The United States Department of Justice created the Health Care Fraud Unit to investigate allegations of health care fraud. This unit does not just focus on doctors and hospitals. Any professional that submits a bill with Medicare, Medicaid or other health insurance providers can find themselves the subject of the unit’s scrutiny and under investigation for alleged health care fraud.
A recent investigation by the government provides an example. The investigation focused not on a medical physician, but on an acupuncturist. The government’s allegations were the result of an investigation that spanned back to 2013. The government states that between 2013 and 2018, the accused repeatedly requested reimbursement for services that patients did not receive. In addition to unprovided services, the accused allegedly also billed for services that were not medically necessary.
Based on the results of this investigation, the United States Attorney’s Office has accused the acupuncturist of multiple counts of health care fraud. The 46-year-old acupuncture professional faces one count of making a false statement during the investigation and six counts of health care fraud. If convicted, he could face a prison sentence of up to 65 years and over $1.75 million in monetary penalties.
The case serves as reminder to anyone that is billing the government or a private health care insurance provider. A failure to properly submit claims can lead to criminal charges. If you or your business is under an investigation, take the matter seriously. Contact an attorney to better ensure your legal rights are protected.