Florida HealthCare Fraud & False Claims Act Defense Lawyers
In the high-stakes world of health care fraud, a fraud allegation in Florida and its metro areas is more than just a legal challenge—it’s a direct threat to your business future and personal livelihood. Are you equipped with the right legal strategy to protect and defend your practice and your reputation before it’s too late?
Healthcare providers throughout Florida and its metro areas are targeted by HHS, DEA, DOJ and other law enforcement agencies in high-stakes federal healthcare fraud investigations.
If you or the company have received a target letter, Civil Investigative Demand, or subpoena for a criminal case, immediately send our Miami, Florida healthcare fraud defense lawyers.
Government Investigations | HealthCare Fraud Whistleblower Defense Strategies | Subpoenas & Civil Investigative Demands (CIDs) | FBI, HHS, Office of the Inspector General (OIG) and DOJ Investigations | Indictments | Medical Billing Fraud Defense | Federal Criminal Defense & Trials | Corporate Compliance | Internal Investigations | Health Care Fraud Investigations Defense
Legal defense for healthcare fraud Florida: For many healthcare providers, manufacturers, and small and large businesses, participating in federal government benefit programs such as Medicare, Medicaid, and Tricare is essential to maintaining their financial success. When investigated for health care fraud, federal investigations can be intrusive, scary and complex.
Your company is subjected to Health Care Fraud False Claims Act charges. This makes you subject to both civil and criminal penalties. Allegations of fraud for Tricare, Medicare, or Medicaid fraud investigation could also mean the end of the business.
Federal Healthcare providers in Florida and nationwide are being targeted in federal healthcare fraud and False Claims Act investigations. Failure to secure the proper legal defense can expose you to jail time and serious fines. It’s time to find and hire an experienced healthcare fraud defense attorney in Florida.
What Is Healthcare Fraud?
The Health Care Fraud Statute, codified under 18 USC 1347, makes it a federal offense to intentionally and knowingly defraud a healthcare benefit program. This law also covers attempts to commit such fraud, treating them with the same severity as the crime itself.
For physicians, pharmacists, and other healthcare providers in Florida, being accused of healthcare fraud is a serious and complex matter. The implications of such an accusation are far-reaching and multifaceted, creating significant challenges when facing health care fraud investigations by federal agencies such as the DOJ, DEA, OIG, or others. A federal investigation into “healthcare fraud” can arise from a variety of alleged actions, depending on the specific circumstances involved. This includes:
- Providing and billing for medically unnecessary services
- Billing for services not actually rendered to patients
- Falsifying patient records, prescriptions, physician certifications, and election statements
- Offering or accepting illegal “kickbacks” or referral fees
- Prescribing opioid medications to drug-dependent patients, diverting opioid prescriptions, and other forms of prescription drug fraud
What are Possible Legal Defenses to HealthCare Fraud?
There are some potential legal defenses to healthcare fraud charges:
Lack of Intent or Mistake – To commit fraud under health care fraud rules , you must have the requisite legal intent to cheat the government or insurer out of money. If you acted in good faith but made a mistake, accidentally omitted information, made an error, or made a mistake in billing, you cannot be convicted of health care fraud.
Insufficient Evidence – The government must have evidence of your intent to defraud and enough evidence to prove beyond a reasonable doubt. Without sufficient evidence, you cannot be convicted.
Compliance Program – An experienced Florida healthcare fraud defense lawyer and False Claims Act attorney can help you by directing the fact of your case and aggressively surmounting a solid legal defense. Evidence of a comprehensive compliance plan can be used to show you lacked intent to engage in health care fraud.
Consent – You do not commit fraud if you were granted permission for your actions by the alleged victim. Evidence you were given permission to do what you are accused of is a defense against the charges.
Federal False Claims Act
The False Claims Act (FCA) imposes civil and criminal penalties for the submission of “false or fraudulent” claims for payment by the federal government – including payment under Medicare, Medicaid, Tricare, and other federal healthcare programs. This includes intentional and unintentional billing and coding errors, as well as various other forms of healthcare fraud. Civil penalties under the FCA include fines, recoupments, treble damages, and program exclusion. Criminal penalties include fines and federal imprisonment. Call our Florida healthcare fraud defense lawyers for immediate help.
The Anti-Kickback Statute
The Anti-Kickback Statute (AKS) makes it illegal for healthcare providers to offer, pay, solicit, or receive any form of payment, rebate, referral fee, or kickback in return for referring patients whose care is reimbursed by federal healthcare programs. The AKS imposes both civil and criminal penalties for violations. However, it also outlines specific “safe harbor” provisions that protect certain types of relationships and transactions from legal liability, shielding them from civil or criminal prosecution.
Stark Law
Florida Stark Law Attorneys: The Stark Law specifically prohibits “physician self-referrals,” which occur when a physician refers patients to entities in which they or their immediate family members have a financial interest. Although the Stark Law shares similarities with the Anti-Kickback Statute—both addressing unlawful referral arrangements—it is distinct in several key ways.
The Stark Law is a civil statute, not criminal, and its application is confined to transactions between physicians and their affiliated entities. Furthermore, it only pertains to transactions involving “designated health services.” Despite its civil nature, federal authorities frequently employ the Stark Law to investigate physicians, and violations can result in significant civil penalties.
The Federal Healthcare Fraud Statute 18 USC 1347,
The healthcare fraud statute, 18 USC 1347, makes it a federal offense for you to “knowingly and willfully” defraud or attempt to defraud any healthcare benefit program or seek to secure payment from a healthcare benefit program by “false or fraudulent pretenses.” 18 USC 1347 is a federal criminal statute used by the feds to come after you. You can be convicted at trial if you do not put up a defense of knowingly and willfully defrauding the federal government. You can be liable for huge fines and years of jail time.
Florida Medicaid Fraud Defense Lawyers
Medicaid fraud criminal in Florida cases are typically investigated and prosecuted by the Office of the Inspector General’s (OIG) Fraud Strike Force. These focus is usually to target false billing by medical professionals, doctors, and nurses. Oftentimes law enforcement agencies will set up undercover “sting” operations on suspected individuals who could be engaged in Medicaid fraud in Florida. Many criminal investigations are opened due to whistleblower tips.
The Health Care Fraud Prevention and Enforcement Team (“HEAT”) was created by the Department of Justice in conjunction with the Department of Health and Human Services. HEAT is dedicated to the prevention of fraud, waste, and abuse. HEAT only deals with Medicaid fraud and Medicaid fraud. If you are investigated or charged as a result of healthcare fraud, please call our Florida Medicaid Fraud defense lawyers.
In Medicaid fraud cases, the investigators may allege or uncover several other offenses that often accompany Medicaid fraud allegations. These criminal offenses might include:
- Aggravated identity theft
- Asset forfeiture charges
- Conspiracy to commit healthcare fraud
- Durable products fraud
Immediate Help from Watson & Associates LLC
Whether you. are under federal investigation, presented with a civil investigative demand (CID) or subpoena, or being indicted by a grand jury, our Florida healthcare fraud attorneys are here to help.
We represent and defend:
- Physicians;
- Physician assistants;
- Nurses;
- Physical and occupational therapists;
- Pharmacies;
- Pharmacists;
- Drug manufacturers;
- DME suppliers;
- Hospitals; and
- Clinics
Types of Medical Fraud Cases:
- Upcoding;
- Duplicate claims;
- Medically unnecessary services;
- Non-rendered services;
- Kickbacks;
- Stark violations;
- Trade Agreements Act
- Drug diversion; or
- Other fraud-related allegations.
Contact Our Florida Healthcare Enforcement Action Defense Lawyers
As 18 USC 1347 Healthcare enforcement action defense lawyers, we represent clients in all Florida and federal courts in Florida healthcare fraud cases under 18 USC 1347,. Please contact us to schedule a FREE initial consultation. Speak to our lead attorney, Theodore Watson, directly.