Defense Against Healthcare Fraud Charges

By Brock Benjamin
Founding Attorney

What is the penalty for healthcare fraud in Texas?

Healthcare fraud is a significant national problem. The National Health Care Anti-Fraud Association estimates that healthcare fraud costs the nation over $68 billion per year, while some estimates place the cost of healthcare fraud at more like $230 billion. In recent years, the federal government has cracked down on individuals who commit healthcare fraud. Prosecutors on the federal and state level are seeking long prison sentences and forfeiture of assets from doctors, office staff, brokers, and others. Accordingly, anyone who has been accused of the crime of health care fraud will need to contact our experienced El Paso, Texas criminal defense firm.

Health Care Fraud

Healthcare fraud is a federal crime set out in Title 18, Section 1347 of the United States Code. The Code defines healthcare fraud as the knowing and willful execution, or attempt to execute, a scheme in order to defraud any health care benefit program or obtain, by means of false or fraudulent representations or promises, any money owned or controlled by a health care benefit program. Within the statute, there are several different types of health care fraud.

Health care fraud is a serious offense that carries a penalty of up to ten years in federal prison. Should the fraudulent scheme result in injury to a patient, the punishment jumps to 20 years in prison.

Medicare Fraud

One of the most common forms of health care fraud is Medicare fraud. Medicare fraud can encompass a wide range of criminal activities. It may include billing for services that were not provided, or billing for more complex services than those actually provided to the patient. It could also include billing for, and providing, services that were not medically necessary. All of these actions could harm a Medicare patient.

Monetary Penalties

In addition to prison time, those convicted of health care fraud may face hefty monetary policies. The False Claims Act provides that for each false claim made to the government, the provider can be charged somewhere between $5,500 and $11,000. Further, the provider could be forced to pay up to three times the damages incurred by the government due to the false claim. Additionally, it is possible for the government to seek a forfeiture of any monies gained due to the fraudulent activity.
Health care fraud is among the most serious charges you could face, but at times this charge stems from mistakes innocently made. Your defense attorney will assist you in investigating the charges against you and bringing a strong defense.

About the Author
Brock Benjamin is board-certified in Criminal Law by the Texas Board of Legal Specialization.  His practice is primarily state and federal criminal law and appeals.Brock 

Posted in: Criminal Defense