Miramar Medicare Fraud Lawyers: Protecting Your Rights and Reputation
Finding yourself under investigation for Medicare fraud can be an incredibly stressful and frightening experience. However, with the right Miramar Medicare fraud lawyer on your side, you can better understand the charges against you, build an effective defense, and protect your rights, reputation and livelihood throughout the legal process.
An Empathetic, Knowledgeable Ally
As an empathetic Miramar Medicare fraud defense attorney, I understand this situation can make you feel scared, overwhelmed and alone. I aim to provide compassionate counsel so you don’t have to go through this alone. My in-depth knowledge of Medicare billing regulations, fraud statutes and defense strategies allows me to examine the details of your unique situation to build a personalized, strategic defense.
What Constitutes Medicare Fraud?
Medicare fraud refers to intentionally deceiving Medicare by billing for services that were not performed, billing for unnecessary services, billing for services that did not meet standards of care, billing for services performed by unlicensed or excluded individuals, billing for services that were already paid for by another entity, or making false statements on claims forms to gain higher payments, among other fraudulent activities.
If convicted, penalties can include massive fines up to $500,000 per claim, federal prison time, exclusion from Medicare and Medicaid programs, loss of medical license, restitution payments, and loss of hospital privileges. However, many activities that appear fraudulent may have logical, benign explanations when all evidence is reviewed. An experienced attorney can analyze the context and build a defense around extenuating circumstances.
Common Investigations Miramar Clients Face
Some types of Medicare fraud charges I commonly defend Miramar clients against include:
- Upcoding: Billing for more complex, higher reimbursing service codes than were actually performed
- Unbundling: Billing each step of a procedure separately rather than under a single global code
- Phantom Billing: Billing for services that were never performed
- Kickbacks: Receiving illegal compensation for Medicare referrals
- Medically Unnecessary Services: Billing tests, treatments or equipment not needed per standards of care
- Improper Billing Practices: Billing deceased patients, duplicate claims, etc.
However, these complicated billing regulations leave a lot of room for interpretation and human error. We can build strong defenses around misunderstandings, good faith disputes, industry standards and more.
4 Lines of Defense I Use to Protect Clients
I employ four main strategies to defend clients against civil and criminal Medicare fraud charges:
1. Procedural Defense
I review the investigation and charging process itself for constitutional violations and other procedural issues like lack of evidence, lack of probable cause for warrants, improper interviews/interrogations, etc. Suppressing illegally obtained evidence can cripple the prosecution’s case.
2. Good Faith Disputes
If the core allegation stems from a reasonable difference in interpreting complex billing statutes and codes, I can often show you acted in good faith without intent to defraud Medicare. This can achieve dismissal of criminal charges or reduction to a civil settlement.
3. Industry Customs and Standards
By analyzing billing patterns and practices across your specialty and region, I can often show your billing activities aligned with widespread industry customs that regulators have not clearly deemed improper. This can weaken allegations of intentionally fraudulent conduct.
4. Mitigating Factors
I scour the evidence to identify any mitigating factors that cast doubt on criminal culpability, such as:
- Lack of actual patient harm
- Minimal financial impact on Medicare
- Immediate efforts to self-correct upon notification
- No prior fraud complaints or convictions
- Positive peer reviews and patient satisfaction
- Charitable medical services and other social goods provided
Emphasizing these factors can help secure a dismissal of charges or settlement with no prison time or exclusion from federal programs.
Why Choose Us?
Navigating Medicare fraud investigations and charges requires highly specialized legal knowledge and advocacy skills. As a former Medicare prosecutor, I understand all angles of these cases – including tactics prosecutors use and flaws in their methods. My boutique Miramar firm focuses specifically on complex healthcare law and Medicare fraud defense, allowing us to provide elite, focused representation.
I have over 15 years of experience achieving favorable outcomes for doctors, medical group administrators, practice owners, hospitals and healthcare executives facing Medicare fraud allegations. My track record includes reduced settlements, case dismissals, no prison time and no program exclusion for clients dealing with upcoding, phantom billing, kickback and medically unnecessary services allegations.
I provide aggressive, strategic defense while understanding the immense stress and disruption charges cause in your professional and personal life. I offer transparent, compassionate counsel each step of the way toward the best possible outcome. To schedule a free case evaluation and discuss your legal options, call me today at 123-456-7890 or contact me online.