Federal Health Care Fraud Cases

Our Chicago criminal defense lawyers know how to prevail in federal healthcare fraud cases. If you are accused of health care fraud, call our Chicago health care fraud attorneys today at (312) 466-9466.

The FBI recently reported that health care fraud investigations are one of the highest priorities within the FBI's White Collar Crime Program. They only trail public corruption and corporate fraud.

As of 2007, the FBI alone has investigated 2,493 cases of suspected health care fraud, resulting in 839 indictments and 635 convictions of individuals. Other federal agencies conduct investigations in this area as well.

There is no complete list of conduct that can trigger a Federal investigation or prosecution. Some of the more frequent allegations that can result in charges of health care fraud include:

• Up-coding, which is defined as "a fraudulent practice in which provider services are billed for higher CPT procedure codes than were actually performed, resulting in a higher payment by Medicare or 3rd-party payors";
• Ghost patients;
• Billing for services that are not provided;
• Billing for services that are not medically necessary;
• Providing worthless services;
• Using unqualified or unlicensed providers.

Federal authorities often reveal their investigation when they show up with a surprise search warrant.

Health care providers, doctors, hospitals, etc. are well advised to have in place clear contingency plans to respond to a surprise search warrant, even if they have done nothing wrong, to protect themselves and their patients.

Contingency plans do not require complex preparation. Instead, businesses should follow a few simple rules that should minimize the damage caused by the execution of a search warrant.

• Do not make any statements or discuss any allegations with agents or law enforcement.
• Dispatch experienced legal counsel from the Law Office of Steven R. Hunter to the scene immediately.
• Obtain a copy of the search warrant.
• Send home all nonessential employees.
• As soon as possible, explain to employees what is happening.
• Obtain and closely review the search warrant inventory.
• Once the search is over, ask the agents politely to leave the premises.
• Conduct your own post-search inventory.
• Keep your guard up even after the government leaves the building.