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Healthcare Fraud: Unjustly Compromising the Integrity of all Healthcare Providers

Posted on Oct 25, 2015 by in Criminal Prosecution | 0 comments

Healthcare fraud or health insurance fraud is one type of criminal activity that continues to be a threat to the financial aspect of different programs of the government. The Federal Bureau of Investigation (FBI), which is the prime agency responsible in exposing and investigating health care fraud in federal and private insurance programs, says that healthcare fraud costs the US tens of billions of dollars each year. To be able to identify and arrest, especially the most aggressive offenders, therefore, the FBI works determinedly with the help of local, state, and federal agencies, and private investigative associations, units, and insurance national groups.

Healthcare fraud can be committed through different ways, including: filing claims for treatments that are actually never performed; making claims for illnesses or injuries that do not really exist; fabricating names when filing insurance claims; over-charging the government for treatments provided to patients; filing claims for non-existent medical supplies; and, resorting to “rolling lab schemes,” wherein Medicare and insurance companies are billed for needless and, sometimes, bogus tests provided to retirement homes residents, health club patrons, and people in shopping malls (to make these tests appear legit, physicians’ signatures are often faked).

A number of nursing home facilities have also been found guilty of healthcare fraud, after they have been proven to be charging Medicare and Medicaid huge bills for what they claim as quality care for residents. All these facilities have shown, however, are clear elderly abuse and neglect committed through inadequate or unhealthy food, unhygienic and unsafe environment, lack of staff, little air conditioning or heat inside the facility, mildew, molds, rodents and insects everywhere, claims for patients who have already died or who do not exist at all, falsely placing residents under very high billing classifications, using inferior medical equipment, giving residents cheap and less-effective medicine while claiming payment for branded medication and high-quality service, and so forth.

Due to the greed of a few groups and erring medical professionals, the integrity of all healthcare providers is compromised, while the safety of thousands of patients put at risk. Despite the dedication of authorities and prosecutors in catching offenders, their overzealousness, sometimes, render them ending up running after innocent healthcare providers. In certain situations these authorities exaggerate the extent of the fraudulent acts of those that they arrest, unmindful of the damaging effects that an exaggerated accusation can cause these healthcare providers.

As stated in the webpage of the Yvonne Fraser Law Office, being accused of healthcare fraud, whether based on bogus billing or any other fraudulent medical act, puts one at the risk of losing his or her professional license. The webpage, however, also makes clear that, through the help of a highly-skilled criminal law attorney, the person under investigation may have the acquittal that he or she truly deserves.

His/Her license is a professional’s life; losing it because of a petty mistake or wrong accusation can cause a devastating blow to one’s future. There are thousands of criminal law attorneys in the US; however, there may only be a handful who may be able to provide the kind of legal help that is really necessary.

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