Healthcare Fraud Defense in Florida

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Healthcare fraud is intentionally defrauding a healthcare organization, medical provider, or government-run healthcare institution. This is sometimes achieved through falsely representing a condition, filing false paperwork or fictitious claims, tampering with billing schedules, and so forth. The Federal Bureau of Investigation (FBI), aided by special investigators utilized by the Department of Health and Human Services (HHS), are notoriously eager to prosecute anyone suspected of healthcare fraud, even when it is clear any alleged fraudulent behavior was unintentional.

If you have been accused of healthcare fraud, retain the legal representation of a federal defense attorney right away. At the Law Offices of Greg Rosenfeld, P.A., our West Palm Beach healthcare fraud defense lawyer understands the weight of the accusations and responds with the necessary urgency.

Attorney Rosenfeld has earned prestigious awards and honors for his record of excellence, including:

• 10.0 “Superb” rating from Avvo
• AV® Preeminent™ Rating by Martindale-Hubbell®
• Selection to the Top 40 Under 40 by The National Trial Lawyers
• Multiple Super Lawyers® Rising Stars℠ 2019 selections

Healthcare Fraud in Florida

Florida Statutes Section 817.234 defines healthcare and insurance fraud as providing any sort of falsified information to an insurer when filing a claim. There are also additional or varied definitions of healthcare fraud under federal statutes. The end result being that criminal investigators can try to pin criminal charges on patients, doctors, and healthcare groups alike when there are only loose grounds for the accusations.

Common definitions of healthcare fraud are:

• Falsified information: Providing knowingly false or misleading information on medical insurance claims.
• Kickbacks: Incentives given to medical providers for prescribing certain medications or pharmaceuticals when better options for treatment exist.
• Un-rendered services: Billing a medical company or government institution for services that were never actually administered.
• Up-coding: Billing for a service that is more expensive than the service that was actually provided.
• Unbundling: Submitting invoices or bills for services that are broken apart when properly submitting them as a “bundle” would result in a lower cost to the insurance company.
• Excessive services: Billing for services that were administered but not deemed medically necessary. 

Many forms of alleged healthcare fraud can be traced back to paperwork and billing errors, not intentional criminal activity. This allows our white collar crimes defense attorney to focus on why the alleged fraud happened. Honest mistakes or misinterpretations of a medical bill are not a crime. Without criminal intent being established, or with the prosecution’s argument being dismantled, there should be no conviction.