Protecting Yourself When Charged with Medicare Fraud

A charge of Medicare fraud is a serious accusation that comes along with even more serious consequences, including monetary liability and prison time. If you have received notification from the government that they plan to pursue a criminal charge against you or your organization — get into action mode right away. Learn what measures you need to take right away to protect yourself.

Medicare Fraud

When a person thinks of fraud, the word "intentional" comes to mind. People are often shocked to discover that the federal government is considering the idea of levying a criminal charge against them for Medicare fraud. An important thing to remember is that this form of fraud can surface in several different ways. A failure to notify the government of overpayments or including inaccurate information on an application or claim form are both forms of fraud. Rather than outright assume that there is no way you could be even the slightest at-fault, you should carefully read over the charge to see how you need to move forward. 


Once you have read over the charges being made by the government, you should immediately start collecting documentation to support your stance. Again, unlike many people assume, committing Medicare fraud is something that can occur even by accident, especially if you operate a large medical practice that submits hundreds of claims a month. As you collect your documentation, look for any information that can disprove the government's claim. For example, if the government is stating that you were overpaid, but you have proof to show that your organization was due the payment amount based on the claims you submitted, this information can help you. Remember, the government makes mistakes too, so if you can highlight them, you can help yourself. 

Civil Penalties

When an individual is found guilty of Medicare fraud, time in prison is a real possibility. However, if you partner with an attorney, he or she can work to have the charge moved from the criminal sector to the civil sector. Unlike a criminal charge, with a civil penalty, a prison sentence is avoided, but the individual must instead pay a monetary fine to the government. This amount is typically equivalent to any over or undue payment the individual received for Medicare claims and is a much better outcome in the long run. 

Again, a charge of Medicare fraud is serious. Speak with a criminal defense lawyer as soon as you can to help organize your defense and protect your freedom.