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Houston DWI Lawyer > Blog > Criminal > Accusations Of Fraudulent Medicare And Medicaid Benefit Claims

Accusations Of Fraudulent Medicare And Medicaid Benefit Claims


While people across the US and in the state of Texas access healthcare benefits in different ways, millions of Americans rely on Medicare and Medicaid programs. These government programs have a lot of intricacies, and when it comes to disbursing funds, there’s the potential for fraud.

Houston criminal lawyers are well-acquainted with the legal complexities of healthcare claims, including those surrounding fraudulent Medicare and Medicaid benefits. If you have been accused of healthcare fraud, talk to an attorney about the serious nature of these offenses and learn how to protect yourself from harsh consequences.

Fraud Has Far-Reaching Consequences

Offering medical coverage to eligible individuals, Medicare and Medicaid are designed to provide much-needed assistance to individuals who access these benefits based on their age, income, or another qualifying reason. Yet it is also an unfortunate reality that some individuals and groups exploit these programs for personal gain. They do this by submitting fraudulent benefit claims, such as billing for services not provided, inflating the cost of services, or even enrolling patients who do not actually exist.

Law enforcement takes fraudulent Medicare and Medicaid claims seriously, because the criminal actions divert funds allocated to genuine healthcare needs, potentially leading to financial strain on the system’s delicate balance, which can impact the quality and reach of services provided.

Additionally, the system leans on public trust, and fraudulent claims promote distrust in government programs and the healthcare industry. Erosion of credibility in America’s healthcare system can move past the fraudulent claim itself and lead individuals to cast suspicion on legitimate providers, tarnishing quality reputations that healthcare organizations worked years to build.

Because Medicare and Medicaid fraud is carefully reviewed by both federal and state authorities, a range of legal consequences follow if there is proof that an individual healthcare provider or a group of administrators working within a healthcare team submitted false claims, unbundled services to receive a higher reimbursement, or participated in illegal kickbacks. Some of the penalties that could follow:

  • Hefty fines
  • Restitution orders
  • Imprisonment
  • Loss of professional licenses

If you are in an environment involving false claims, hire an attorney to protect yourself and your future.

Whistleblowers and the False Claims Act

The False Claims Act encourages individuals with knowledge of fraudulent claims to come forward as whistleblowers, meaning they will then be afforded legal protection against retaliation provided they shed light on the criminal behaviors of others.

If you have been accused of fraud or noticed fraudulent activity at your place of work, talk to a Houston criminal lawyer with experience in healthcare cases as soon as possible. An attorney will work diligently to investigate the evidence, build a strong defense, and ensure that your rights are protected throughout the legal process.

Could your life be upended because of Medicare or Medicaid fraud accusations? Don’t hesitate to reach out to the qualified Texas criminal attorneys at Ayson Law Firm. Together, we can navigate the legal complexities, safeguard your rights, and work towards a just resolution. Contact us today for a free consultation.

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