Although not everyone in Louisiana and other states is aware of it, healthcare fraud has become a significant problem in the United States over the past few decades. The magnitude of the damage to the healthcare system, including public and private insurance programs, led federal legislators in the 1990s to make defrauding the Medicare system a federal crime. Even so, criminal offenses involving healthcare providers and individuals with criminal motives continue to take billions in taxpayer dollars out of the economy. For this reason, anyone facing federal charges of fraud faces prison if convicted.
So what constitutes healthcare fraud? The Health Insurance Portability and Accountability Act of 1996 addressed two principal areas of Medicare fraud: overbilling and fraudulent billing. Conviction of these offenses can mean up to 10 years in prison as well as significant fines. If any patient is injured or dies as a result of fraudulent acts, then penalties increase substantially, bringing the ultimate possibility of life in prison if a patient dies. Healthcare fraud at the state level usually involves Medicaid programs, and every state also has felony penalties for these crimes.
What else can happen to someone convicted of healthcare fraud? A conviction for healthcare fraud can damage a person's reputation and livelihood. Physicians can lose the right to practice medicine and could be liable for civil damages in cases of injury or death.
So what should someone facing fraud charges do? Anyone accused of federal fraud charges will likely need to immediately assess their options in order to protect their interests. Over the years, hundreds of people in Louisiana have been convicted of federal healthcare crimes. Because they were convicted in federal courts, they were sentenced according to complex but severe sentencing guidelines. Addressing fraud charges early on is the best way to avoid conviction.
Source: Nhcaa.org, "The challenge of health care fraud," accessed on Feb. 16, 2015Post Type: Q&A