Medicare is an ongoing problem that defrauds the federal government of millions of dollars every year. Investigators, police and government agencies work hard to prevent and stop fraud by way of Medicare billing. In the process, sometimes hard-working medical professionals are accused of fraud that was, in fact, unintentional.
Was your medical clinic, hospital or private physical therapy practice caught in the cross fire of an overzealous investigation? Were occasional, honest mistakes in billing and bookkeeping construed to be a full-blown Medicare fraud practice? Have your accountants been accused of double billing? Have your physicians been charged with billing for services that they did not provide?
The False Claims Act prohibits a person from defrauding the government. The law covers all government programs, including Medicare. A physician can be held liable for deliberately submitting a false Medicare claim or for acting in reckless disregard of the truth in filing a Medicare claim. The law has both criminal and civil components, meaning that violators are subject to prison sentences and heavy fines.
The Criminal Health Care Fraud Statute prohibits a person from knowingly and willingly defrauding Medicare. A person in Albany who violates the statute is subject to a prison sentence and/or fines.
The Anti-Kickback Statute – Criminal penalties, including prison time, apply to anyone who offers or receives compensation for referring patients to receive items or services reimbursable by a federal health care program.
The Physician Self-Referral Act (Stark Law) specifically prohibits physician self-referrals. This means that a physician may not refer patients to private facilities in Albany where he or she has an ownership or financial interest. A physician who violates the law can be fined and excluded from participating in federal health care programs.
The Exclusion Statute – Calls for physicians in Albany who commit Medicare fraud to be excluded from participating in all federal health care programs. Health care facilities that ignore the statute and employ an excluded physician may incur heavy fines.
The Civil Monetary Penalty Law – Contained in the Social Security Act, this law imposes civil penalties on physicians who commit Medicare fraud or who violate one of the other Medicare fraud statutes.
The Law Office of James E. Tyner, PLLC is a full-service, well-established Albany criminal defense law practice serving individuals as well as entities such as businesses and medical practices. We defend clients in all Federal District Courts (Northern District of New York, Western District of New York, Southern District of New York and Eastern District of New York).
Our attorneys are here to provide the aggressive representation that you need to salvage your reputation and keep your medical practice thriving while the fraud case is being resolved. You can count on our Albany criminal defense lawyers to be discreet in handling this time-sensitive legal matter.
If you have been charged with any type of white collar crime, such as health insurance fraud or Medicare fraud, and need to speak with an attorney, schedule a free consultation. Call us at 518-783-3800 or email us directly regarding fraud defense for your dental office or medical practice.
I was referred to Mr. Tyner from a fellow colleague and I was more than impressed with the way he handled my case. From the first consultation, to the final decision, he thoroughly explained each step of the process. There was open communication which I found very helpful. I never hesitated to call and he was always there to answer any and all of my questions or concerns I had. He is very professional, efficient, and detail oriented. I would not hesitate to use Mr. Tyner in the future.
Posted by: Christine Bazicki