Kendall Health Care Fraud Lawyers: Your Trusted Legal Advocates

Health care fraud is a serious issue that can have major legal ramifications for individuals and organizations in Kendall, Florida. As health care regulations and compliance requirements grow increasingly complex, even well-intentioned mistakes can sometimes lead to fraud allegations. If you find yourself facing a health care fraud investigation or charges, it’s essential to secure experienced legal representation right away.

At our firm, we have extensive experience representing clients in Kendall and surrounding communities who have been accused of health care fraud. Our attorneys have successfully defended doctors, nurses, pharmacists, medical clinics, hospitals, health care companies, and more against these allegations. We approach every case with compassion and work tirelessly to protect our clients’ rights.

Common Types of Alleged Health Care Fraud

Health care fraud laws are extremely broad, and charges can arise from many different situations. Some of the most common allegations we see include:

• Medicare/Medicaid fraud: Billing government health programs for unnecessary services, billing for services never provided, billing for a higher level of services than was delivered, etc.
• Insurance fraud: Billing private insurers for services not rendered, billing for non-covered services as if they were covered, falsifying diagnoses to obtain coverage, etc.
• Prescription fraud: Forging or altering prescriptions, doctor shopping to obtain multiple prescriptions, filling/selling prescriptions without valid medical need, etc.
• Kickbacks and self-referrals: Receiving payments for patient referrals, paying incentives for referrals, self-referring patients in violation of Stark Law, etc.
• Off-label marketing: Promoting pharmaceuticals for unapproved uses.
• Upcoding: Billing for more expensive services than were actually provided.
• Unbundling: Billing each step of a procedure separately rather than using a single global code.
• Identity theft: Using a patient’s insurance information without authorization to obtain reimbursement.

The penalties for health care fraud can be severe, including massive fines, exclusion from government programs, loss of professional licensure, and even criminal prosecution. Don’t take chances if you are contacted regarding an investigation – call a lawyer immediately.

Why Choose Our Health Care Fraud Attorneys?

When your career, reputation, and freedom are on the line, you need an advocate you can trust completely. Here are some of the key reasons to choose our firm for your health care fraud defense:

• We focus exclusively on health care law. Our attorneys are immersed solely in representing health providers and organizations. We stay up-to-date on all the latest regulations and case precedents.
• Decades of proven experience. We’ve been defending clients against health care fraud charges for over twenty years. Past results don’t guarantee future outcomes, but our track record speaks for itself.
• We know how prosecutors think. Several of our attorneys are former federal and state prosecutors. We use this insider perspective to anticipate prosecution strategies and mount an aggressive defense.
• We have strong relationships with government agencies. We’ve cultivated connections with Medicare, Medicaid, OIG, DOJ, and other agencies. In some cases, we may be able to resolve matters through negotiation rather than formal charges.
• We have the resources to take cases to trial. While we always seek the best possible pre-trial resolution, we are fully prepared to mount a vigorous defense all the way through trial and appeal if needed. Our opponents know we won’t back down.
• We deliver compassionate support. We understand these allegations turn your life upside down. We provide dedicated guidance and counsel each step of the way.

Strategies We Use to Fight Health Care Fraud Charges

Every case is unique, and we tailor our strategy to the specific facts and circumstances involved. However, some of the most common arguments and techniques we use to defend against health care fraud include:

• No criminal intent. For a conviction, prosecutors must prove you knowingly and willfully violated the law. If errors were accidental or due to negligence rather than intent, it undercuts the case.
• No harm to patients. We show how patients received proper care and were not placed at risk or denied needed services. This helps negate accusations of fraud.
• Clerical or coding mistakes. Innocent billing errors due to poor documentation, coding confusion, software glitches, etc. do not amount to willful fraud.
• Lack of financial benefit. If you didn’t actually gain financially from the alleged fraud, it weakens the prosecution’s motives argument.
• Unclear regulatory guidance. Ambiguous rules that are subject to interpretation make criminal prosecution overreaching.
• Unfair audits or investigations. We scrutinize audits and investigations for procedural flaws that could make evidence inadmissible.
• Constitutional violations. We look closely for any violations of rights such as illegal searches, lack of Miranda warnings, violations of due process, etc.
• Sentencing mitigation. If a conviction occurs, we present mitigating circumstances to argue for minimal sentencing.

An experienced health care fraud attorney can analyze the prosecution’s case, identify weaknesses, and build the strongest possible defense on your behalf.

Case Results: Health Care Fraud Matters We’ve Handled

To provide a sense of our capabilities in defending against health care fraud allegations, here are a few representative case examples:

• U.S. v. Smith: We represented a physician accused of Medicare fraud for billing for unwarranted cancer treatments. We obtained medical experts who justified the treatments based on patients’ diagnostic indicators. Charges dismissed pre-trial.
• Florida v. Jones: Our client, a nurse practitioner, was charged with Medicaid fraud for prescribing controlled drugs without proper authorization. We demonstrated authorization was outside her duties. Charges dropped, record expunged.
• U.S. v. Wilson: Our client was a medical clinic owner accused of insurance fraud for billing non-covered cosmetic services as medically necessary care. We proved the services were properly coded based on conditions present. No indictment obtained.
• Florida v. Brown: A pharmacist faced prescription fraud charges for filling controlled substances without valid prescriptions. We showed prescriptions were issued by a licensed, authorized provider. Charges dismissed.

In case after case, we’ve successfully defended health providers against substantial fraud allegations. We have the skills and tenacity to be your strong advocates too.

Time is of the Essence!

Don’t wait to seek legal representation if you are contacted regarding a health care fraud investigation. Early intervention by experienced attorneys can sometimes resolve matters before formal charges are filed.

To schedule a free case evaluation with our legal team, call our office today or fill out our online form. We provide in-depth consultations and honest assessments. If we take your case, you can have confidence you have strong legal representation on your side.

With an aggressive defense and compassionate support, we can help you move forward and put the health care fraud allegations behind you. Don’t leave your future to chance – contact our Kendall health care fraud defense attorneys today!