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Guide to Medicare Fraud Defense

Being accused of Medicare fraud is a serious matter that can jeopardize your career, reputation, and livelihood. These charges often involve complex regulations, and even an honest mistake can escalate into allegations of criminal activity. As a healthcare professional, you’ve worked hard to build your career—don’t let an accusation take that away.  Houston criminal defense attorney Robert J. Fickman understands the high stakes of Medicare fraud cases, and he is committed to protecting your rights and future. Reach out to him for a confidential case review.

What Is Medicare Fraud?

Medicare fraud occurs when someone knowingly submits false claims or misrepresents facts to receive payments from the Medicare program. This can include a wide range of actions, from overbilling for services to receiving kickbacks for referrals. Unfortunately, even honest healthcare providers can find themselves accused of fraud due to billing errors or misinterpretations of Medicare regulations.

Consequences of Medicare Fraud Accusations

Medicare fraud accusations are more than a legal headache—they can upend your entire life. If convicted, you can face:

  • Criminal Penalties: Fines, restitution payments, and imprisonment.
  • Civil Penalties: Substantial financial settlements or judgments.
  • Professional Consequences: Suspension or revocation of medical licenses, barring you from future Medicare participation.

Beyond these penalties, the damage to your professional reputation can be devastating. Patients may lose trust, colleagues may distance themselves, and your business can suffer irreparably.

Common Types of Medicare Fraud Allegations

Understanding the nature of the accusations against you is the first step in building a strong defense. Here are some of the most common allegations healthcare professionals face:

  • Billing for Services Not Provided: Submitting claims for procedures or treatments that were never performed.
  • Upcoding and Unbundling Charges: Charging for more expensive procedures than those performed or billing separately for services that should be bundled.
  • Falsifying Patient Records: Altering or fabricating documentation to justify higher reimbursements.
  • Illegal Kickbacks: Paying or receiving compensation for patient referrals, a violation of the Anti-Kickback Statute.

Even if the accusations stem from honest mistakes or third-party errors, the government takes these allegations seriously.

Key Steps to Take If Accused of Medicare Fraud

If you’re accused of Medicare fraud, it’s natural to feel overwhelmed. However, your response can make all the difference in your case. Here’s what you should do immediately:

  • Seek Legal Representation: The most important step is to hire a Medicare fraud defense attorney who will fight for  you through every phase of the case
  • Stay Silent: Do not speak to investigators or authorities without legal representation. Anything you say can be used against you.
  • Preserve Records: Secure all relevant documentation, including patient records, billing data, and correspondence. These can be critical in building your defense.
  • Notify Relevant Parties: Contact your malpractice insurer and inform them of the situation, if applicable. In some situations, your malpractice insurance may provide a lawyer. The malpractice lawyer can work side by side with your with your criminal defense lawyer.

Houston Medicare Fraud Defense Lawyer

Building a Strong Medicare Fraud Defense

Defending against Medicare fraud requires a clear, aggressive approach. Here’s how Robert J. Fickman Criminal Defense builds a case for our clients:

  • Analyzing the Evidence: We scrutinize every detail of the government’s case, identifying inconsistencies, procedural errors, or misinterpretations.
  • Challenging Intent: Many Medicare fraud cases hinge on intent. We demonstrate when errors are the result of misunderstandings or administrative mistakes rather than deliberate fraud.
  • Highlighting Compliance Efforts: If your practice has a history of following Medicare rules or implementing compliance programs, we ensure the court sees this as evidence of good faith.

Get Trusted Defense with Houston Criminal Lawyer Robert Fickman

When you’re accused of Medicare fraud, your future is on the line. You need an attorney who will fight with passion and precision. Houston criminal lawyer Robert Fickman brings four  decades of experience to every case, driven by his commitment to defending the accused and protecting their rights. Known for his strong advocacy and unwavering dedication, Robert understands your challenges and tailors his approach to your unique situation.

Don’t face these accusations alone—put a proven defender in your corner. Call (713) 655-7400 or connect with us online to explore your defense options. With Robert Fickman, you’ll have a determined advocate every step of the way.

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