Tampa Medicaid Fraud Lawyer
As a whole, people are motivated by profit. To get money, some people will engage in fraud. Even healthcare providers may exploit government healthcare programs for illegal personal gain.
The U.S. Government Accountability Office has designated Medicaid as a program with a high risk of fraud. Improper payments are very common. Improper payments include those made for treatments or services that were not covered by program rules, that were not medically necessary, or that were billed for but never provided. There are many state and federal laws in place to punish those who fraudulently seek to obtain improper payments from Medicaid. Federal laws include the Health Care Fraud Statute, the False Claims Act, the Anti-Kickback Statute, the Patient Access and Medicare Protection Act, and the Civil Monetary Penalties Law.
Any type of healthcare fraud can result in hefty fines and prison time. Providers may also face license suspension and other professional liability. If you are in this situation, get the help you need from a Tampa Medicaid fraud lawyer from Scriven Law, P.A.
Types of Medicaid Fraud
Medicaid fraud may include the following:
- Billing for services not rendered. Healthcare providers may submit claims to Medicaid for services that were never provided to patients.
- Providers may bill for a more expensive service than what was actually provided. An example would be billing for a complex procedure when only a simple one was performed.
- This involves billing Medicaid separately for services that are typically bundled together at a lower cost, thereby inflating the reimbursement.
- False diagnosis. Providers may falsify diagnoses to justify unnecessary procedures or treatments, which are then billed to Medicaid.
- Healthcare providers may receive kickbacks or bribes in exchange for referring patients to certain services or facilities, leading to inflated Medicaid billing.
- Phantom billing. This means billing Medicaid for services or supplies that were never provided, including fictitious patients or beneficiaries.
- Identity theft. Individuals may use stolen Medicaid beneficiary information to obtain healthcare services fraudulently, sometimes in collusion with healthcare providers.
- Double billing. This involves submitting multiple claims to Medicaid for the same service or treatment – essentially billing Medicaid twice for the same transaction.
- Prescription fraud. This includes activities such as prescribing unnecessary medications, overprescribing controlled substances, or billing for medications that were never dispensed.
- Document falsification. This involves altering medical records or other documentation to support fraudulent Medicaid claims.
- Pharmacy fraud. This involves pharmacies overbilling Medicaid for medications, submitting claims for generic drugs while dispensing brand-name drugs, or engaging in prescription drug diversion schemes.
- Transportation fraud. This refers to billing Medicaid for transportation services that were not provided, or submitting claims for transportation costs that are not eligible for reimbursement.
Contact Scriven Law Today
Medicaid fraud may involve healthcare providers, beneficiaries, and pharmacies. It can result in significant financial losses for the Medicaid program as well as potential harm to patients.
Medicaid fraud is no laughing matter. If you are facing charges, see how a Tampa Medicaid fraud lawyer from Scriven Law, P.A. can assist you. To schedule a consultation with our office, call 813-226-8522 or fill out the online form.
