Have You Been Accused of Medicaid or Medicare Fraud? What You Should Know

The medical billing system is complicated. Many medical facilities are at risk of innocently making mistakes that can be construed as Medicaid or Medicare fraud.

Some examples include:

• Billing for services that weren’t actually provided
• Billing for a more expensive procedure than was actually performed
• Billing for separate services that are supposed to be billed out in a package
• Falsely documenting a diagnosis to justify billing for a procedure that wasn’t necessary
• Misrepresenting a procedure to get coverage for something not ordinarily covered

Why It Happens

Not all cases of fraud happen because a doctor or medical facility is looking to make dishonest income. It can also happen as a result of honest mistakes.

Less experienced medical billing staff may make some unwitting mistakes. A compassionate team is often eager to find ways to help their patients afford care. Some care providers may not be up-to-date on the latest billing standards and order certain tests and procedures per their routine.

Don’t Talk to the Investigators!

No matter who’s bringing the charges against you, don’t attempt to contact or talk with them. Only share documents with those who have a warrant allowing them access. Always contact a criminal defense attorney before you do anything. The early stages of the investigation are the most critical and you can’t afford to overlook anything or make any mistakes.

Medicaid or Medicare fraud is a serious charge to have leveled at your practice. Such a claim could ruin your professional reputation for good. If you are facing such fraud charges, then you need expert help to clear your name. Contact Jeff Manciagli, Atlanta Trial Attorney and let our team explain the next steps necessary to protect you.