Medical Fraud
Medical Fraud Defense in Houston: Brazoria, Ft. Bend, Galveston, Harris & Montgomery Counties
Medical fraud is a legal term applied to a variety of deceptive activities that share a common theme: criminal behaviors that abuse the health care system. These acts can include Medicaid or Medicare fraud, insurance fraud, pharmacy fraud and many others. In general, any action that subverts the legal regulations of the medical care system can be prosecuted as health care fraud.
The health care system in the U.S. is largely overseen and regulated by the national government. Medicare and Medicaid are examples of federal health care programs. This means that attempts to commit fraud against a program like Medicare can be classified as a federal criminal offense. Federal offenses almost always carry stricter sentences than state or civil offenses.
Types of Medical Fraud
Chapter 32 of the Texas Penal Code describes various fraud offenses. Fraudulent activities that are related to health care can be divided into several categories based on the circumstances of a particular fraud case. Some of these categories include:
- Health care fraud: This type of criminal fraud is one of the most common among medical fraud cases. Health care fraud typically targets a federally regulated system. An example of this kind of fraud scheme would be a physician billing the government for medical procedures that are unnecessary or were never performed. This could be done in an attempt to obtain funds for personal gain.
- Insurance fraud: Defrauding insurance providers is also common. A perpetrator of this crime will usually attempt to obtain insurance coverage illegally or to receive an excessive amount of coverage payouts. One common example is providing false information on an insurance application, such as listing a medical condition that does not exist, to receive insurance money that would not otherwise be paid out.
- Pharmacy fraud: Also known as pharmaceutical fraud or medication fraud, this usually occurs when a pharmacist orders an unnecessary amount of drugs. This can be done in an effort to sell the extra prescription medication for personal profit or to obtain controlled substances for personal use. Medicine fraud can also occur if a patient fakes a medical condition in order to obtain narcotics or restricted drugs for use or sale.
The federal government has a strong interest in prosecuting cases of health care or insurance fraud. A skillful medical fraud attorney can help to prepare a defense against the government’s charges.
Because insurance claims and medical forms can be complex and confusing, it is quite common for people to accidentally engage in fraudulent behavior. A medical fraud lawyer can help such people defend their rights and freedom.
Set a Free Consultation With a Medical Fraud Lawyer in Houston, TX
Schedule a free consultation with Greg Tsioros at (832) 752-5972 if you would like to learn more about medical fraud charges.