Tampa Insurance Fraud Attorneys
When individuals or corporations intentionally deceive an insurance company or agent in order to collect money to which they are not entitled, they can be charged with insurance fraud (18 U.S.C. Sections 1007, 1014, 1033 and 1035). Additionally, insurance companies or agents can defraud policyholders.
Because insurance fraud costs Americans an estimated $54 billion a year, it is often aggressively prosecuted. Penalties for conviction will depend on the specifics of the offense but may include fines and/or a prison sentence. In addition, you may face penalties for other charges associated with insurance fraud such as mail and wire fraud, arson or Racketeer Influenced and Corrupt Organization (RICO) Act charges.
O’Brien Hatfield Reese, PA, provides criminal defense representation for individuals and businesses charged with insurance fraud. Our Tampa insurance fraud lawyers have experience fighting state and federal criminal charges, including white collar crime and violent crime. Not only are our founding partners former prosecutors, but they also previously worked at insurance defense firms defending national and local insurance companies. We can handle all charges associated with your arrest.
Our results include a dismissal of four of the six counts that our client faced, including arson and insurance fraud.
Complex Insurance Fraud Defense
Our firm can take on all types of insurance fraud cases, including:
- Life insurance fraud
- Medicaid and Medicare fraud
- Health insurance fraud
- Homeowners insurance fraud
- Long-term disability insurance fraud
- Commercial property insurance fraud
- Social Security Disability Insurance (SSDI) fraud
- Workers’ compensation insurance fraud
We can defend you against soft fraud, such as inventing or exaggerating robbery, fire or other losses or faking illness and injuries. Our attorneys also take cases of hard fraud, including insurance-related arson, staging car accidents and committing murder to collect insurance.
Tampa Health Care Fraud Attorneys
Under 18 U.S.C. Section 1347, health care fraud is defined as a party knowingly and willfully executing or attempting to execute fraud on a health care benefit program or fraudulently obtaining money or property from a health care benefit program in connection with the delivery of or payment for health care benefits, items or services.
The penalties for conviction of health care fraud include:
- A prison term of up to 10 years
- If the fraud causes serious bodily injury, a prison term of up to 20 years
- If it causes death, the sentence can be up to life in prison
In addition to a prison sentence, you could lose your professional license and be subject to hefty fines and years of probation. To convict an individual or business of health care fraud, the prosecution must prove that a fraudulent claim was submitted and that the organization knew that the claim was fraudulent. Our attorneys will strive to show that there was no fraudulent intent. In some cases, a simple error in accounting, such as the selection of the wrong code or poor record-keeping, can be mistaken for intentional fraud.
Dedicated Defense For Providers Charged With Health Care Fraud
Since it began its efforts to target health care fraud, the federal government has recovered billions. With growing successes behind them, investigations are likely to intensify. Law enforcement works with private insurance companies to try and identify suspicious billing patterns.
Our lawyers are dedicated to providing an aggressive defense to hospitals, clinics, home health care providers, doctors, nurses, personal care attendants, medical coding companies, pharmacists and durable medical equipment companies throughout Florida that are being investigated for or have been charged with:
- Submitting bills for services that were not provided or submitting duplicate bills
- Submitting bills for services that are not covered as covered
- Submitting bills for unnecessary medical equipment
- Distributing unnecessary or nonapproved devices or drugs or modifying medical records
- Attempting to maximize payment by intentionally reporting the wrong diagnosis or procedure
- Prescribing services, tests or treatments that are not necessary
- Providing fake or unnecessary tests to people as part of a rolling lab scheme
- Using untrained or unlicensed personnel to provide services or intentionally misrepresenting oneself as a licensed health care provider
- Misrepresenting dates, services or identities of members
- Providing kickbacks for patient referrals or waiving co-pays
Defending against provider health care fraud is not easy. It requires an experienced attorney capable of providing a robust defense in both state and federal courts.
Understanding Employer Liability In Health Care Fraud Cases
According to 18 U.S.C. Section 1035 and 18 U.S.C. Section 1347, anyone who makes false representations regarding the existence of a health care benefit or conveys false facts in order to obtain benefits or payments is guilty of health care fraud. Employers do not need to have any knowledge of the law or intention to break it to be guilty of fraud. Our attorneys defend employers who have been accused of:
- Improperly enrolling ineligible employees in a company health care plan
- Adjusting dates of hire or termination to provide greater coverage dates
- Forming fake health insurance companies or employee benefit plans
- Misrepresenting the employer group to obtain health care benefits
Employers who attempt to obtain benefits under false pretenses may be charged with other white collar offenses, including RICO Act and mail fraud charges.
Tampa, Florida, Medicare And Medicaid Fraud Attorneys
The penalties for a Medicare or Medicaid fraud conviction can be harsh. You may be charged with multiple offenses, such as 18 U.S.C. Section 287, or the False Claims Act. A conviction for this offense may result in up to five years in prison, a fine of $250,000 for an individual and $500,000 for a corporation for a felony conviction. A fine of $100,000 for an individual and $200,000 for a corporation will be levied for a misdemeanor conviction.
Typical issues involved in these cases may include:
- False billing
- Billing multiple times for the same procedure
- Billing for phantom patients
- Falsifying information
Medicare and Medicaid regulations are notoriously complex, and honest mistakes are not unusual. A billing or record-keeping error can be misinterpreted by federal officials as intentional fraud. Our attorneys will work to force the prosecution to prove that intentional fraud occurred. As former prosecutors, we know how to expose weaknesses in the government’s case.
Professional License Defense Attorney In Orlando
If you are facing criminal charges or allegations of professional malpractice, it is possible that your professional license may be suspended or revoked. It is critical that you speak with an attorney as soon as possible, even if you have not committed any wrongdoing. In some cases, simply being charged with a crime can damage your professional reputation.
People with professional licenses are required to uphold the accepted legal and ethical standards in their professions. If they do not, they can lose their license and career. At O’Brien Hatfield Reese, PA, we represent professionals, such as doctors, pharmacists, therapists, attorneys, financial advisers, accountants, architects, engineers, insurance agents and real estate agents who are charged with crimes or professional negligence.