Los Angeles > Federal Criminal Defense > Healthcare Fraud

Los Angeles Federal Healthcare Fraud Attorney

Have you or someone you care about been arrested on federal healthcare fraud charges in Los Angeles? Contact The Rodriguez Law Group for immediate legal assistance. The federal government will prosecute these charges aggressively and seek incredibly harsh penalties.

In these types of cases, a conviction can mean years behind bars in federal prison and a requirement to pay incredibly expensive fines. Our Los Angeles federal crimes defense attorneys will defend you at every turn, working tirelessly to protect your future.

We offer a free consultation, so reach out to us online or give our Los Angeles law office a call today at (213) 995-6767 to schedule a time to discuss your case. Our legal team can review your case, advise you of your rights, and help you understand how this process will work.

Why Should I Call The Rodriguez Law Group For Help With Healthcare Fraud Charges in LA?

If you’ve been accused of attempting to defraud the federal government, prosecutors will work incredibly hard to convict. Federal prosecutors will pour endless resources into investigating your alleged fraud and gathering evidence to support its case against you. It will spare no expense in attempting to punish you for your alleged scheme.

The best way to prevent a conviction or limit the consequences is to devise and assert an aggressive defense strategy from the start. When you call The Rodriguez Law Group for help, that’s exactly what our criminal defense lawyers will do for you. We not only have decades of experience defending clients against complex criminal matters – but experience trying these very same crimes, as well.

That’s because, prior to turning to defense, Ambrosio Rodriguez spent 13 years as a Senior Deputy District Attorney. So, at The Rodriguez Law Group, we really know how the system works – because we were the system. We draw on that experience and insight every single day as we defend clients like you. We believe this gives you an unparalleled edge when your future is on the line.

When you’re charged with a federal crime, the stakes are incredibly high. For that reason, you can’t entrust your defense to just any defense attorney in Los Angeles. Your case needs to be handled by someone who has handled federal criminal matters before.

The attorneys at The Rodriguez Law Group have represented countless client sin federal court. We know understand the unique system works and, more importantly, know how to craft a successful defense strategy. Let us put our unique and unparalleled experience and track record of success to work for you. Give us a call today and learn more.

What is Healthcare Fraud?

More than one trillion dollars is spent on healthcare in the United States every year. The federal government estimates that more than $100 billion of that is lost to fraud. What exactly is healthcare fraud?

Specifically, healthcare fraud, which is codified in 18 U.S.C. §1347, occurs when a person, in connection with delivery or payment of health care benefits,  knowingly and willfully executes (or attempts to execute) a scheme to:

• Defraud any health care benefit program, OR
• Obtain, by means of fraud or fraudulent pretenses, representations, or promises, any money or property owned by or under control of any health care benefit program.

In more general terms, healthcare fraud occurs when a doctor, healthcare provider, clinic, or hospital submit false or inflated medical bills to an insurance provider.

Charges for healthcare fraud typically involve federal providers, including Medicare, Medicaid, or Tricare. However, it can also be a crime to defraud a private health insurance provider.

There’s no requirement that you have actual knowledge that what you’re doing is a crime. The fact that you defraud a healthcare benefit program, or attempt to do so, is sufficient.

Patients Can Be Charged With Healthcare Fraud, Too

Healthcare fraud doesn’t just apply to practitioners. You can potentially face healthcare fraud charges if you present and use someone else’s insurance card in an attempt to receive medical care.

Examples of Healthcare Fraud

The term “healthcare fraud” can refer to a lot of different things. Here are a few examples to make things a little clearer.

Example: Dr. Smith falsifies Joan’s patient records to indicate that she has gallbladder disorder so that he can perform and bill an unnecessary removal surgery.

Example: Dr. Cohen performs a breast reduction surgery on Alex, strictly for cosmetic purposes, which isn’t covered by her insurance provider. However, he submits a bill to her provider anyway, using a code to indicate that it was done for medically necessary reasons.

Example: Sam made a trip to the Emergency Room after falling off his bike, gets an X-Ray, and is diagnosed with a broken arm. The attending physician bills for services and tests that were never performed, including an MRI and a cat-scan.

Example: Dr. Stephens upcodes – or charges an insurance company for more expensive procedures than were actually performed.

Example: John, who is uninsured, takes his friend’s Medicaid insurance card and presents it as his when he goes to the Urgent Treatment Center.

Example: Dr. Short accepts money, services, and goods in exchange for certain accepting patients, in violation of state and federal anti-kickback statutes.

Essentially, deceiving or making false claims to a health benefits program – but namely Medicare or Medicaid – is conduct that will be classified as healthcare fraud.

What Are the Penalties for Healthcare Fraud in Los Angeles, CA?

Federal healthcare fraud is a felony in the United States. It doesn’t matter whether you submitted false claims to Medicare, Medicaid, or another benefit program. If you are convicted on healthcare fraud charges, you will face up to 10 years in prison and be required to pay up to $250,000 in fines.

If a scheme or an attempt to defraud a healthcare provider causes someone to suffer a serious bodily injury, the penalty increases to a maximum of 20 years in prison. If healthcare fraud results in death, you can potentially be sentenced to life in prison.

Collateral Consequences of a Healthcare Fraud Conviction

If convicted on federal healthcare fraud charges, you can face up to a decade behind bars and be required to pay substantial fines. However, the conviction can continue to follow you long after you’ve completed your sentence. That’s because a felony conviction carries collateral consequences, as well.

Collateral consequences are social or civic penalties that exist because of your criminal record. With a healthcare fraud conviction on your record, you might find that:

• You lose any professional licenses you once held
• It’s hard to keep or find a job in your profession
• You are unable to hold public office
• You lose the right to own or possess a firearm, and
• You can’t enlist in the United States military.

Additionally, since the conviction involves a crime of dishonesty, it might be difficult to secure a loan or financial services in the future.

Dynamic Defense Strategies in Federal Healthcare Fraud Cases

Keep in mind that, for federal felony offenses, you must be indicted by a grand jury before you can formally be charged with a crime. That means that the government has to have enough evidence to establish that there’s probable cause to support charges of healthcare fraud. But, even if you are indicted, that doesn’t mean you will be convicted.

In any criminal case, the prosecution has the burden of proving guilt beyond a reasonable doubt. That’s a much higher standard than is necessary to indict. It can be difficult to satisfy, especially when faced with an aggressive defense.

At The Rodriguez Law Group, our Los Angeles healthcare fraud attorneys will carefully investigate your alleged fraud scheme, gather evidence in support of your defense, consult with experts, and diligently craft a dynamic defense strategy for you. As part of this defense, we may argue that you:

• You simply made a mistake and did not intend to defraud a healthcare benefit program
• You did not make a false statement
• You did not act knowingly or willingly, or
• Evidence in your case was gathered in violation of your rights.

We will also carefully examine the state’s evidence and case against you, searching for any weaknesses that we can exploit in your favor. A strong defense not only involves highlighting why or how you may not be guilty, but also attacking the government’s evidence and allegations.

Schedule a Free Consultation With a Los Angeles Federal Crimes Lawyer

If you’re facing federal criminal health care fraud charges, call the experienced defense team at The Rodriguez Law Group. Our Los Angeles federal crimes lawyer has decades of experience representing clients in these serious matters. We know what it takes to successfully defend health care fraud cases and we are here to help you fight for your future. Contact us today to schedule a free initial case assessment and learn more.