8th May 2018
If you have been charged with healthcare fraud, it is important to talk to a South Florida criminal defense attorney during a confidential consultation. Your attorney can explain the nature of the charges against you and the potential penalties that you face. During your confidential consultation your South Florida criminal defense attorney will explain the crime of healthcare fraud and the punishment the court can hand down.
Crime of Healthcare Fraud
Healthcare fraud is the knowing and willful execution of a scheme that is intended to defraud any healthcare benefit program or to obtain something of value. This crime is often charged when a doctor or other healthcare provider bills Medicaid or Medicare for services that were not provided or by double billing. However, healthcare fraud is not limited to just this type of action or this type of defendant. Healthcare fraud charges can be pursued if a person received anything of value or attempted to receive something of value based on his or her fraudulent conduct.
Elements of the Offense
To secure a conviction, the prosecution must establish that a defendant knew a submitted claim was false. The prosecution must establish the following elements by proof beyond a reasonable doubt:
- The defendant knowingly executed a scheme to defraud a healthcare benefit program or attempted to obtain something of value by fraud, false promises or fraudulent representations;
- The false promises, fraudulent representations or fraud related to a material fact;
- The defendant acted in a willful manner and indented to defraud through his or her actions; and
- The defendant defrauded the benefit program to receive or have paid healthcare benefits, items or services.
Penalties for Healthcare Fraud
Healthcare fraud can be charged under a variety of different state and federal statutes. For example, 18 U.S.C. § 1347 provides a penalty of imprisonment up to 10 years. If the crime causes serious bodily injury, the maximum sentence is increased to 20 years.