 738-4703 (Paralegal Kathy Archuletta)