Heath Care Fraud

   A health care fraud is an incredibly serious and complicated matter. While similar business practices may be acceptable in other fields, the health care industry is highly regulated and heavily scrutinized. If you have been contacted by federal investigators you should contact an attorney right away. Paul Doyle can help guide you through the complicated process and help divert the serious criminal allegations that often follow a federal health care investigation.

Under The False Claims Act it is a federal offense to commit healthcare fraud. The Anti-Kickback statutes specify that it is illegal for medical professionals to “knowingly and willingly” accept bribes or remuneration for the referral of patients. This includes specifically targeting federal health care programs such as, Medicare, Medicaid, and Tricare. Kickbacks are not always as overt as providers accepting cash for the explicit referral of patients. They often appear in more subtle ways. Referrals are a significant aspect of the health care industry causing Anti-Kickback laws to place immense pressure on providers.

          There are “safe harbors’ or exceptions to the Anti-Kickback statutes, however they require strict qualifications. A lapse in attention toward these qualifications could suddenly launch a criminal investigation. These investigations blanket individuals at all levels of the industry, independent of their involvement. Many individuals often get stuck in organizations they had no knowledge of being illegal or fraudulent. It is a priority that the client is informed and understand what they are facing, and that all documentation and records be obtained in order truly see the real target and scope of the investigation. The more information available the stronger a case can be built. Therefore, it is important to have a lawyer who has the ability to digest what is alleged in detail in order to avoid and or limit the client's exposure. Many times this translates to countless hours reviewing thousands of documents.

These health care fraud investigations are aggressively increasing and are actively seeking to prosecute providers for these violations. Paul takes an experienced and strategic approach in defending your reputation, interests, and career. The first decision you make could be the most important. This decision could include whether or not you should even talk to the government if they come knocking.

Penalties under Anti-Kickback laws are severe and fighting the case is not simple. Therefore, it is imperative that you hire experienced, qualified, and thorough counsel. Paul Doyle has the experience and work ethic required to properly defend these cases.