Understanding Healthcare Fraud Legislations and Defenses

 The medical field has reported an increasing number of false billing cases, kickbacks, illegal prescriptions, up coding, tampering with documents, etc. The victims have been patients and the loved ones of these patients. Several legislations were enacted to counter the rise in frauds and illegal activities in the medical field, prescribing severe punishments to those found guilty of the charges laid out in the legislation. The rise in fraud reports also led to an increase in the number of false allegations arising against medical practitioners and institutions. 

Legislations And Punishments Prescribed

The various legislations enacted to combat the rise in Medicare frauds include the False Claims Act, the Anti-kickback Statute, the Criminal Healthcare Fraud law, the Stark law, or more commonly known as the Self-referral law. It prevents practices where doctors refer patients to their family members or close associates with an intent to make a profit from the patient's condition. The punishment prescribed for Medicare or healthcare fraud includes fines that could amount to over $100,000, jail time, cancellation of license to practice medicine, and even seizure of assets.

Who Can Be Held Liable Under These Laws?

The legislations stated above are meant to deter medical practitioners and medical institutions from acting fraudulently. This puts everybody associated with a medical institution or the practice of a medical professional under the radar, including the staff. If the medical staff is subject to investigation of any sort, a medical staff attorney can be engaged to shield the privileges and rights due to the person under investigation. They mediate between the parties involved and ensure that the investigations do not jeopardize the medical service offered. 

Defend Yourself Against False Allegations

A medical professional entangled in a healthcare fraud suit for no fault of theirs should seek a healthcare defense lawyer's help. These lawyers are specifically trained in defending their clients against healthcare fraud allegations. The common defenses raised include actions done with authorities' permission, bona fide acts, and the lack of sufficient evidence to convict based on accusations.

Protect Yourself From Fraudulent Whistleblowers

The enactment of the False Claims Act has led to an increase in the number of reported medical frauds. While most of them might be true, the Act offers whistleblowers protection and provides for whistleblowers to receive up to thirty percent of the total amount recovered from fraud. True, this is meant to be a means to get more people to report medical misdemeanors and fraud. However, it also acts as an inducement for those looking to profit off of the provision. False allegations against medical practitioners with the intent of securing this reward is on the rise, and a Medicare fraud defense lawyer is one's best bet against these false whistleblowers.

Summary: False allegations of Medicare fraud, if left undefended, could prove costly. Medicare fraud defense lawyers help one build a case defending oneself against allegations raised.

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