Health Care (Medicare & Medicaid) Fraud

Medicare fraud and Medicaid fraud have cost the federal government billions of dollars. They want revenge. In 2007, the feds uncovered more than a half-billion dollars in fraudulent claims in South Florida alone.

 

There are many different ways companies and individuals can bill Medicare and Medicaid. Knowing and intentional deception or misrepresentation, which results in some unauthorized medical payment or benefit to a person, entity, or to a third party, can result in charges of Health Care Fraud.

 

One example of medicare health care fraud is billing for services not rendered. One common act is billing for durable medical equipment (commonly called "DME") that was never bought, rented, or delivered. Durable medical equipment includes things like: wheelchairs, walkers, respirators and motorized scooters. back braces, canes, electric beds and shower-transfer tubs.

 

Some doctors bill for procedures they never performed. Sometimes there are false billing records made in order to support the fraudulent bills. Other examples of health care fraud include kickbacks, infusion therapy and fraudulent cost reports.

 

In Miami, Florida, the Feds have a new Medicare Fraud Strike Force. The Feds are arresting and charging people left and right for Medicare fraud. Typically, the Feds will also charge conspiracy to defraud the Medicare program, criminal false claims, and violations of the anti-kickback statutes.

 

Check Fraud

Writing a check on a closed account, or where there are insufficient funds to cover the check, forging a check, altering a check, or counterfeiting a check, can result in Check Fraud charges.

 

Credit Card Fraud

Using a credit card attached to a closed account, or that has been lost, or stolen, in order to purchase anything of value, can result in being charged with Credit Card Fraud. Credit Card Fraud charges may result from crimes such as, counterfeiting credit cards, using lost or stolen cards, and fraudulently acquiring credit cards through the mail. Another form of Credit Card Fraud is misappropriation, the crime of using a credit card number by itself to make purchases. Credit Card Fraud crimes are investigated and prosecuted primarily by the U.S. Secret Service. However, other state and federal agencies may pursue Credit Card Fraud cases.

 

Credit Card Fraud crimes, and penalties are explained by Title 18, 1029 of the U.S. Code, which more broadly addresses the category of Fraud and Related Activities in Connection With Access Devices. An access device is a mechanism which allows access to account funds. Examples of access points may include devices such as, credit cards themselves to telecommunications equipment to PIN codes to counterfeit cards. Most credit card fraud today takes place through the computer and internet.

 

Disaster Fraud

Following any natural disaster, or catastrophe, any activity which is designed to defraud citizens or the government, can result in charges of Disaster Fraud.

 

Embezzlement

Embezzlement is the fraudulent appropriation of property or money entrusted to a person's care but owned by someone else, to his or her own use. For example, a clerk or cashier can embezzle money from his or her employer; a civil servant can embezzle funds from the treasury. The Federal Bureau of Investigation (FBI) defines embezzlement as the "misappropriation or misapplication of money or property entrusted to one's care, custody or control."

 

Identity Theft

Identity theft is growing rapidly. I get calls just about every week for identity theft. It is a federal crime, pursuant to the Identity Theft and Assumption Deterrence Act of 1998, to knowingly transfer or use the identifying documentation of another person without legal authority, and with the intent to commit, aid, or abet unlawful criminal activity.

 

Insurance Fraud

Making an insurance claim or increasing the amount of a claim by deceptive statements or misrepresentations regarding the nature of the loss can result in charges of Insurance Fraud. Insurance Fraud is a form of theft by deception.

 

Money Laundering

Filtering dirty money, or the proceeds from illegal activities, through a series of transactions until the funds appear to be proceeds from legal activities, is illegal and can result in charges of Money Laundering.

 

Securities Fraud

Any manipulative or deceptive activities which affect the purchase or sale of a securities, usually including the misrepresentation or omission of material information is Securities Fraud and can result in serious criminal charges. The Securities Act of 1933 and the Securities Exchange Act of 1934 are two laws which seek to counter this type of criminal activity in order to protect investors.

 

Telemarketing Fraud

Any scheme designed to obtain money or property from victims using dishonesty, and deceptive behavior using telemarketing, is Telemarketing Fraud, and can result in serious criminal charges.

 

Bankruptcy Fraud

Concealment and misrepresentation of assets as part of bankruptcy proceedings can constitute Bankruptcy Fraud. Bankruptcy statutes can be used in the prosecution of both individuals and organizations. Title 11 of the U.S. Code addresses Bankruptcy Fraud, and criminal sanctions for Bankruptcy Fraud are located in Title 18 of the U.S. Code, 152 and 157.

 

The Internal Revenue Services Criminal Investigation Bankruptcy Fraud Program is the government agency charged with investigating Bankruptcy Fraud Cases. Following investigation by the IRS, cases are referred to the Department of Justice for prosecution. In 2006 the average sentence for those convicted of Bankruptcy Fraud was 29 months in either federal prison or some other form of detention. Those convicted of bankruptcy fraud face fines, imprisonment of no more than five years, or both. If you are under investigation or face prosecution for bankruptcy fraud, it is important to seek the counsel of an experienced bankruptcy fraud defense attorney as soon as possible.

 

Business Fraud and Theft

Where an employee commits a theft against his/her employer, and that the employee attempted to conceal the theft and used the assets for personal gain, Business Fraud charges may result. Business fraud and theft sanctions are addressed in 18 U.S.C. 641-649.

 

Internet Fraud

Internet fraud is any fraud scheme using the Internet to present fraudulent solicitations to prospective victims, to conduct fraudulent transactions, or to transmit the proceeds of fraud to financial institutions or to others organizations or individual connected to the scheme.

 

Counterfeiting

Counterfeiting involves the creation of forged (fake) versions of bills, checks, bonds, or other valuable documents. In order to be guilty of counterfeiting, a person must have intent to deceive or defraud. Many crimes may be categorized as counterfeiting. Possession of paper closely resembling the paper used by the Treasury to print money may result in being charged with a Class B Felony. Regulations regarding forgery crimes such as forging military discharges (498) and changing the VIN on your car (512) are addressed by Title 18 of the U.S. Code, Chapter 25.

 

The investigation and enforcement of counterfeiting of U.S. obligations and securities is under the direct jurisdiction of the U.S. Secret Service. The Secret Service Financial Crimes Division may also investigate forgery of government bonds, checks, and other bank fraud.

 

Individuals may be accused of counterfeiting without even knowing that the currency or other instrument in their possession was forged. A person arrested under these circumstances may face charges, including conspiracy. An experienced criminal defense attorney may be able to limit the charges, mitigate the sentence, and provide the best opportunity to get charges dropped.

 

If you need a Federal fraud white collar crime lawyer, call me,