Shreveport Healthcare Fraud Attorney Representing Patients and Healthcare Providers in Louisiana
When you or a loved one is dealing with a serious health issue or if you are a medical provider, federal laws likely are the last thing on your mind. However, forms filled out at times when you are under a good deal of stress may come back to haunt you. If you find yourself under criminal investigation for seeking or for providing medical services, you will need a Shreveport healthcare fraud attorney experienced in federal criminal matters to help tell your story and to explain to the government why you took the actions or made the statements you did.
Lee Harville is a Shreveport healthcare fraud attorney who has decades of experience, including defending patients and healthcare providers. Regardless of the specific allegations you are facing, Lee can help protect you. With that said, time is of the essence when you are under investigation or facing charges, so we strongly encourage you to contact us promptly to discuss your case in confidence.
State and Federal Authorities Aggressively Target Healthcare Fraud in Louisiana
Unfortunately, there are some who take advantage of health care benefits and services. They engage in simple and complex fraudulent schemes to make hundreds, thousands, and even millions of dollars. Because of that, local, state, and federal agencies review insurance and medical records looking for fraud.
This can lead to questioning of even honest mistakes or claims. Because of this, companies or government agencies can refer those who seek or who provide medical services for prosecution by the federal government.
We Handle Cases Involving All Types of Healthcare Fraud Allegations
Of course, many of those who seek or who provide medical services are not used to dealing with federal laws, statutes, and forms. This may cause them to make honest mistakes that some in the government may think are intentional criminal acts. While honest mistakes shouldn’t expose you to criminal prosecution, once you are facing scrutiny, it is up to you to make sure you do not face unnecessary consequences.
Shreveport healthcare fraud attorney Lee Harville defends patients and healthcare providers who are facing all types of healthcare fraud allegations in Louisiana. Whether you made an honest mistake or you need to fight to avoid the consequences of intentional fraud, Lee can use his experience to build and execute a defense strategy that is custom-tailored to the circumstances of your case. He provides representation in state and federal healthcare fraud cases involving allegations, including (but not limited to):
Anti-Kickback Statute and Stark Law Violations
The Anti-Kickback Statute and Stark Law are federal statutes that prohibit healthcare providers from paying for referrals of Medicare and Medicaid beneficiaries. They also prohibit offering to pay, soliciting, and accepting referral fees (and other forms of remuneration) in these cases. While exceptions apply, both statutes are extremely broad and allow the prosecution of healthcare providers and other individuals and entities in a wide range of circumstances.
False Claims Act Violations
The False Claims Act is a federal statute that prohibits healthcare providers from improperly billing Medicare, Medicaid, and other federal healthcare benefit programs. Some common examples of False Claims Act violations include:
- Billing for ineligible items or services
- Double-billing
- Phantom billing
- Unbundling
- Upcoding
While evidence of intentional fraud is required to substantiate criminal charges under the False Claims Act, even inadvertent billing errors can lead to liability for recoupments and civil monetary penalties. False Claims Act violations can also have serious consequences for healthcare providers in Louisiana.
Healthcare Fraud Statute Violations
The federal healthcare fraud statute (18 U.S.C. Section 1347) imposes criminal penalties for defrauding federal healthcare programs. This includes (but is not limited to) “obtain[ing], by means of false or fraudulent pretenses, representations, or promises, . . . money . . . under the custody or control of[] any health care benefit program.” Violations of the federal healthcare fraud statute carry substantial fines and up to 10 years of federal prison time in most cases, but prosecutors can seek a 20-year prison sentence in cases involving patient harm.
Louisiana Medical Assistance Programs Integrity Law (MAPIL)
The Louisiana Medical Assistance Programs Integrity Law (MAPIL) allows state prosecutors to pursue enforcement actions against individuals who commit Medicaid fraud. Similar to federal cases, state cases can involve a wide range of allegations, and executing a strategic defense starts with ensuring that you have a clear (and comprehensive) understanding of the allegations involved.
Other Healthcare-Related Offenses
From taking advantage of patients to taking advantage of private health insurance companies, healthcare fraud cases can involve a range of serious allegations. If you are facing any state or federal healthcare fraud allegations in Louisiana, Lee can provide the advice and representation you need to defend against them.
Why You Need an Experienced Shreveport Healthcare Fraud Attorney
In all cases, defending against allegations of healthcare fraud requires experienced legal representation. Some of the reasons why it is important to have an experienced defense attorney on your side in this scenario include:
- Healthcare Fraud Can Take Many Different Forms – You could be facing a variety of allegations, and you need to make sure you defend against all of the government’s allegations in order to avoid civil or criminal liability.
- Healthcare Fraud Cases Are Complex – Healthcare fraud cases are complex, often involving multiple laws, multiple law enforcement agencies, and voluminous records. You need an attorney who knows what it takes to defend you.
- You Are Going Up Against the Government – Defending against healthcare fraud allegations means taking on the government. Hiring an experienced attorney levels the playing field and helps ensure that you are not overwhelmed by the government’s case against you.
- Combating Healthcare Fraud is a Top Priority for Prosecutors – Due to widespread fraud under Medicare, Medicaid, and other healthcare benefit programs, combating healthcare fraud is a top priority for prosecutors at the state and federal levels.
- You Have A Lot At Stake in Your Case – Healthcare fraud is a serious charge that carries serious penalties. You have a lot at stake in your case, and you owe it to yourself to fight by all means available.
FAQs: Facing Allegations of Healthcare Fraud in Louisiana
I made a billing error. Is that still fraud?
Yes, even inadvertent billing errors are classified as “fraud” under the False Claims Act. While inadvertent errors should not put you at risk of facing criminal charges, they can have serious legal consequences even if the government agrees that criminal prosecution isn’t warranted.
What is the Louisiana Medical Assistance Programs Integrity Law (MAPIL)?
The Louisiana Medical Assistance Programs Integrity Law (MAPIL) is a state law that targets fraud, waste, and abuse under the state’s Medicaid program. It imposes steep penalties for healthcare providers and others who submit fraudulent billings and engage in other forms of fraud.
What should I do if agents show up at my Shreveport clinic?
If agents show up at your clinic in Shreveport, you should engage experienced defense counsel promptly. This is a high-risk scenario, and you need to ensure you rely on the advice of an experienced Shreveport healthcare fraud attorney.
Can I face criminal charges for healthcare fraud in Louisiana?
Yes. Accusations of healthcare fraud can result in civil enforcement actions as well as criminal prosecution. Both federal and Louisiana prosecutors may pursue criminal healthcare fraud charges if they believe a provider’s billing practices were done knowingly and included kickbacks, false records or claims, or intentional fraudulent conduct.
Potential penalties for criminal healthcare fraud include criminal fines and restitution, exclusion from Medicare or Medicaid programs, and possibly jail time. Investigations often start well before you know they’re happening. Complaints from employees, competitors, or auditors can all trigger an enforcement action based on false claims.
That is why it is so important to seek legal guidance as soon as you suspect an investigation is underway.
Can I be investigated even if I didn’t personally submit the claims?
Yes, you can still be accused of fraud. Doctors, clinic owners, practice managers, and healthcare executives can be held liable for the actions of their employees under both federal and Louisiana healthcare fraud statutes.
You may be accused of not properly training or supervising your employees, consciously disregarding red flags related to compliance with billing regulations, or profiting from fraudulent claims submitted on your behalf. Simply put, you cannot delegate billing responsibilities and avoid potential legal consequences.
For these reasons, you should not assume that an investigation will only involve human resources or your office manager. An attorney can work to identify your exposure and limit damage to you and your staff.
Can they take my medical license if I have not been convicted of a crime?
No. While attorneys cannot guarantee specific outcomes, they can assure you that your medical license will not be taken from you without due process. Under Louisiana law, and the law of all states, a criminal conviction does not necessarily equate to losing your medical license.
Your license may still be suspended or revoked if you are found guilty of violating medical practice standards through a hearing process separate from the criminal justice system. Your attorney can defend you in both criminal and administrative proceedings.
Whereas your lawyer will fight to prevent your conviction in criminal court, your attorney can challenge the state medical board’s evidence against you and argue on your behalf during a license suspension or revocation hearing.
Do I have to give the government anything during an investigation?
You do not have to give the government your personal records, documents, or answers to their questions. Providers often do not know they are being investigated until they receive a document request from the government, are met in the office by government agents, or are asked to provide an interview.
By that point, you’ve already given the government access to your records and allowed them to interview your employees. Keep in mind, investigators are not looking out for your best interest and are not trying to clear up a misunderstanding. They are building a case against you.
You have the right to consult with an attorney before you give up any information or records to government investigators. Your attorney can help you identify what, if any, documents should be turned over to investigators.
Contact Shreveport Healthcare Fraud Attorney Lee Harville
Lee has experience defending clients charged with federal criminal charges and in defending against charges of healthcare fraud. If you have been charged with healthcare fraud or related charges, contact us today to see how Lee can help. Call 318-222-1700 or contact us online to schedule a confidential consultation today.