The Federal Bureau of Investigations (FBI) is reporting on the recent conclusion of an extensive investigation. According to an agency press release, five residents of South Florida entered guilty pleas in federal court this week in relation to their participation in a multimillion dollar Medicare scam. Each of the defendants pled guilty to one count of conspiracy to defraud the United States government. As stated in court records, the parties were involved with a Miami-based home health care agency, providing medical and therapy services inside the homes of clients. The allegation of fraudulent claims prompted a federal investigation that included several state and national law enforcement agencies.
According to the report, the defendants submitted falsified billing statements to Medicare for services that were either medically unnecessary or never provided at all. They then created false patient documentation in an attempt to fraudulently justify these services. The claims resulted in Medicare payments to the home health agency in excess of $6 million. In addition to these offenses, the defendants also admitted their involvement in a scheme to solicit fraudulent clients. Managers of the agency paid kickbacks in exchange for recruitment of new patients.
Medicare fraud charges are serious and the accused should begin forming a defense as soon as an investigation is discovered. The Medicare Fraud Strike Force was formed in 2007. It is a multi-agency collaboration aimed at preventing and investigating allegations of Medicare fraud. Since its inception, the agency is responsible for the prosecution of more than 2,000 defendants, accounting for more than $6 billion in claims. The task force is stacked with criminal investigators, so an early defense is vital.
When official charges are brought in a Medicare investigation, an experienced lawyer may bring a variety of defenses. To win a fraud conviction, the prosecution must prove that you intended to provide false information and receive financial gain in return. By creating reasonable doubt about your intent to defraud Medicare, your lawyer may successfully defend your case. Another possible defense would place the accuracy of the relevant claims in question. Your lawyer may provide evidence that service did actually occur for the duration of the billed amount, and that it was medically necessary. Proof of accuracy can disprove fraud.
An additional Medicare fraud defense is mistake. There are a lot of responsibilities that accompany the ability to bill Medicare for services. Employee errors, even if made innocently, can bring fraud charges upon managers and owners if they did not adequately supervise their subordinates. Multiple billing for the same service and over billing are common mistakes in medical billing.
For patients accused of Medicare fraud, there may be confusion about what services were actually rendered. These innocent misunderstandings can cause patients to make false verifications to Medicare. A competent lawyer can take these mistakes and create a defense to Medicare fraud allegations.
If you or a loved one is facing Medicare fraud charges, Attorneys Mycki Ratzan and Jude Faccidomo can provide you with an aggressive and comprehensive defense. Contact Ratzan & Faccidomo, LLC in Miami today at (305) 330-3905 for a confidential and free consultation.