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What offenses qualify as federal health-care fraud?

Defrauding a health-care system such as Medicare is a serious federal crime everywhere in the United States, including Louisiana. Every month it seems federal health care fraud cases involving health-care professionals make the news. It is important to note that physicians, surgeons, dentists and pharmacists are not the only ones who can face federal charges. If they have violated any law governing federal health-care coverage, consumers can also face charges.

If you are a health-care provider, you can be charged with fraud if you bill for a medical treatment that was never performed. Ordering and charging for unnecessary tests and procedures can also lead to health-care fraud charges. Billing for a service that costs more than the actual amount of that procedure, a practice known as "upcoding," can also lead to a federal charge. If you accept a kickback for a patient's referral, you can also be charged with fraud. Finally, if you charge a patient an amount higher than the allowable copay, you could be charged with fraud.

Consumers can be charged with federal health-care fraud by filing a claim for a treatment that was never received or performed. Other offenses include submitting fake receipts or bills and using another person's insurance card or account.

Health-care fraud charges can lead to tough penalties and fines for anyone who is convicted. Federal agents will thoroughly investigate an allegation of fraud.

If you have been charged with federal health-care fraud, you should immediately speak with a legal professional who knows how to handle this type of case. The legal professional can investigate your case, determine the nature, extent and source of the charges and then build a defense that protects your best interests by working toward the best possible outcome.

Source: cms.gov, "Common Types of Health Care Fraud," Accessed August 28, 2014

Source: cms.gov, "Common Types of Health Care Fraud," Accessed August 28, 2014

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