The Importance of Medicare Fraud Attorneys

Due to recent crackdowns on Medicare fraud, an increasing number of people are finding themselves contacting Medicare fraud attorneys. These crackdowns began in 2009 with the creation of the Health Care Fraud Prevention and Enforcement Action Team, otherwise known as HEAT, and since then nearly 1,500 people have been arrested for the crime. This includes several coordinated arrests where government officials have raided businesses and taken documents by force, sometimes capturing more than 100 medical professionals at a time. For example, in early May of 2012, the government conducted a countrywide takedown and charged people in 7 different U.S. cities with fraud, resulting in 107 individuals in need of Medicare fraud attorneys. A year later, the government led another bust in which officials invaded businesses in Miami and Detroit, making 89 accusations.

In addition to the establishment of HEAT and its associated Medicare Strike Force, the government has cracked down on Medicare in other ways. It has created tougher laws and harsher penalties, partnered with private organizations such as Blue Cross and Blue Shield, and devised ways to use technology to target possible fraud. This government zeal has resulted in a veritable witch hunt in which many innocent people are likely to get burned. Without Medicare fraud attorneys, many of these individuals will face five years of prison and up to $25,000 in fines for each offense. Since penalties for multiple offenses can be piled on top of each other, the effect could be a $500,000 fine and life imprisonment. Only attorneys can protect the rights of the accused and prevent the scales from tipping overwhelmingly in favor of the organizations.

Government establishments are not the only reasons medical professionals may require Medicare attorneys, either. The Centers for Medicare and Medicaid Services also provide financial incentives for private individuals to report fraud, and the organization has recently proposed increasing these rewards to as much as $9.9 million. The government has made it easier to detect and report such fraud, providing patients with a Summary Notice and explaining the process of checking for errors and informing Medicare of possible fraud. Not only that, but CMS has increased its efforts to inform patients of whistle blowing incentives, so more people are likely to dig for fraud out of greed. This means that even a simple misunderstanding or an honest mistake could result in a serious accusation and a call to attorneys.

As these situations lead to skyrocketing fraud accusations, it is more important than ever that practitioner fully understand fraud. Unfortunately, this can be difficult for anyone but attorneys because the laws are constantly changing. One example of this is the Stark Act, which makes it illegal for a doctor to refer patients to services in which the physician may have a financial interest. Originally, physicians in a group practice could refer patients to imaging services within their practice and still be in compliance. In 2010, however, the act was changed to require these practitioners to inform such patients in writing about alternative places to obtain the services. These types of changes are becoming more and more common with the enactment of the Affordable Care Act, making it now absolutely essential that every member of the healthcare industry knows some good attorneys.