Two federal cases this year demonstrate the measures authorities are taking to fight recent healthcare fraud in Texas. In one case, a Texas couple that owned and operated several group homes was sentenced to 60 months in prison for engaging in a $1 million Medicare fraud scheme to send residents to a community health center in exchange for illegal kickbacks concealed as payment for undelivered or unnecessary services. In the second case, a Texas doctor pleaded guilty to authorizing illegitimate or unnecessary prescriptions for medical equipment and cancer genetic testing to patients in exchange for more than $466,000 in Medicare kickbacks.
These cases are typical examples of healthcare fraud that are prosecuted every week in Dallas. Healthcare fraud often involves sophisticated systems that may involve millions of dollars of alleged fraud and professionals like doctors and business owners. The criminal defense firm of Broden & Mickelson, LLP provides dedicated legal assistance to individuals facing serious allegations of healthcare fraud. If you are facing serious healthcare fraud charges, contact us today for a free consultation with an experienced Texas healthcare fraud attorney.
What Is Healthcare Fraud?
The Texas Attorney General defines healthcare fraud as “a deliberate deception or misrepresentation of services that results in an unauthorized reimbursement.” Healthcare fraud can be complex, multi-million-dollar schemes involving multiple parties. People may commit healthcare fraud against federal healthcare benefits programs such as Medicare and Medicaid, state or local healthcare agencies, hospital systems, or patients.
Types of Healthcare Fraud Charges
Healthcare fraud takes many forms and covers many related crimes, including the following:
- Conspiracy to commit healthcare fraud
- Insurance fraud
- Prescription drug fraud and abuse
- Fraudulent use or possession of identifying information
Possible Penalties for Healthcare Fraud
The penalties for healthcare fraud depend on factors such as the breadth of the scheme (i.e., interstate or within the state), the amount of money involved, and whether the fraud breaks other federal or state laws.
- Class C misdemeanor (fraud valued at less than $100) – A fine of up to $500
- Class B misdemeanor (fraud valued between $100 to $749) – A fine of up to $2,000, jail time for 180 days or less, or both
- Class A misdemeanor (fraud valued between $750 to $2,499) – A fine of up to $4,000, jail time for one year or less, or both
- State jail felony (fraud valued between $2,500 to $29,999) – A prison term of 180 days to 2 years and a fine of up to $10,000
- Third-degree felony (fraud valued between $30,000 to $149,999 or 25-49 fraudulent claims) – A prison term of two to 10 years and a fine of up to $10,000
- Second-degree felony (fraud valued between $150,000 to $299,999 or 50 or more fraudulent claims) – A prison term of two to 20 years and a fine of up to $10,000
- First-degree felony (fraud valued at $300,000 or more) – A prison term of five to 99 years and a fine up to $10,000
If a defendant is charged with a federal crime, they could face time in federal prison and thousands of dollars in fines per false or fraudulent claim.
How a Healthcare Fraud Defense Attorney Can Help
If you are facing charges for healthcare fraud, you need a Dallas healthcare fraud lawyer who can vigorously defend your rights. Your freedom, future, and finances are at stake. The healthcare fraud defense attorneys at Broden & Michelsen, LLP are ready to protect your rights and fight for the best outcome possible. Contact our office today for a free, confidential consultation.