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HEALTHCARE FRAUD

Even though numerous government and watchdog organizations regulate the health care industry, there are instances in which a health care provider may be accused of perpetrating a fraud, in most cases against an insurance provider such as Medicare or Medicaid.

At Barzee Flores, our staff has the experience and resources to defend clients against all types of health care fraud allegations. As a team of effective and highly skilled trial attorneys and litigators, we know what it takes to defend your rights, your reputation and your livelihood.

Health care fraud generally involves a practitioner or provider of health care services who attempts to defraud the system by falsifying or submitting fraudulent claims in order to receive compensation to which they are not legally entitled.

According to the Cornell University Law School’s Legal Information Institute, statistics estimate that 10 cents of every dollar spent on health care in this country goes toward paying for fraudulent health care claims. The prevalence of these types of crimes, coupled with laws requiring insurance companies to pay a legitimate claim within a 30-day period, means that the governing agencies rarely properly investigates a reported case of health care fraud. In other words, they miss most of it and what they catch, they often get wrong at the expense of innocent doctors, businesses or other health care providers.

Research shows that Medicare fraud alone costs taxpayers $60 billion annually nationwide, with 20 percent of it originating in South Florida. And the problem is growing – $952 million in false Medicare claims were filed in 2009, up from $703 million in 2008. A federal health care fraud task force, established in 2006, has prosecuted over 800 people and identified more than $2.5 billion in fraudulent claims since its inception.

Florida lawmakers are trying to pass legislation intended to curb the problem. Democratic Congressman Ron Klein of Boca Raton, and Congresswoman Ileana Ros-Lehtinen, a Republican representing Miami, introduced the Medicare Fraud Enforcement and Prevention Act in April 2010. The bill, which was authored by Klein and co-sponsored by Ros-Lehtinen and 9 other congressional representatives, would double the penalties for those found guilty of Medicare fraud, provide law enforcement with additional resources to uncover and prosecute fraud and escalate the screening process of those interested in establishing health care-related companies that would rely on billing Medicare.

Still, the existing system has little or no enforcement. And simply increasing the penalties for presumed violators, while paying little more than lip-service to adequate investigation and enforcement, likely means nothing more than the prosecution of more wrongfully charged health care providers.

An indictment by a grand jury is not uncommon for those suspected of committing health care fraud through the operation of health clinics, home health care providers, physician’s groups, medical billing firms and purveyors of items like powered mobility scooters and oxygen supplies. This can be a truly frightening and intimidating experience, and attempting to present your case without the benefit of having aggressive legal representation at your side can prove to be a serious error.

Contact our office immediately to learn more about our firm and our experience, and to schedule a free, confidential consultation to review the facts surrounding your case.

Call Barzee Flores today at 305-374-3998 to learn how we can help.

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