Estimates of losses due to healthcare fraud crimes range from $20 to $105 billion. As noted in a publication by the National Association of Criminal Defense Lawyers, these high financial stakes have translated to federal and state prosecutors giving priority to healthcare fraud investigations.
Healthcare fraud investigations can target more than just doctors and nurses. The government has investigated a wide range of professions, including psychiatric hospitals, medical laboratories, ambulatory companies and home health agencies. As such, anyone in a medical professional can be subject to an inquiry. Those who are the subject of an investigation can benefit from the following tips.
#1: Build a defense.
Defensive strategies to accusations of healthcare fraud can include an independent investigation with an interview of all past and present employees. It may also be wise to review paperwork used to submit claims.
In some cases, this proactive approach can result in the interview of employees not yet interviewed by the government. The attorney representing the accused can inform the employee of their rights during an interview with the government and encourage they reach out to legal counsel when contacted.
#2: Cooperate wisely.
A Medicaid Fraud Control Unit official stated that a favorite tactic involved the issuance of a subpoena for records followed by seizure of the target’s trash for the following thirty days. The agency uses this strategy to establish the accused is throwing away records in an attempt to deceive the government. This evidence can be used to support obstruction charges, even if the accused is not guilty of healthcare fraud.
#3: Hire experienced counsel.
This is a niche area of the law. Prosecution for healthcare fraud crimes often hinges on statutes specific to the Medicare and Medicaid systems. As such, it is often wise for those accused of such a crime to seek legal counsel experienced with this area of the law.