Experienced Healthcare Fraud Defense Attorneys in Tampa, Florida
Trombley & Hanes provides insightful and practical advice bolstered by our intrepid team with over 110 years of combined skill and dynamic legal experience to produce actual results for our clients. Since 1977, our trusted Tampa healthcare defense lawyers have provided full-service state and federal legal defense strategies for individuals and businesses in Florida and throughout the U.S.
This is important for healthcare professionals because by the time they have been contacted by state or federal government officials — either through the receipt of an official letter or in-person contact from an investigator — the agency that is investigating the individual or group has typically already gathered the evidence they need to believe the accused has engaged in fraudulent behavior.
This puts medical professionals at a significant disadvantage. That is why we are here.
No matter why you or your healthcare organization is being investigated for fraud, our skilled defense lawyers have the legal skills, knowledge, and resources necessary to mount a defense that meets your unique needs. Contact our healthcare defense attorneys in Tampa today.
Which Healthcare Providers Can Be Pursued for Fraud?
Healthcare fraud occurs when a company, person, or group misrepresents the nature, scope, or type of medical care provided in a way that may cause unauthorized payments, according to the U.S. Department of Justice (DOJ) and its Healthcare Fraud Unit.
Common individuals and groups that are targets of healthcare fraud investigations may include, but are not limited to:
- Private medical practices and physician groups.
- Doctors and other medical providers, including, but not limited to, chiropractors, dentists, and pharmacists.
- Hospitals and staff, including individual directors, managers, and accounting staff.
- Home healthcare companies and staff.
- Nursing home companies and staff.
- Pharmaceutical and medical equipment providers.
Healthcare fraud cases can be pursued against healthcare providers by United States attorneys, district attorneys, federal and state law enforcement agencies, private insurance company fraud units, and auditors trained in the complexities of healthcare fraud investigations and litigation.
When these individuals, groups, or organizations are investigated for healthcare fraud or are charged with a crime, they will need trusted defense counsel to protect their rights and provide customized legal defense strategies that reduce risks and deliver real results.
We can help. Contact our healthcare fraud defense lawyers in Tampa to learn more.
What are the Most Common Examples of Healthcare Fraud?
The Government views healthcare fraud as a growing problem across the United States. In response to this increasing problem, the Attorney General made healthcare fraud one of the Department’s top priorities. Through increased resources, focused investigative strategies, and better coordination among law enforcement, the Department continues to upgrade its efforts in combatting the full array of fraud perpetrated by healthcare providers.
Healthcare fraud can be prosecuted civilly and criminally under various statutes and regulations, including Fraud Against the Government, Mail and Wire Fraud, and Program Fraud and Bribery.
Although federal authorities typically investigate healthcare fraud, states also prosecute such offenses, including:
- Altering medical records.
- Billing for a noncovered service as a covered service.
- Billing for medically unnecessary services or procedures.
- Billing for services not provided.
- Billing for supplies that were never provided.
- Billing non-existent companies for services never rendered.
- Charging for services that you did not provide.
- Falsifying a medical diagnosis.
- Obstruction of justice, including destroying medical records, billing information, or financial documents.
- Overbilling or double billing.
- Prescribing unnecessary medications.
- Prescription drug fraud.
- Receiving kickbacks for patient referrals.
- Submitting falsified billing records.
- Upcoding, unbundling, and other billing fraud.
- Using false credentials.
- Using unlicensed staff.
Healthcare fraud penalties are too significant to navigate your legal journey alone. We can help.
Allow our Hillsborough County healthcare defense attorneys to pursue the best outcome for your case — just as we have for hundreds of clients before you. Do not let the fear of the unknown overwhelm you. Contact our Florida healthcare defense attorneys for help today.
The Health Insurance Portability and Accountability Act (HIPPA) established and funds a Healthcare Fraud and Abuse Program to combat fraud and abuse committed against all health plans, both public and private. HIPPA empowers the Attorney General to issue investigative demands to obtain records for investigations relating to Federal criminal healthcare fraud offenses; these records are not subject to the constraints applicable to grand jury matters outlined in Fed. R. Crim. P. 6(e).
The Department’s healthcare fraud efforts are centered in the United States Attorneys’ Offices, the Criminal Division, and the Civil Division. Yet, each public program has its own rules for the provision of services, reimbursement for the costs of services, and the investigation of fraud.
The potential penalties for healthcare fraud conviction are severe and may include:
- Fines
A federal conviction for Medicare, Medicaid, or other healthcare fraud can result in fines equal to twice the loss, up to a $250,000 fine for individuals, and up to $500,000 for corporations, whichever is greater.
- Professional Sanctions
State and federal investigations and audits involving healthcare providers may result in appearing before the Office of Administrative Hearing, suspension, or permanently canceling your license to practice by the Florida Board of Medicine.
- Prison
Federal sentences are based on the dollar amount of loss. Although, each false claim is a separate offense. If the investigating agency alleges dozens or hundreds of fraudulent billings, prosecutors can seek the maximum sentence under sentencing guidelines.
Trombley & Hanes has extensive experience representing healthcare providers, including most recently representing a chief compliance officer of a publicly traded health insurance company. While multiple other executives were ultimately charged and convicted, our client avoided prosecution. We can also help pursue positive results for your unique healthcare fraud case.
Our Attorneys Also Focus on the Following Areas:
- Antitrust Fraud
- Cares Act Fraud
- Covid 19 Fraud
- Defense Contract Fraud
- EDIL Fraud
- Immigration Fraud
- Maritime Fraud
- Money Laundering
Contact Our Dedicated Healthcare Defense Attorneys in Tampa, Florida for Help Today
Our trusted healthcare defense lawyers in Florida know how important your career in the medical industry is to your livelihood. Being the target of healthcare fraud not only comes with severe penalties but can also significantly damage your personal and professional reputation and overall financial well-being.
You deserve more. Our healthcare fraud defense lawyers have been producing actual results for real people for more than 110 combined years and will provide the confidence you need to tell your side of the story and put these charges behind you.
Contact us at 813-229-7918 or online to schedule a consultation to learn more.
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Frequently Asked Questions for Our Healthcare Fraud Defense Attorneys in Tampa, Florida
What Legal Statutes Establish the Offenses and Penalties for Healthcare Fraud?
Healthcare fraud can be prosecuted under various state and federal statutes.
Some of the federal statutes most used to prosecute healthcare fraud in the U.S. include, but are not limited to:
Which Federal Agencies Pursue Healthcare Fraud Claims?
Like the statutes that apply to healthcare fraud, some of the following agencies work solely in healthcare, others in general fraud claims, and often collaborate for healthcare fraud prosecution:
What Should I Do If I Am Being Investigated for Healthcare Fraud?
If you believe you are being investigated for healthcare fraud or have received a subpoena for your medical or financial records or other information from federal investigators, you should contact a skilled healthcare fraud defense lawyer immediately. This will ensure that your legal rights are protected from the start and that you are not intimidated into turning over any potentially incriminating evidence to investigators not outlined in their warrants. The federal government does not have your best interests in mind. We do. Contact us today to learn more.
What is a Qui Tam Action?
Qui Tam Actions allow a private person, known as a qui tam relator, to prosecute a lawsuit for the government and receive a reward. The False Claims Act authorizes qui tam lawsuits to assist the government in prosecuting cases to recover damages and penalties for fraud against the government. If the case is successful, the relator can earn a whistleblower reward.
