HEALTHCARE FRAUD

If you need a healthcare fraud defense attorney, contact the aggressive and knowledgeable legal team at Adams & Associates, PLC.  We have been focused on this complex area of the law for many years and we are well equipped to defend your rights in an increasingly hostile environment. Healthcare fraud is drawing increased scrutiny from the federal government and prosecutors are becoming extremely aggressive. Recent statistics show that federal healthcare fraud cases have risen by 71 percent from five years ago.  To put an end to this increase, the government is trying to crack down. A conviction for healthcare fraud can bring severe penalties, including substantial fines and lengthy periods of incarceration. Professionals may also lose their right to practice in the medical industry.

If you are under investigation or have been charged with healthcare fraud, attorney Ashley D. Adams can provide you with solid, effective representation. As a former prosecutor with the United States Attorney’s Office, Ashley D. Adams has been involved in numerous healthcare fraud cases and brings a wealth of experience and skill to your defense. Call us today for a free case evaluation: 480-219-1366.

WHAT IS HEALTHCARE FRAUD?

Healthcare fraud is a type of white-collar crime that involves the filing of fraudulent healthcare claims in order to make a profit. It consists of intentional deception or misrepresentation of healthcare transactions by a provider (such as a doctor or therapist), employer group, or insured member for the purpose of attaining financial gain or receiving unauthorized benefits. Although healthcare fraud is rampant, what were once regarded as simple billing errors are now routinely prosecuted as fraud. The problem is particularly acute I states like Arizona where a large number of retirees reside.  As efforts to detect and prosecute health care fraud have grown more aggressive, you need an experienced and skilled attorney like Ashley D. Adams to protect your rights.

Contact our Phoenix fraud attorney for a free and confidential consultation.

TYPES OF HEALTHCARE FRAUD

Fraudulent health care schemes can come in many forms. They can be generally divided as follows:

Provider Healthcare Fraud

  • billing for services not provided (including submission of fake bills)

  • duplicate billing

  • misrepresentation of dates, description of services, or identities of members or providers

  • billing non-covered services as covered services

  • modifying medical records

  • intentional incorrect reporting of diagnosis or procedures to maximize payment

  • prescribing unnecessary tests, treatment or services

  • misrepresenting oneself as a licensed healthcare provider

  • kickbacks in return for referring patients

  • services provided by untrained or unlicensed personnel

  • failure to supervise unlicensed personnel

  • distributing non-approved devices or drugs

  • waiving member co-pays

  • medical equipment fraud

  • “rolling lab” schemes (unnecessary and sometimes fake tests given to people at health clubs, retirement homes or shopping malls and billed to insurance companies or Medicare)

Insured Member Healthcare Fraud

  • providing false information when applying for programs or services

  • using someone else’s coverage or Medicare insurance card to obtain services

  • filing claims for services, treatment, or medication not received

  • forging or altering documents

  • using transportation benefits for non-medical related purposes

Employer Healthcare Fraud

  • enrolling ineligible employees for healthcare coverage

  • falsifying hire or termination dates to expand dates of coverage

  • establishing fake health insurance companies or employee benefit plans

  • misrepresentation of an employer group in order to secure healthcare coverage

MEDICARE FRAUD

Medicare fraud is the most common of all health care fraud prosecutions. Because it is so common, prosecutors and law enforcement officials aggressively pursue dramatic punishments against those charged with the crime. They want to discourage others from participating in Medicare fraud. This means you need an aggressive and knowledgeable attorney to defend your rights.

Medicare fraud involves the investigation and prosecution of individuals and organizations who are accused of defrauding public health care systems such as Medicare and Medicaid. If you are being investigated or have been accused of Medicare fraud, it is essential that you hire a qualified medical fraud attorney right away. At the Law Offices of Adams & Associates, PLC, our Phoenix medical fraud attorney has the experience and skills to provide you with a strong defense. We will work diligently and aggressively to ensure that your rights are protected.

WHAT IS MEDICARE FRAUD?

Medicare fraud is a white collar crime that is committed when a person or organization defrauds the Medicare system in order to obtain funds or services. Usually Medicare is billed for services that were never provided or received. There are many types of Medicare fraud (see examples below), but they all have the same goal: the illegal billing and receipt of Medicare benefits. Often honest mistakes are involved, however the government carefully monitors Medicare billing and too many errors may lead to fraud charges. In these cases the government must prove that the “errors” were made intentionally.

WHAT ARE COMMON TYPES OF MEDICARE FRAUD?

Medicare fraud is usually committed by individuals seeking to obtain benefits to which they are not entitled, or by companies, such as health care providers, who over-bill or render unnecessary services. Some of the more common types of Medicare fraud include the following:

  • recipients providing false information on applications, lying about injuries or age, or utilizing other people’s names and social security numbers to obtain benefits

  • false billing

  • over billing

  • billing for phantom patients

  • billing multiple times for the same procedure

  • billing for services not rendered

  • upcoding (billing for a higher reimbursable service than performed)

  • performing unnecessary services (procedures that are not medically necessary)

  • kickbacks for member referrals or waiving member co-pays

  • falsifying medical records

  • use of unlicensed staff

  • prescription or sales of unproven remedies

Whatever the circumstances of your legal challenges, Phoenix Medicare Fraud Attorney Ashley D. Adams has the experience and the resources to protect your rights. Conviction of Medicare fraud can result in harsh penalties, such as fines and imprisonment. It also causes significant damage to a person’s personal and professional reputation. The best way of avoiding stiff penalties and negative stereotyping is by retaining the services of a qualified Medicare fraud attorney.

At the Law Offices of Adams & Associates, PLC, our Phoenix medicare fraud attorney can fight the criminal charges against you no matter how aggressive prosecutors may be. Ashley D. Adams focuses on handing complex white collar criminal cases such as Medicare fraud. As a former health care prosecutor with the United States Attorney’s Office, Ashley D. Adams understands the tactics and procedures the government will use to obtain a conviction. With this experience and knowledge, a solid defense can be prepared on your behalf.

MEDICAL EQUIPMENT FRAUD IN ARIZONA AND NATIONWIDE

Durable medical equipment supply companies have recently been under heightened scrutiny by federal and state agencies that have freely brought criminal charges without clear facts. Although some of these companies have been used to defraud the government and insurance providers, many others have come under investigation because of simple errors in processing transactions. Durable medical equipment fraud has serious consequences for the owners of these companies, including fines and prison sentences, and it is essential to retain a seasoned criminal defense attorney if you have been accused of such fraud. At the Law Offices of Adams & Associates, PLC, our experienced and skilled medical equipment fraud lawyers in Arizona will aggressively protect your rights. If you are currently under investigation or have been charged with medical equipment fraud, call Adams & Associates, PLC today for a free case evaluation.

WHAT ARE SOME TYPES OF MEDICAL EQUIPMENT FRAUD?

Common types of fraud relating to medical equipment include the following:

  • billing for equipment or supplies that were never provided to the patient

  • overbilling for medical equipment and supplies

  • providing or billing for a product that was no longer medically necessary or that was not ordered by the treating physician

  • altering or fabricating wholesale invoices

  • billing for a more expensive product than the one actually provided to the patient

  • kickbacks from suppliers to physicians for referrals

  • fake letters of medical necessity

  • submission of claims for fictitious patients by using borrowed social security numbers

Contact our medical equipment fraud lawyers in Arizona today for a free case evaluation.

TELEMARKETING BY MEDICAL SUPPLIERS

The federal Social Security Act also prohibits durable medical equipment suppliers from making unsolicited telephone calls to Medicare beneficiaries unless:

  • the patient has given written permission to the supplier to make telephone contact;

  • the contact is regarding a covered item that the supplier has already furnished the patient; or

  • the supplier has furnished at least one covered item to the patient in the preceding 15 months.

Violations of these rules can subject a person to criminal, civil, and administrative penalties, including exclusion from federal health care programs. Medical supply companies are also prohibited from using independent marketing firms to make unsolicited telephone calls and cannot contact a patient based solely on a treating physician’s preliminary written or verbal prescription of durable medical equipment for a patient.

In many instances, simple mistakes in the process of supplying a patient with medical equipment and supplies can cause problems with what began as a legitimate, legal transaction. The government may view these mistakes as fraudulent action and begin an investigation. If you are currently being investigated or have been charged with medical equipment fraud, call the Law Offices of Adams & Associates, PLC, today. Our fraud lawyers in Arizona can provide you with a solid defense and protect your rights.

CONTACT HEALTHCARE FRAUD ATTORNEY ASHLEY D. ADAMS, SERVING CLIENTS IN ARIZONA AND NATIONWIDE

If you are being investigated or have been charged with healthcare fraud, contact a Phoenix fraud attorney at the Law Offices of Adams & Associates, PLC before you speak with government investigators or law enforcement officers. Ashley D. Adams has the experience and knowledge necessary to evaluate your case and determine your best legal options. We can effectively and aggressively defend individuals and corporations charged with a variety of white-collar crimes, including healthcare fraud. With our deep understanding of prosecution strategies, we can thoroughly prepare your defense. We offer the skilled representation to protect your personal and professional freedom.

Contact Adams & Associates

At Ashley D. Adams, PLC, we have a well-established track record of success that can make a difference, whether in defending charges of white collar crime, health care fraud, financial fraud, general fraud charges, other criminal or civil matters, or representing our clients during a government investigation.

Ashley D. Adams, Principal
+1 (602) 524.3801
aadams@azwhitecollarcrime.com

Adams & Associates, PLC

7502 E. Monterey Way
Scottsdale, AZ 85251
Phone: 480.219.1366
Cell: 602.524.3801
Fax: 480.219.1451

 

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