Stepped-up state and federal initiatives to manage Medicare costs have meant health care providers and medical billing services have come under increasingly close scrutiny in recent years. As a result, there has also been a significant increase in Medicare fraud investigations and fraud indictments–and that is especially true here in Miami and South Florida.
Yet, Medicaid programs are so complex that even experienced physicians, physicians assistants, medical office managers, and specialized medicar billing personnel can unintentionally violate the current fraud laws. Even a simple error may get noticed in a government audit and lead to a state or federal investigation.
While the Office of the Inspector General is responsible for taking reports of potential fraud, the Health Department’s Office of Medicaid Management reviews recipient utilization and investigates other charges of fraudulent behavior and abuse in order to take action against them when necessary. Medicare fraud cases are typically brought against the owners of doctor’s offices, clinics, pharmacies and medical supply companies and often the doctors, dentists and physician’s assistants in those offices are also charged in the fraud cases.
Medicare Recipient Fraud
- Providing false information on their Medicaid application
- Forging a prescription
- Lending or reselling their Medicare benefits to another party
- Knowingly receiving excessive, duplicative, contraindicating or conflicting health care services or supplies
- Use of more than one Medicare card
Medicare Provider Fraud
- Billing for services that were not provided
- Billing Medicare and private insurance and/or the recipient for the same services
- Administering unnecessary services
- Upcoding – billing for services more expensive than those performed
- Billing for professional services performed by unlicensed personnel
- Billing for more time than was actually spent with the patient
- Kickbacks for certain drugs or treatments
- The sharing of Medicare reimbursement payments between providers in lieu of referral fees
Medicare Fraud Defense
Whether you are innocent or guilty, it is important to be represented by an attorney who is experienced in defending clients charged with Medicare Fraud. Failure to defend your case properly can result in a prison sentence, monetary forfeitures, RICO litigation, and the forfeiture of medical and professional licenses. At Barzee Flores, we aggressively defend healthcare providers and individuals who face Medicare fraud charges.
Barzee Flores aggressively defends healthcare providers and individuals who face Medicare fraud charges.
Call us today if you’ve been charged with or are under investigation for Medicare fraud: (305) 374-3998.
- Medicare Part C Fraud
- Medicare Part D Fraud
- Infusion Therapy Fraud
- Home Health Care Fraud
- Oxygen Therapy Fraud
- Chiropractor Fraud
- Medicare Billing Fraud
- Radiation Oncology Fraud