Medical treatments are assigned a Current Procedural Terminology (CPT) code and a list of CPT codes are submitted to insurers for payment. Insurers pay health care providers a designated sum for each covered treatment. Healthcare providers are expected to bill only for services rendered, and to choose the correct code for each service. Law enforcement agents often investigate providers in an effort to discover billing for services not performed, the performance of unnecessary services, or the billing of inappropriate CPT codes to receive higher payments. A DC federal healthcare overbilling lawyer can provide legal representation to healthcare professionals who have been accused of fraudulent behavior.
Investigation for or a conviction for healthcare fraud can result in forfeiture of assets, the loss of a medical license, large fines, or prison time. You should strongly consider contacting a DC federal healthcare overbilling attorney as soon as possible for help responding to an investigation and fighting to avoid conviction if you are accused of fraud.
Accusations of overbilling may occur as a result of:
Federal laws impose both civil and criminal penalties for overbilling. Penalties may include:
A charge of fraud can result in your assets being frozen under 18 U.S.C. 1345. The government is also able to seize personal and real property under 18 U.S.C. 982 if it is likely the property was acquired as part of a healthcare fraud scheme.
Prosecutors generally must show that overbilling was intentional in order for you to be assessed civil penalties or face incarceration for the crime of overbilling. A DC federal healthcare overbilling lawyer can assist you in arguing:
Prosecutors have a tougher job in criminal, rather than civil, cases. A prosecutor must prove guilt beyond a reasonable doubt to convict you of a crime. Your DC federal healthcare overbilling lawyer can help fight fines, jail, and other penalties. A federal overbilling attorney in DC may also be able to help negotiate a settlement where you keep your license and even continue to receive Medicaid and Medicare payments.
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