When you do business with the government, the government is inclined to take a pretty close look at any discrepancies or red flags. That’s a major concern if your medical office participates in the Medicaid and/or Medicare programs.
Medical fraud is estimated to cost billions each year through things like:
- Billing for services that were never provided
- Upcoding, or charging for a more expensive procedure than the one actually performed
- Filing fraudulent claims for reimbursement
- “Unbundling,” or filing individual charges for treatments that are usually billed together to pad the bill
- Ping-ponging a patient back and forth between doctors unnecessarily to increase their bill
- Providing unnecessary testing or treatments
It’s not just doctors who get caught up in a Medicaid or Medicare fraud investigation, however. Virtually anybody who works in the medical office where fraud is suspected can be accused of having their hands in the government’s cookie jar. Even those who are totally innocent of wrong-doing often have a difficult time proving it.
To survive a Medicare or Medicaid fraud investigation, play it smart. The moment that you know that an investigation is in process, take steps to protect your rights and preserve your future.
The number one thing that you need to remember is that you shouldn’t talk to investigators alone. They wouldn’t be speaking to you unless they either believe you have information that they want or that you’re guilty of wrong-doing. Nothing you can say is likely to dissuade them of that belief without evidence.
An experienced criminal defense attorney can help you deal with investigators and protect your rights.