Medicaid Fraud Protecting Our Clients' Rights

Arizona Medicaid Fraud Defense Lawyer

Have you recently found out that you are under investigation for Medicaid fraud in Arizona? If so, then you may be wondering what steps to take next. One of the most important measures you can take to protect your rights and best interests is to consult with an Arizona Medicaid fraud defense lawyer. Furthermore, taking the time to understand what constitutes Medicaid fraud and the potential consequences/defenses can work in your favor.

Understanding Medicaid Fraud

Unfortunately, Medicaid/Medicare fraud and abuse is a very real problem in the United Sates. In fact, according to the National Conference of State Legislatures, this type of fraud costs the United States billions of dollars each year and threatens the very services that these programs aim to provide. Understandably, then, there are many efforts being made to combat this type of fraud and abuse among healthcare providers.

There are many different types of actions that can constitute Medicaid fraud, including:

  • Billing for unbundled services
  • Billing for equipment that was never provided
  • Billing for services that were never provided
  • False invoicing
  • Excessive/improper use of specific medical services or procedures
  • Prescribing medicines that are not medically necessary
  • Accepting “kickbacks” for patient referrals
  • Falsifying a diagnosis
  • Billing more than once for the same service

Generally speaking, Medicaid fraud refers to the use of any illegal actions to collect Medicaid funds. When Medicaid fraud is suspected, an audit is typically performed. These are usually carried out by state agencies using many different actions ranging from data mining to detailed records review.

From there, if fraud is believed to have occurred and is provable in court, a criminal indictment will likely take place. Fines and penalties may be charged, and depending on the nature of the alleged fraud, the audit team may even choose to go after the healthcare provider’s medical license or other credentials.

Facing A Medicaid Audit Or Investigation?

If you are a health care provider and have recently received notice that you are under investigation for Medicaid fraud, you may be feeling understandably concerned about what will lie ahead and what to expect next. Unfortunately, Medicaid fraud audits can be very stressful because if even a small, innocent mistake is found, there is a chance you could end up facing tens of thousands of dollars in fines, charges, and the like. And of course, if more serious issues are uncovered, you could face serious criminal charges as well.

The best thing you can do right now if you have received notice of Medicaid fraud investigation is to seek out a defense lawyer who will be able to consult with you and help prepare you for your audit, as well as work with proper authorities throughout the process. Should you end up facing criminal charges, a defense attorney will also be able to determine possible defenses and work to represent and defend your best interests in court.

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