All Medicare And Medicaid Fraud Charges Are Serious
If you were contacted by the state attorney general or the office of inspector general concerning Medicare or Medicaid fraud, you need to act right away. Even if it’s a groundless accusation based on false testimony by a disgruntled ex-employee or a competitor, a fraud charge can do irreparable damage to your reputation. Failure to respond can place you in legal jeopardy and result in the suspension of your Medicare or Medicaid number.
Common Medicare And Medicaid Fraud Accusations
Fraud charges sometimes result from billing patterns revealed in routine administrative audits. These patterns may mean nothing, but it opens the door to further audits and investigations, costing you time and money. Most fraud charges are related to one of the following accusations:
- Billing for services that were not performed
- Upcoding, or submitting inaccurate billing codes to get higher reimbursements
- Recommending or performing services that are unnecessary
- Billing both a private insurer and Medicare or Medicaid for the same services
- Accepting or inducing referrals by offering payments or anything of value
Individual doctors accused of Medicare or Medicaid fraud also face possible disciplinary actions. Penalties may include having privileges at hospitals revoked, excessive fines and criminal prosecution. The sooner you contact an attorney to protect your rights, the better your chances of avoiding additional charges and penalties.