The healthcare industry is incredibly complicated. Not only do doctors and nurses have to be trained and educated sufficiently enough to adequately treat their patients and avoid medical malpractice claims, but they also need to know how the law applies to their billing practices so that they don’t end up facing criminal charges. After all, the fact of the matter is that the federal government is constantly investigating and charging medical professionals with healthcare fraud.
A cautionary tale
In fact, just recently, a federal jury found two doctors and a nurse guilty of healthcare fraud for their roles in submitting false claims to Medicare for reimbursement and accepting kickbacks for referrals. The jury also found that the professionals destroyed documents to try to hide their actions from federal investigators. According to testimony from one of the professionals who pleaded guilty, doctors certified that patients were examined and required certain treatment even though those individuals were never examined, and doctors were paid kickbacks to refer patients to this particular hospice company.
The ramifications for these individuals are enormous. Many of them may be facing up to 14 years in federal prison. It almost goes without saying, then, that their professional licenses will be stripped from them. In other words, absent a successful appeal, their futures are devastated.
Don’t let that happen to you
If you believe that you’re under investigation for healthcare fraud, then you need to be very careful. Your best option at this point is to consult with a legal professional who knows the intricacies of the federal healthcare and fraud laws. It’s a good idea to avoid speaking to investigators until you consult with an attorney of your choosing. An attorney can help you navigate the investigation or a Medicare audit.
Don’t underestimate the power of your statements during this process. If you provide an explanation during an audit or an investigation, those statements can be used against you later on in a criminal prosecution. In fact, in a lot of cases those statements made during an audit are the catalyst for criminal charges. Therefore, don’t make the mistake of thinking that a civil audit means that you’re not the subject of a criminal investigation.
What’s your best course of action?
If after the government’s audit or investigation you’re threatened with criminal charges, then you’ll likely be faced with a tough question. Should you cooperate with the government? The answer to this question really depends on the facts of your case. Sometimes the government is more concerned with recouping money than it is with imprisoning those who wronged it. Therefore, you might have the ability to negotiate a resolution that protects you from criminal action and secures your future.
But even if that isn’t the case, the government may turn to you with some sort of plea deal. In most of these instances, the government is willing to offer significantly reduced penalties in exchange for information or testimony. Is that option right for you? It depends on the strength of the government’s case and what you’re comfortable with.
But the truth of the matter is that you might not have a lot of time to think about it. Federal prosecutors often approach multiple individuals who are alleged to have taken part in the crime, and they usually give the best plea deal to the first person who cooperates. Again, this means that thinking these matters through early on in your case may better position you for the best outcome possible under the circumstances.
Have a zealous advocate on your side
Very few people have a full understanding of the criminal law as it applies to healthcare fraud. This leads them to delay and take cases to trial that simply are unwinnable. You can’t afford that type of haphazard representation. Instead, you need an advocate on your side who can give you a realistic picture of your chances at trial and can build the criminal defense strategy that best protects your rights and your future. If you’d like to have that kind of assistance on your side, then now may be the time to reach out to an experienced and skilled firm like ours.