Medicare fraud is a serious topic that affects seniors across the nation and wastes billions of taxpayer dollars every year. When discussing Medicare fraud, many people focus on con artists and scammers who take seniors’ Medicare numbers to use them illegally. But many doctors and other medical practitioners perform Medicare fraud as well, over the course of providing very real services for their work. Keep reading to learn all about Medicare fraud attorneys and how they can help.
What is “Accidental” Fraud?
The problem is that because of the vagaries of Medicare law, many doctors and their offices may not know that they’re doing anything illegal. You might be running afoul of a law that you didn’t know existed.
The government keeps close track of Medicare billing. If they find you’re billing your Medicare patients in a way that suggests fraud, you may receive a letter from the federal government asking you to surrender some of your billing and treatment records.
The Importance of Legal Counsel
Receiving that kind of communication can be very frightening for medical practitioners and their offices. If you fail to prove to the government’s satisfaction that you haven’t abused Medicare, you might be fined large sums of money, face action from your state’s medical board, and even be denied the right to bill Medicare in the future. How can you be sure you avoid that sort of legal nightmare?
Your absolute best practice is to hire a Medicare attorney as soon as you start taking patients who are on Medicare. This way, you’ll receive special guidance before you start about common pitfalls in billing and other practices. You’ll also have an expert on hand who can review your practices as you go to let you know you’re doing everything above-board.
Steer clear of allegations with the healthcare fraud lawyers at the Law Offices of Seth Kretzer.
Common Medicare Mistakes
In lieu of personalized advice from a Medicare fraud lawyer, here are several common mistakes practitioners make when providing services to patients on Medicare. As you might imagine, these errors may have a profit motive in mind, or they might be the result of a simple accident.
- Improper recording of services. Many practitioners may keep incomplete records of services provided to patients. When your patients visit you, keep close track of all services you provide, including in-person care, medication, and medical equipment. All these records should be signed (by the practitioner) and dated.
- Accurately describing all services. Medicare does not cover all medical care your patients can receive. Because of this, it’s important to provide clear and accurate diagnoses in your records, along with a clear explanation of the medical necessity of a given procedure. (Different states have different definitions of medical necessity for different procedures.) Attempting to “fudge” information about what services you provided and why — even if you’re doing so to try to get more services covered, for the good of your patient — is Medicare fraud.
- Failure to return overpayments. If you accidentally overbill Medicare, or if you receive more money than you’re due from Medicare for any reason, you need to take steps to rectify the situation immediately. Contact Medicare within 60 days to explain the circumstances, and send back the overpayment.
Many healthcare providers are not aware that they are committing a form of Medicare fraud. This sort of fraud is often unintentional, and while it may seem harmless at first, it can be costly. That’s why you need a trusted attorney by your side. Get help from a Medicare fraud defense lawyer as soon as you suspect trouble.
Consequences of Medicare Fraud
Health care fraud is a very serious issue in the United States. The consequences are not only felt by the government but also by the people who need healthcare. Medicare fraud is a felony and there are many penalties for those who are convicted. They can be fined up to $250,000, sentenced to up to 10 years in prison, or both. There are also potential civil fines and damages that the perpetrator may be ordered to pay if convicted.
The Law Offices of Seth Kretzer Are Here to Help
Medicare fraud is a serious issue and can lead to hefty fines for those who are caught. It could be anything from falsifying information on a claim to lying about patient eligibility for Medicare. If you or your office is accused of Medicare fraud, don’t go it alone. Hiring a healthcare fraud lawyer to handle your case, as soon as the allegation is made, is vital to coming out on top.