Los Angeles Medicare Fraud Defense Attorneys

Skilled & Innovative California Criminal Defense Attorneys

Medicare fraud occurs when an individual claims benefits from a federal health care program (like Medicare or Medicaid) using a false statement or misrepresentation of facts. If you have been accused of Medicare fraud in southern California, you need a strong legal defense to back you up. At Lessem, Newstat & Tooson, LLP, our team of knowledgeable and experienced attorneys have what it takes to get you off with the lightest sentence possible depending on the circumstances of your alleged crime. We will work together to come up with an innovative and pragmatic defense that works best for you.

Contact us at (800) 462-7160 to work with our skilled Medicare fraud defense attorneys.

Types of Medicare Fraud

Medicare fraud occurs when an individual or institution purposely bills Medicare for services that were never provided or received. Any person or entity—from a physician to an insurance broker to a medical supplier—can be accused of this federal crime.

Examples of Medicare fraud include:

• Billing for equipment other than what the beneficiary actually received
• Billing for home medical equipment after it is returned
• Billing non-covered services as covered services
• Enrolling a beneficiary into a Medicare Advantage plan without their consent
• Making unsolicited phone calls, emails, or home visits
• Soliciting, offering, or receiving a bribe or kickback
• Submitting bills for services not provided, or unnecessary services
• Unbundling services (charging services individually rather than bundling them together)
• Upcoding a service (charging for a more expensive service than the one provided)
• Using false information to mislead beneficiaries into joining Medicare plans

There are many other ways to commit Medicare fraud—what it comes down to is that you used your own or someone else’s Medicare benefits in a way that you were not authorized to in order to make a profit.

Medicare Fraud Convictions

Healthcare providers found to have committed Medicare fraud face serious consequences. In addition to fines, they may also face prison time and be required to repay the Medicare payment they received and face prosecution by the federal government.

Medicare fraud convictions require proof beyond a reasonable doubt that an individual or company knowingly and/or willfully engaged in Medicare fraud. However, you can be convicted if you were found to have acted with deliberate ignorance or reckless disregard as well.

Because there are so many methods of committing Medicare fraud, these cases range from simple to immensely complex. Our Medicare fraud defense attorneys are highly suited to defend such claims. We have an extensive knowledge of federal criminal law and we also understand and can apply medical concepts like the standard of care, clinical practice guidelines, and conditions of payment to your defense.

Contact us now to schedule your free consultation.