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What are the most common forms of Medicare fraud?

On Behalf of | Jan 28, 2023 | Criminal Defense |

Medicare is an insurance program funded by the federal government and available to individuals who are age 65 and older, or those who have certain disabilities or medical needs. This provides critical coverage for individuals who need assistance. As it is a federally funded program, defunding Medicare is a serious criminal offense, and the court prosecutes these crimes to the fullest extent of the law. Medicare fraud comes in different forms, but the penalties for all of them are severe.

If you are facing accusations of Medicare fraud, your future interests are at stake. Conviction of a federal offense could result in time in prison and a range of other penalties that may change the course of your life. By understanding what you are up against, you will be better prepared to build an effective defense strategy though which you can fight for your personal freedom and more.

Types of fraudulent schemes involving Medicare

There are different ways one can defraud the Medicare system. While they are all different, the intent of each of them is financial gain or access to personal information they can use for the intent of financial gain. Some of the most common fraud schemes involving Medicare include the following:

  • Medicare abuse — This occurs when a care provider seeks a payment from Medicare to which they do not have the right. This can happen inadvertently, such as through a billing mistake.
  • Medicare fraud — This happens when pharmacists, doctors and other care providers intentionally claim reimbursement to which they have no right. This allows them to illegitimately collect money from Medicare.
  • Medicare scams — This occurs when someone presents himself or herself as a care provider in order to gain access to a Medicare beneficiary’s personal information. They may use this information to get money or health care.

Whether it is through double billing, phantom billing, unbundling or through other means, the federal government takes all forms of Medicare fraud seriously, and it will prosecute these cases to the fullest extent of the law.

Your defense options

There is no one-size-fits-all solution to defending against charges of Medicare fraud. If you are facing these allegations, you will benefit from seeking the support and guidance of a professional who can provide insight regarding your defense options. Starting with an assessment of your case, you can have an understanding of the most beneficial way to confront the case against you and protect your future interests in Kentucky.