Combating Medicare And Medicaid Fraud Charges
Medicare and Medicaid fraud is serious. Even honest billing mistakes can lead to criminal charges that could result in criminal penalties, not to mention job loss or the loss of your professional license.
At Valenzuela Law Firm, our team has defended the accused against these allegations in El Paso and throughout Texas since 2014. Led by Yale Law School graduate Felix Valenzuela, named on the Super Lawyers Rising Stars list, we bring Ivy League knowledge and local experience to every legal case.
Understanding Medicare And Medicaid Fraud
A white collar crime, Medicaid and Medicare fraud involves deceptive financial practices to obtain unlawful payments from government health care programs. Common schemes include:
- Upcoding: Billing for a more expensive service than the one actually provided
- Billing for services not rendered: Submitting claims for never-performed services
- Double-billing: Billing both the patient and the insurance company for the same service
- Unbundling: Breaking down a single service into multiple charges to increase reimbursement
- False or misleading diagnoses: Fabricating or exaggerating a patient’s condition to justify unnecessary treatments
These practices are not only unethical but also illegal, and they can lead to severe penalties.
State And Federal Charges
Texas health care fraud cases can be prosecuted at state and federal levels based on the nature and scope of the alleged fraud. State charges typically involve smaller scale fraud, while federal charges often relate to more extensive schemes that affect multiple states or involve significant sums of money. The charges and potential penalties escalate based on the amount of money involved in the fraudulent activity.
At the state level, penalties can range from a Class A misdemeanor for fraud under $1,500, which results in up to one year in jail, to a first-degree felony for fraud over $200,000, which carries a potential sentence of five to 99 years or life in prison. Between these extremes are different felony classifications with incrementally increasing penalties.
Federal charges often carry even stiffer penalties. Individuals convicted of federal health care fraud can face fines up to $250,000, while organizations may be fined up to $500,000. Additionally, federal convictions can result in up to 10 years in federal prison per count, and those found guilty may be permanently excluded from participating in federal health care programs.
Our attorneys can handle your health care fraud case, helping you obtain a favorable outcome.
Call Us To Discuss Your Case
We offer confidential consultations and can communicate in both English and Spanish. Conveniently located in El Paso, we’re ready to put our experience and tech-savvy defense strategies to work for you. Contact us at 915-292-3173 or online.