Health care fraud can come in a variety of forms and can involve a variety of types of medical practitioners and workers, but it can also involve more unusual situations where there is no medical worker at all. A case out of Tampa is just such a case, involving as it does a man who has been indicted for posing as a social worker. The man had reportedly been hired at two New Port Richey home health care companies which routinely submitted claims for Medicare services.
In this case, the home health care providers submitted claims for services the man said he performed for patients. However, because such services are only covered by Medicare when they are performed by a qualified worker, he was arrested for Medicare fraud. In this case, the government is asking for a minimum of $114,000 in restitution if he is convicted. He has already been indicted by a grand jury in Tampa.
Fortunately for the companies, authorities have found no evidence that they had any knowledge of the fraud and no charges have been filed. Hopefully it stays that way. Fraud, of course, is often not proven by direct evidence. In many cases, fraud rather has to be proven by circumstantial evidence. Circumstantial evidence is, by definition, indirect evidence, and can often be open to different interpretations.
In order to be convincing in a fraud case, circumstantial evidence must—among other things—not be open to explanations which exclude fraudulent intent. Therefore, when prosecutors in a fraud case attempt to introduce circumstantial evidence in court, it is critical to have the assistance of a legal advocate to ensure that objections are made to evidence that does admit of innocent explanations. A skilled criminal defense attorney is important in every fraud case to ensure the defendant’s rights are protected.
Source: tampabay.com, “Pasco’s man of disguises accused of scamming Medicare,” Claire McNeill, October 9, 2014.
