Medicare/Medicaid
Medicare and Medicaid Fraud
Healthcare is a complex industry that is heavily regulated and investigated by federal agencies, including the FBI, the Drug Enforcement Agency (“DEA”) and Georgia Drugs and Narcotics (“GDNA”). Because of this, healthcare providers often encounter a wide range of very serious allegations that can affect their careers, families and futures.
As healthcare costs continue to rise, physicians and other health care providers are facing a dramatic increase in government regulation and scrutiny, including an increase in the number and scope of investigations and prosecutions for health care fraud, as well as a surge in Medicare and Medicaid audits. Private insurance carriers also are aggressively pursuing civil health care fraud cases against medical providers.
What were once accepted practices may now be considered criminal behavior by the government or an administrative agency. Many health care providers are not aware that they are doing anything improper, much less committing a federal or state offense.
Physicians and other healthcare providers must take great care to comply with state and federal regulations, and to protect themselves against accusations of healthcare fraud.
Practitioners and healthcare offices will want to ensure that their billings are correctly coded to avoid actions by Medicare, Medicaid and private insurance companies seeking recoupment for paid claims.
If you are a healthcare provider under investigation by a governmental agency or insurance carrier for improprieties, Frances Cullen, PC can help you defend yourself against these charges, including:
- Healthcare fraud
- Medicare and Medicaid fraud
- Improper coding or billing
- Accepting kickbacks
- False medical claims
- Overbilling
- Improper coding practices
- Unnecessary medical treatment
- Altered documents
- Improper insurance collections and duplicate billings
- Prescription Drug Crimes
You need a law firm experienced in defending professionals against these kinds of charges because convictions and civil judgments for Medicare and/or Medicaid fraud can result in severe collateral consequences, including the possibility of imprisonment. Even a reasonable settlement of government claims can disrupt your successful practice and may include a significant settlement payment. Collateral consequences of these actions could prompt the discipline or revocation of a professional license and potential exclusion from government health care programs. Contact Frances Cullen, PC as soon as possible when Medicare or Medicaid charges are brought against you and let us guide you through every step in the defense process. Our firm has a proven record of success in defending these kinds of actions.
Health care providers undergoing an audit by Medicaid (Department of Community Health – DCH) also need experienced legal representation. Our firm can help you respond to audit questionnaires, and prepare the medical records and supporting documentation that can help defend yourself against civil recoupment penalties. With capable legal representation, you can settle a civil recoupment audit or negotiate favorable repayment terms. Frances Cullen, PC will put our extensive experience to work for you.
If you are a physician or other healthcare provider facing a criminal or civil investigation or prosecution by Medicare or Medicaid (Department of Community Health – DCH), contact Frances Cullen, PC for experienced representation.
