Miami Medicare Fraud Attorneys
With recent crackdowns in Medicare fraud, Miami healthcare professionals can face criminal charges related to this serious white collar offense.
Florida is home to many retirees who have moved to our sunny state from regions across the country. Many older adults in the Miami area rely on Medicare for medical treatments, in-home care, and nursing home facility care. These patients often pay for healthcare services through Medicare, which requires providers to submit a bill to the government. As a result, the Centers for Medicare and Medicaid Services (CMS) keeps a very close eye on Florida healthcare providers. In Florida, medical providers can include but are not limited to physicians, pharmacies, nursing homes and assisted-living facilities, and even medical supply companies.
Indeed, the Miami Herald recently referred to the Miami area as a “Medicare fraud hot spot.” In other words, Miami prosecutors are familiar with Medicare fraud cases, and prosecutors have been cracking down on healthcare fraud in Florida. If you have been charged with Medicare fraud, it’s very important to discuss your case with a Miami Medicare fraud attorney. These cases can be extremely complicated, and you’ll need experienced legal counsel on your side.
Defining Medicare Fraud in Miami
Medicare fraud can result in very serious penalties, including the loss of a medical license, substantial fines, and in some cases imprisonment. It’s just one type of healthcare fraud in our state. In addition to Medicare fraud, other healthcare fraud charges can involve Medicaid fraud or insurance fraud, for example.
Florida law defines Medicare fraud as an “intentional deception or misrepresentation made by a person with the knowledge that the deception results in unauthorized benefit to herself or himself or another person.” In other words, when you intentionally deceive or misrepresent for your own benefit, you may be charged with Medicare fraud.
The federal government defines Medicare fraud simply when Medicare is billed for services or supplies that were never actually delivered. Medicare fraud is different than Medicare abuse which occurs when doctors and other medical professionals do not follow good medical practices, and as a result Medicare is billed for services and supplies that are not medically necessary.
It is important to also understand that any member of a healthcare clinic involved in Medicare fraud can potentially be prosecuted whether you are the biller, nurse or just drive the patients to the clinic.
What Constitutes Medicare Fraud?
Some examples of acts that can constitute Medicare fraud in Miami include but are not limited to:
- Prescribing unnecessary medications, unnecessary medical equipment, or unnecessary procedures;
- Billing for unnecessary procedures, unnecessary medical equipment, medical equipment that wasn’t actually provided, or services that haven’t been performed;
- Submitting Medicare claims for services that have been provided to patients who don’t actually exist or falsified cost reports; and
- Making self-referrals or taking kick-backs.
In addition, the Florida Attorney General’s office emphasizes that prescription drug diversion also might be classified as Medicare fraud. Drug diversion can include some of the following scenarios:
- Physicians illegally prescribing medications;
- Nurses ordering medications without physician approval;
- Pharmacists filling counterfeit prescriptions; and
- Healthcare workers stealing patients’ medications, selling those medications, or using those medications.
Some examples of acts that can constitute Medicare fraud on a federal level include, but are not limited to the following:
- Billing twice for the same service or supply
- Using another person’s Medicare card to obtain services
- Billing for services or goods that were not provided
- Misrepresenting a diagnosis in order to justify Medicare billing
- Altering claim forms in order to obtain a higher payment amount
- Soliciting, offering, or receiving a kickback, bribe, or rebate
In Florida, healthcare fraud is a very serious offense. If you have been accused of Medicare fraud, you do not want to handle your case alone. Let the experienced Miami Medicare fraud attorneys at Ratzan & Faccidomo, LLC take a look at the specific elements of your case.
Contact a Miami Medicare Fraud Attorney
At the law office of Ratzan & Faccidomo, LLC, we have years of experience handling criminal defense cases in the Miami area. When you have been charged with Medicare fraud you are facing an offense with grave penalties that can affect your professional well-being and even can result in jail time. Contact an experienced Miami Medicare fraud attorney today to learn more about how we can assist you.