Miami Billing Fraud Defense Lawyer

Billing fraud is a serious crime in the healthcare industry, and if you are facing accusations, the consequences can be severe. According to the U.S. Sentencing Commission, healthcare fraud accounted for 8.4% of all reported cases involving theft, property destruction and fraud in fiscal year 2022, and healthcare fraud prosecutions have been rising over the past several years. Notably, the Southern District of Florida saw more prosecutions than any other court in the country by far. In the face of such zealous prosecution, you need an attorney on your side with the skills and experience to fight for you and win. Contact our Miami billing fraud defense lawyers today.

At The Baez Law Firm, our experienced and passionate legal team is dedicated to defending healthcare professionals against these high-stakes allegations. We leverage our access to top experts and extensive resources to provide the best defense possible.

What Is Billing Fraud?

Billing fraud, often discussed synonymously with healthcare fraud, occurs when a healthcare provider submits false or misleading claims to insurance companies, Medicare, or Medicaid to receive payments for services not provided or not necessary. Common examples include:

• Upcoding: Billing for more expensive services or procedures than were actually provided.
• Unbundling: Separating services that are typically billed together to increase the total amount charged.
• Phantom Billing: Charging for services, tests, or procedures that were never performed.
• Double Billing: Submitting multiple claims for the same service.
• Billing for Unnecessary Services: Ordering tests or equipment such as wheelchairs that aren’t needed for diagnostic or therapeutic purposes.

Penalties for Billing Fraud

The penalties for billing fraud can be severe and may include significant prison time. Federal charges can result in sentences of up to 10 years for each count of fraud, with longer sentences if patient harm or large-scale fraud is involved. Monetary penalties can also be substantial, with fines reaching millions of dollars, depending on the amount of fraud. On top of any fines assessed, courts often require repayment of the fraudulent gains.

Beyond the criminal penalties, healthcare providers may lose their licenses, be excluded from Medicare and Medicaid programs, and suffer irreparable damage to their reputations. Moreover, civil cases can result in additional fines and penalties under the False Claims Act.

How The Baez Law Firm Can Help

At The Baez Law Firm in Miami, we understand the gravity of billing fraud charges and are committed to providing a robust defense to protect your career, reputation, and freedom. Our team begins with a thorough evaluation of the charges and the evidence against you. We scrutinize the billing records, financial documents, and any other relevant materials to identify weaknesses in the prosecution’s case. We collaborate with leading experts in healthcare, billing practices, and forensic accounting as needed to provide testimony that supports your defense. These experts can challenge the prosecution’s claims and offer alternative explanations for billing discrepancies.

Our defense strategies are tailored to the specifics of your case. Potential defenses against billing fraud charges include, for example:

• Lack of Intent: Demonstrating that any billing errors were unintentional and resulted from clerical mistakes or miscommunication.
• Absence of Knowledge: Proving that you were unaware of the fraudulent activities conducted by employees or third parties.
• Compliance with Regulations: Showing that your billing practices were in line with industry standards and regulations at the time of the alleged fraud.
• Challenging Evidence: Questioning the credibility, accuracy, and legality of the prosecution’s evidence.

In some cases, negotiating a favorable plea deal may be the best course of action. Our skilled negotiators will work to reduce charges or secure a plea agreement that minimizes penalties, allowing you to avoid the most severe consequences of a trial. If your case does go to trial, our seasoned litigators are prepared to aggressively defend your rights in court. We present compelling arguments, cross-examine witnesses effectively, and strive to achieve a favorable verdict.

Contact The Baez Law Firm Today

Facing billing fraud charges brought by the full weight of federal law enforcement agencies can be overwhelming and intimidating, but you don’t have to face them alone. The Baez Law Firm is here to provide the expertise, dedication, and relentless advocacy you need. Call us today at 800-588-BAEZ or contact us online for a free consultation and take the first step toward protecting your future.

At The Baez Law Firm, we are dedicated to going the extra mile for our clients, ensuring that every possible defense is explored and every resource is utilized. Trust us to fight for your rights and secure the best possible outcome in your billing fraud case.