Top-Tier Advocacy In High-Stakes Cases

Options when faced with a charge of health care fraud

On Behalf of | Apr 15, 2020 | Firm News |

Health care fraud is a serious federal felony, but an accused physician may counteract the charges with a resilient legal defense. When a prosecutor alleges that an individual engaged in fraudulent practices, medical records may disprove the purported incriminating evidence. 

Because of the prescription pill epidemic, more doctors may find their practices scrutinized over the slightest suspicion of fraud. Allegations of providing a false or unnecessary script may result in an investigation by law enforcement officials. 

While individuals may prepare to defend themselves while under investigation, a prosecutor may have compiled evidence from a variety of sources. The habit of keeping accurate and meticulous patient reports, however, may provide assertive legal protection during a questioning procedure. 

When a plea deal presents a workable option 

Ongoing changes creating loopholes in billing requirements may tempt a medical professional to bend the rules or cut corners. When a defendant cannot counter a prosecutor’s assertion, a plea deal may reduce the severity of penalties that could otherwise include imprisonment. 

In one such case, a federal prosecutor filed a fraud charge against a Pennsylvania physician alleging that he wrote a prescription for his wife, but instead took the pills himself. The evidence presented to the court showed the doctor also submitted several false claims for the pills to his wife’s insurance company. 

By admitting guilt to one count of health care fraud, his sentence resulted in six months of home confinement and five years of probation, according to the Department of Justice. The judge also ordered him to pay restitution to the insurance company and a $5,000 fine. The most significant end result of the plea deal was the avoidance of jail time. 

Early intervention and evaluating long-term effects 

preemptive approach may help dissuade investigators from continuing and pressing charges. An individual under investigation may present evidence that effectively counteracts suspicions of wrongdoing. 

When a conviction appears likely, a plea bargain may serve to lessen the punishment. Before entering into a plea deal, an individual may benefit from considering the long-term effects. The outcome could include license suspension, community service and other requirements to regain professional standing.