Antitrust laws were established to protect trade and commerce from abusive practices. Violations can include price-fixing, price discrimination, restraints, and monopolization.
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Miami Healthcare Fraud Attorney
If you are a Miami-based or South Florida-based doctor or a licensed medical professional under investigation for healthcare fraud, you need to act immediately. Considering that billions of dollars are poured every year on government healthcare programs such as Medicare, Medicaid, and Tricare, state and federal officials relentlessly pursue and investigate healthcare crimes.
How you respond to a target letter or subpoena could affect you and your family for years to come.
The minute you are accused of being involved in a healthcare fraud scheme in Miami or the greater South Florida area, you should speak to our competent Miami healthcare fraud defense attorneys.
At the Kirlew Law Firm, we strategically defend clients in complex and sensitive white-collar crime matters, including healthcare fraud. We are proud to offer you a free phone consultation to help you plan a proactive defense strategy that will protect your rights in court.
What is Healthcare Fraud?
Healthcare fraud occurs when a licensed medical professional (or even a medical institution or group) knowingly submits false claims to a private or government health insurance program to receive financial benefits they are otherwise not entitled. Whether the healthcare benefit plan is provided by Medicare, Medicaid, or a private employer, healthcare fraud is prosecuted using the same general principles.
Like most white-collar crimes, healthcare fraud cases involve deception, fraudulent documents, using the internet or fax to submit invoices, and collusion with various individuals. These types of crime do not rely on the threat of physical force or violence.
Some examples of acts that can trigger a healthcare fraud investigation in Miami include but are not limited to:
- Prescribing unnecessary medications or performing unnecessary procedures to bill an insurance company.
- Billing for services that were never rendered.
- Unbundling or billing every step of one test or treatment as if they were individual procedures.
- Submitting inflated claims.
- Submitting claims for a patient who does not exist.
- Soliciting illegal “kickbacks” or referral fees.
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How is Healthcare Fraud Prosecuted?
Healthcare fraud is predominantly prosecuted by the federal government and the U.S. Department of Justice (DOJ) Healthcare Fraud Strike Force, which is based in Washington D.C.
The following are just a few of the federal statutes that are used to prosecute healthcare fraud:
- The False Claims Act (FCA), 31 USC §§ 3729 – 3733
- Anti-Kickback Statute (AKS), 42 USC § 1320a–7b
- Physician Self-Referral (Stark) Law, 42 USC § 1395nn
- Criminal Health Care Fraud, 18 USC § 1347
Healthcare Fraud Penalties and Consequences
Defrauding federal healthcare programs is illegal. The consequences of a healthcare fraud conviction are severe and life-altering. A conviction can expose you to potential criminal, civil, and administrative liability.
The potential penalties and consequences of a healthcare fraud conviction are:
- Exclusion from participating in any Federal healthcare program.
- Loss of professional licenses.
- Up to 30 years in federal prison.
- Fines of up to $250,000 per offense.
- Fines of up to three times the number of false claims submitted.
- Forfeiture of all assets related to the charged offense.
Substitute forfeiture of assets unrelated to the charged offense.
You Need to Act Quickly to Defend Your Rights. Contact Our Brian Kirlew and the Kirlew Law Firm NOW!
As soon as you receive a subpoena or a federal agent asks to speak to you about a healthcare fraud criminal investigation, it would help if you were concerned. Bear in mind that when federal agents reach out to someone, the research itself has been ongoing for a long time, and they likely already have their prosecution strategy drawn out. It is critical to contact our Miami white-collar criminal defense attorney when you suspect you are the target of a healthcare fraud criminal investigation.
If you face something as career-threatening (and potentially life-changing) as healthcare fraud prosecution, your entire life is hanging by a thread. You need an experienced, knowledgeable, and aggressive Miami healthcare fraud defense attorney who will fight for you and seek your best interests.
At the Kirlew Law Firm, we have years of legal experience handling all types of white-collar defense cases in Miami and greater South Florida. Our healthcare fraud defense attorneys can effectively intervene in the investigation and quickly gather the necessary information to execute a strategic defense.
When you retain our white-collar criminal defense services, you can count on the support and strength with experience. Brian Kirlew, Esq. and his Miami healthcare fraud defense team, have a proven track record of getting results in and out of the courtroom.
Contact us without any obligations; we are here to help you!
Call us at (305) 521-0484 or online to schedule a free phone consultation.
This form of white-collar crime is increasingly common as more people use computers, phones, and other internet-enabled devices to commit acts of fraud, hacking, extortion, and theft.
Thieves take personal information to access banking and financial accounts, make purchases, open utility accounts, or steal tax refunds. In some cases, an identity thief may even use a false identity during an arrest.
This white-collar crime occurs when a thrift utilizes a stolen credit card or other information from that account to make unauthorized purchases. In some cases, they may use the stolen information to take out cash advances against the account.
The illicit selling of fake goods or services over the phone. Many phone scams are framed as a giveaway, or free offer in exchange for sensitive information, like access to banking or credit card accounts.
Often paired with another form of fraud, bankruptcy fraud can be the concealment of assets to prevent forfeiting them, filing incomplete or false forms, filing multiple times in different locations using fake or forged documents, and bribing of court-appointed trustees.
Largely committed by organized crime groups, this form of fraud includes performing unnecessary procedures to bill an insurance company, billing for services that were never rendered, and billing every step of one procedure as if they were individual procedures.
Environmental law makes actions like the illegal disposal of waste, improper storage of hazardous materials, or failure to comply with EPA and state regulations illegal.
An act committed to defraud an insurance company is considered a white-collar crime. This could include attempting to obtain benefits or advantages that an individual is not entitled to or when an insurer denies benefits that someone is due.
One of the most common forms of fraud, mail fraud is when the USPS or private carrier is used to commit a crime of deceit. This could be to obtain money or to sell and distribute illicit goods.
These forms of fraud start with a scheme to steal or obtain financial information by using false representation or promises of goods and services in return.
Crimes committed through extortion and coercion are considered racketeering. Generally, a racketeer obtains money or goods from someone using intimidation tactics or force.
Largely connected to federal government contracting or federally-funded programs, government fraud might involve public housing, agricultural programs, corporate subsidies, and bribery.
This form of white-collar crime is the deliberate failure to pay your taxes or the underpayment of the taxes you owe. It can be underreporting of income, overreporting of deductions, or improperly claiming tax credits and exemptions.
Also called investment fraud, securities fraud involves misrepresenting the information that investors use to make financial decisions.
This is the trading of the stock or securities of a public company that is based on non-public information about the company. This is the profiteering of information based on a company’s assets.
A bribe is the giving or receiving of something of value in order to influence the actions of another person or group.
The major focus of the FBI, public corruption covers a variety of crimes, including the violation of federal law by public officials, fraud related to the procurement, contracts, and funding of federal programs, and other crimes that are related to local, state, and federal governments.
By withholding assets, funds, or goods from an employer or business partner, you are committing an act of embezzlement.
Generally sponsored by foreign entities or outside corporations, economic espionage can target the U.S. government, U.S. companies, or other establishments and institutions. Economic espionage is the unlawful obtaining of financial information.
Trade secrets are the information or assets that give a company an advantage over others in the market. The theft of these assets is when someone uses this information without consent of the business.
Contact a Miami White Collar Criminal Attorney today!
If you are being investigated for a White Collar crime at the state or federal level (or both), the sooner you get a qualified attorney on your side to protect your rights, the better. Brian Kirlew, Esq. is experienced and skilled at handling these complex and sensitive matters, and is here to represent you in court. Our criminal defense attorneys in Miami are proud to offer you a phone consultation to ensure that we can best serve you. Contact us immediately to get started.
Committed to aggressive, personalized legal representation for criminal defense, white collar, federal, and family law matters throughout Florida since 2012.
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