Criminal Defense Attorney in Broward County: Three Laws You Need to Know About If Facing Medicare and Insurance Fraud

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23rd Apr 2019

Medicare and insurance fraud are serious offenses in Florida. A criminal defense attorney in Broward County can explain the charges against you and which laws may apply. There are a number of important and far-reaching federal laws that may impact your case. Our criminal defense attorney in Broward County discusses three important federal laws below.

False Claims Act

The False Claims Act makes it illegal to submit claims for payment to Medicare or Medicaid that the healthcare provider knows is false. This law protects the government’s interest by trying to prevent it from being charged for services that were not necessary or appropriate. Under this law, the healthcare provider can be fined up to three times the amount that the program lost because of the claim, plus $11,000 per false claim.

Anti-Kickback Statute

This is a criminal law that illegalizes the act of accepting payments to reward patient referrals or to generate business for federal healthcare programs. The law illegalizes both the act of rewarding these referrals and accepting these rewards. Physicians who pay or accept these kickback payments can be fined up to three times the amount they received in kickbacks, plus $50,000. Additionally, they may face jail time.

Stark Law

This law prohibits physicians from referring patients to receive certain designated health services that Medicare or Medicaid pay. They are not permitted to refer patients to providers in which the physician or family member has a financial connection, such as having an ownership interest in the business or a referral arrangement. This law does not require the government to prove that you intended to violate the law. Physicians found in violation of the law can face fines and exclusion from participation in the federal healthcare programs.