If you are facing accusations of Medicare fraud, the ramifications can be quite serious. It could affect your career and your professional reputation. Many medical professionals risk losing their license. It could also result in fines, jail time and other such penalties.
But what exactly does Medicare fraud look like? There are many different examples, but it generally refers to a case where a person tries to defraud the Medicare system for their own financial gain. Below are a few examples of how this could happen.
Ordering unnecessary treatments
For one thing, if a medical professional knows that they can bill Medicare and then intentionally orders tests or treatments that aren’t necessary, it could be an example of fraud. The patient doesn’t actually need that treatment, but the doctor is just looking to pull money out of the Medicare system by billing for it.
Double billing for treatments that were necessary
Even when the treatment is necessary, it must be billed properly. One type of fraud is double billing or inflated billing. If the doctor gives someone a low-cost treatment but then submits the bill to Medicare at a much higher level, it could be an example of fraud. The same is true if they bill twice for one treatment.
Accepting kickbacks
Finally, kickbacks can be an example of fraud involving multiple parties. For instance, maybe a doctor knows that a patient doesn’t need a certain medication but prescribes it anyway because they will get kickbacks from the company that manufactures that medication.
If you are facing these types of allegations, the case can be quite complex. Be sure you understand all of your legal defense options at this time.
