Issue of fraudulent intent an important one in criminal defense

Health care fraud, as Florida readers are aware, is a big business across the United States and here in Florida. According to the Federal Bureau of Investigation, tens of billions of public tax dollars are lost to health care fraud every year, and that number is increasing. Because the threat is so great, federal authorities have been increasing efforts to target health care fraud in recent years. Florida is a significant hot spot for fraud of all kinds, including health care fraud.

To take one recent example, a total of nine hospitals and a local ambulance company in Jacksonville agreed last month to settle civil charges that they submitted fraudulent claims to Medicare. Authorities said the ambulance rides were medically unnecessary.

While most of the parties targeted in the investigation participated in the settlement, one ambulance company—Liberty Ambulance—did not. The company reportedly refused to participate in the settlement on the grounds that there was no actual intent to commit fraud. The company maintains that the mistakes were due to confusing Medicare billing rules, and that such mistakes are ordinarily corrected as soon as they are noticed.

While it isn’t clear how far that defense will go in the civil case, the point about intent is an important one to keep in mind. In criminal fraud cases, it is necessary for prosecutors to demonstrate that the defendant had intent to defraud.  Doing so is not always a straightforward matter, though. In our next post, we’ll speak more about this issue and how an experienced criminal defense attorney can help scrutinize the strength of evidence supporting criminal intent in federal fraud cases.

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