Fighting for Clients in Abilene, San Angelo, Lubbock, & Amarillo

Millions of people receive Medicare and Medicaid benefits throughout the United States. These systems are a huge mass of various laws, regulations, and procedures that are difficult to understand and unravel. Health care professionals, hospitals, and clinics are subject to the system and expected to follow these rules and procedures. The opportunities for mistakes as well as fraud have become well-known leading to many people being investigated and charged for crimes by state and federal prosecutors.

If you or someone you know is facing such an investigation or charge, you would do well to retain the services of our Abilene Medicare/Medicaid crimes lawyer. Attorney Russell Lorfing has more than a decade of experience working as a federal prosecutor. His background includes handling hundreds of cases involving complex investigations and charges related to fraud crimes ranging from health care fraud to money laundering. His work in this field was recognized by the FBI with an award in 2020. He is an experienced trial lawyer as well who can manage your case from investigation through all court proceedings, including trial. He brings a depth of understanding of the federal law enforcement and criminal justice system that can only work to your benefit when your freedom and future could be on the line in such cases as Medicare/Medicaid crimes.

Discuss your case with our experienced attorney in a confidential consultation. Call Keith & Lorfing today at (325) 308-6960.

Medicare & Medicaid Fraud Cases in Texas

Medicare and Medicaid crimes basically consist of submitting false claims to these governmental systems. Every year, billions of dollars in claims are found to be suspicious leading to investigations for fraud. Even if, as a health care professional, you believe you have competently organized the administration of your practice, you could eventually face an audit from investigators. This especially holds true if your volume of claims is high.

Various laws apply to health care fraud, including the False Claims Act prohibiting false statements or misrepresentations submitted to obtain Medicare or Medicaid payments, the Stark Law that prohibits self-referrals such as a doctor referring a patient to a family member who owns a clinic, the Anti-Kickback Statute, and more. Violations of these laws are investigated by such agencies as the Office of Inspector General, the Department of Health and Human Services, the Department of Justice, the FBI, and state Medicaid agencies.

Health care violations of law apply to all health care facilities and workers, including doctors, nurses, managers of health care practices, and even individuals working in the health care industry who are not licensed.

Examples of health care crimes can include but are not limited to:

• Billing for services that were never given to patients, referred to as “phantom billing.”
• Billing for services that were not necessary for the patient.
• Billing for more costly services than were actually given to the patient, called “upcoding.”
• Providing kickbacks to those who refer patients.
• Billing separately for services that are meant to “bundled” into one combined bill.

Penalties for Health Care Crimes

If convicted of state or federal health care crimes, the penalties you face will depend on the crimes involved and other factors. Penalties can include civil fines of up to $11,000 for every false claim made, damages, restitution, jail or prison time, criminal fines, and being prohibited from making future claims against the state or federal program. For many, this can mean the end of a career or business.

Outstanding Legal Help Is Available

Many health care fraud accusations are based on errors that were not done intentionally. Human error can occur when dealing with such complicated programs. Our criminal defense firm has the state and federal governmental experience that you need when dealing with an investigation into your practice or business and the charges that can follow. These investigations can lead to either civil consequences or criminal consequences. We will do everything to help you avoid penalties that could lead to a criminal conviction and permanent criminal record.

Learn more about how we can defend you by calling us at (325) 308-6960 today.