If you put in the considerable time and effort to pursue a medical career, you likely have a commitment to achievement and a passion for helping your fellow man. A charge of Medicaid fraud can put everything you have worked so hard for in jeopardy, and if this is the situation you find yourself in, it is in your best interest to reach out to an experienced Gatesville criminal defense attorney today.
A Challenge of the Medical Profession
The medical profession is fraught with challenges, but dealing with insurance issues is right up there. In fact, providing the Medicaid program with information that is incorrect is considered fraud in the eyes of the law, and if you are deemed to have derived a financial benefit from the proceeds you received, the State of Texas can levy considerable penalties against you.
Common Charges
Some of the most common charges related to Medicaid fraud include:
Submitting bills for patients who are ineligible for Medicaid services (or who are deceased)
Altering Medicaid receipts and bills
Billing patients for services already covered by Medicaid
Submitting bills for medical services that were not rendered
Artificially elevating Medicaid’s cost for medical services rendered
Charging for more costly services than those provided
The unfortunate truth is that charges of Medicaid fraud are often based on very little evidence. Further, insurance billing is so complicated that errors are exceptionally complicated, which can leave you facing a fraud charge that seemingly comes out of nowhere.
Charges
Medicaid fraud is naturally a serious crime, and a conviction can lead to the loss of your medical license to practice – in addition to jail time and fines that can include reimbursing the state’s financial losses. The severity of the charge hinges on the seriousness of the alleged fraud. Consider the following:
If the value of the alleged fraud is under $100, it is a Class C misdemeanor.
If the value of the alleged fraud is between $100 and $750, it is a Class B misdemeanor.
If the value of the alleged fraud is between $750 and $2,500, it is a Class A misdemeanor.
If the value of the alleged fraud is between $2,500 and $30,000 (or the value is too difficult to reasonably ascertain), it is a state jail felony.
If the value of the alleged fraud is between $30,000 and $150,000 – or between 25 and 50 fraudulent claims were submitted – it is a third-degree felony.
If the value of the alleged fraud is between $150,000 and $300,000 – or more than 50 fraudulent claims were submitted – it is a second-degree felony.
You Need an Experienced Criminal Defense Attorney on Your Side
Brett Pritchard at The Law Office of Brett H. Pritchard in Gatesville, Texas, is a formidable criminal defense attorney who takes considerable pride in guiding cases like yours toward their optimal outcomes, and he is on your side. To learn more, please do not wait to contact or call us at 254-501-4040 today.
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