Health care fraud is a big problem in the United States, and is bound to become a bigger problem with more federal money available to the health care system through the Affordable Care Act. In an effort to counteract the problem, the Department of Justice has initiated a crackdown on health care fraud. The recent effort, thus far, has resulted in charges against 90 individuals for submitting over $260 million in fraudulent claims to Medicare.
Miami and Tampa were among the six cities targeted in the crackdown. Among these six, Miami exceeded the others by far in terms of the number of defendants. Whereas 50 individuals were charged in Miami-area schemes, seven were charged in Tampa.
Medicare fraud includes a variety of illegal activities, including submitting claims for services that were never rendered, kickbacks for recruiters who obtain patient billing numbers, and rendering unnecessary medical services. In whatever form it comes, Medicare fraud—and health care fraud in general—is an offense against the public. However, it is important that those who are charged with Medicare fraud receive a fair trial. In some cases, prosecutors may assume more with respect to criminal intent than is warranted by the evidence.
Take the example of rendering unnecessary medical services. To prosecutors intent on targeting those attempting to abuse the system, providing unnecessary services can be spun as an attempt at fraud and prosecutorial resources can be mustered in support of this contention. From a defense perspective, though, it may be something entirely different, having nothing to do with fraudulent intent.
Whatever the specific allegations in Medicare fraud cases, it is important for defendants to work with an experienced attorney in building a strong case. Doing so will help ensure the best possible outcome.
Source: The Christian Science Monitor, “Medicare fraud: Feds charge 90-plus people for $260 million in false claims,”