Healthcare Fraud

KNOXVILLE HEALTHCARE FRAUD LAWYERS

Healthcare fraud involves using false or misleading information to collect benefits through insurance. Patients, doctors, and other individuals can commit healthcare fraud and use unauthorized benefits for their own gain. If you have been accused of healthcare fraud, contact an attorney immediately. Eldridge & Cravens attorneys have extensive experience handing healthcare fraud cases and will provide you with support, advocacy, and fierce defense.

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What is healthcare fraud?

In general, health care fraud includes:

• Billing for services that were never performed.
• Misrepresenting procedures to obtain payment for services not covered by insurance.
• Upcoding or billing for more expensive services than those performed.
• Accepting kickbacks for patent referrals.
• Waiving copays or deductibles and billing insurance company instead.
• Unbundling or billing at every stage of single procedure.
• Billing patient more than co-pay amount for treatments covered in full by insurance.

Patients can also be guilty of healthcare fraud if they:

• Use fake or expired ID to receive medications or medical services.
• Add ineligible beneficiaries to a plan.
• Forge bills or receipts.
• Lend medical ID cards to other people.

Tennessee healthcare fraud laws

For localized medical fraud cases, those found guilty could face felony charges and up to 30 years in prison as well as fines up to $25,000 in extreme cases. The hinge point of a fraud case is if an individual intentionally used deception to deprive a person or entity of tangible or intangible benefits. According to state laws, fraud is accomplished through deceit, treachery, or unfair means. These elements are what the prosecution must prove to the court.

Federal punishment for healthcare fraud

Because many health care fraud cases occur to take advantage of Medicare and Medicaid benefits, the federal government may have jurisdiction in some cases. The Centers for Medicare & Medicaid Services, FBI, and other federal agencies can investigate and punish healthcare fraud.

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