If you are like most New York City residents, your 2017 calendar includes mentions of the Fourth Of July, Labor Day, Memorial Day, Thanksgiving, Christmas and maybe even Groundhog Day. It probably does not include notes marking National Report Health Care Fraud Week, however. Regardless, it takes place in the second week of August, which means it is well underway.
Some estimates peg the cost of health care fraud as high as $300 billion per year. We should all be grateful for the men and women fighting fraud. And we should also all be agreed that investigations of fraud should always respect rights and privacy.
In some situations, investigators begin by looking at mistakes or violations by a particular physician in a home health care company or group practice. Others involved in those organizations might well find their own activities scrutinized by investigators though they have done nothing wrong.
Investigators are often looking for evidence of false claims, overbilling of Medicare or Medicaid, billing for services not needed or rendered, self-referrals (possible Stark Law violations) and possible Anti-Kickback Statute violations.
Investigators can be from FBI, Office of the Inspector General, the Medicaid Fraud Control Unit or other regulators or agencies.
If you find that you or your company is under investigation, you can contact the New York City law firm of Rivas Goldstein, LLP. We represent clients in all phases of administrative and criminal proceedings.
Before speaking with regulators, investigators or law enforcement, talk to an experienced health care law attorney.