Help with Charges of Health Care Fraud and Related Matters
It is estimated that health care fraud in the U.S. runs about $68 billion a year, leading multiple government agencies (the FBI, the Department of Justice, the Health and Human Services Office of Inspector General) to spend tens of millions of dollars in the investigation and prosecution of fraud allegations.
As a former U.S. Attorney with extensive experience and particular expertise handling criminal cases in the healthcare industry, lawyer Bruce E. Reinhart is well-positioned to provide sound legal advice and excellent representation in this area. The law office of Bruce E. Reinhart, P.A., represents doctors, hospitals and laboratories accused of fraud, assists doctors with licensure issues, and helps whistleblowers uncover actual fraud and join in the recovery of money paid by the government in false claims.
Health Care Fraud Defense
Bruce E. Reinhart represents doctors, hospitals, laboratories and other healthcare workers charged with the following types of fraud offenses:
Medicare Fraud – Examples include allegations of submitting claims to Medicare for reimbursement of services which were never provided, duplicate billing, or billing for unnecessary services.
Stark Law – This is the physician self-referral law. Under the Stark Law, a doctor cannot refer a patient to a medical group or other entity the physician or an immediate family member has an ownership or investment interest in or has a compensation agreement with for certain services payable to Medicare or Medicaid. Penalties may include fines, the repayment of claims, exclusion from Medicare, and up to $15,000 in civil monetary penalties. It is important to know that there are exceptions in the Stark Law. An experienced health care fraud defense attorney can help you understand these exceptions.
Anti-Kickback Statute – Illegal activities include knowingly and willfully offering, paying, soliciting or receiving payment directly or indirectly to induce or reward referrals of items or services that are reimbursable by Medicare or other federal health care programs. Penalties include being required to pay three times the amount of the kickback plus an additional $50,000 per kickback, along with criminal fines and prison sentences.
Criminal Health Care Fraud Statute – This law prohibits a knowing and willful execution or attempt to execute a scheme to defraud any health care benefit program or falsely obtain money from a health care program. Penalties include criminal fines, prison or both.
Civil Monetary Penalties Law – A CMP ranges from $10,000 to $50,000 per violation, along with a requirement to pay back three times the actual damage caused.
Attorney Bruce E. Reinhart recently represented a doctor on 16 counts of health care fraud. After a two-month trial in the Southern District of Florida, the doctor was acquitted on all counts.
Licensure & Exclusion Issues
A violation of the fraud laws described above can result in the nonpayment of claims, civil fines, and being excluded from Medicare and other federal health care programs, as well as criminal prosecutions and civil liability. Being excluded from Medicare or Medicaid means that the program will not pay the provider for services.
Exclusion is mandatory in cases of Medicare fraud, patient abuse or neglect, and certain felony convictions. Exclusion is possible but not required for certain misdemeanors, a license suspension or revocation, providing unnecessary or substandard services, submitting false or fraudulent claims, unlawful kickbacks, and even defaulting on education loans or scholarship obligations. Attorney Bruce E. Reinhart can help you understand your rights and options regarding exclusion and represent you in any licensure proceedings.
The False Claims Act creates civil liability for knowingly submitting or causing the submission of a false or fraudulent claim to the federal government. The law encourages people who know of such activity to come forward by allowing whistleblowers to share in any financial recovery the government makes. False Claims Act cases may be pursued by the government or in some cases by the whistleblowers themselves.
Bruce E. Reinhart recently represented two radiologists who blew the whistle on a West Palm Beach imaging company for submitting false claims to Medicare over a period of years. The government reached a $3 million settlement with the imaging company, and $600,000 was paid to the whistleblowers for their role in bringing this fraud to light.
Seek Experienced Legal Representation with Your Health Care Fraud Matter
If you have been charged with healthcare fraud or are facing exclusion from Medicare, or if you know of fraudulent activity at your workplace, contact Bruce E. Reinhart, P.A., at 561-429-8401 for advice and representation from a leading health care fraud defense attorney.