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Health care fraud sentence

Aug 30, 2017 | White Collar Crimes |

A Florida physician who was charged with health care fraud has been sentenced to a year in prison. The 60-year-old physician must also pay more than $1 million in restitution and $1,134,000 in fines. The court mandated that more than $1 million must be forfeited to the federal government. She must also serve three years under a supervised release and perform 1,200 hours of community service. She was convicted of 162 counts of health care fraud.

The doctor owned and operated various medical business like the Hawthorne Medical Center. She used false billing schemes to defraud Medicaid, Medicare and Blue Cross Blue Shield of Florida. The woman and her staff bought drugs not approved by the United States Food and Drug Administration at low rates and gave these drugs to patients while billing insurance companies for the FDA-approved drugs. She also sought reimbursement for false diagnosis codes and unnecessary tests.

The physician also wanted insurance payments for counseling, training and treatment that was never performed. She billed smoking-cessation treatments to patients who did not smoke. Many agencies were involved in uncovering and investigating this case, including the Federal Bureau of Investigation, Florida Attorney General’s Medicaid Fraud Control Unit, the Internal Revenue Service and the FDA.

Health care fraud is a type of white-collar crime that could come with penalties like prison time and fines. Charges might be filed for alleged activities like double billing, falsifying invoices or performing unnecessary procedures. Government organizations or programs may be involved like Medicare or Medicaid, which could result in a federal case. The health care industry involves complex rules and regulations. Billing errors can occur, but not all of them constitute fraud. People who are facing these types of charges might want to discuss their situation with a criminal defense attorney.

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