Health Care Fraud

Health care fraud is the crime that involves the filing of dishonest health care claims in order to turn a profit. In California, Penal Code Section 550 (a) prohibits false claims for such health care benefits.

Medical practitioners can be charged with violation of health care fraud laws. Typically practitioners are charged with crimes for acts such as billings insurance carries for claims that were not performed, falsifying medical records, double billing for work performed, using unlicensed staff, accepting or giving kickbacks for patient referrals, waiving co-pays and prescribing unnecessary medication (which is often sold on the black market). Claims for payment of health care benefits include worker’s compensation claims as well.

Individual members of insurance plans can be charged with health care fraud crimes if the government believes the individual provided false information when applying for programs or services, selling prescription drugs, using another’s insurance card, or permitting another to use the insured’s insurance card.

Health care fraud claims are punishable by the state or federal government, and the severity of the punishment depends dependent upon the dollar amount at issue.

For example, in California Penal Code Section 550 (a) prohibits a person from acts such as knowingly making a false or fraudulent claim for payment of a health care benefit or knowingly presenting multiple claims for payment of the same health care benefit with intent to defraud. A fraudulent claim that exceeds $400 is punishable by imprisonment in state prison for two to five years or by a fine of double the amount of the fraud, whereas a fraudulent claim that is less than $400 is punishable by imprisonment for up to six months or by a fine of up to $1,000. In California, Penal Code Section 550 (a) prohibits false claims for such health care benefits.

On the other hand, a federal prosecution could result in heavy fines or 10 years’ in prison, or 20 years incarceration if death results from the fraud. (18 U.S.C. 1347)

An effective defense can protect against a health care fraud charge.

When facing new criminal charges, hiring the right lawyer is one of the most important things you can do. A health care fraud conviction will affect the rest of your life; you can’t afford to risk your future with a cut rate lawyer.

The experienced criminal lawyers at Law Office of Doreen Boxer, Esq. maximize our clients’ outcomes – from negotiating a favorable settlement to winning at trial.

With decades of criminal defense experience the attorneys at Law Office of Doreen Boxer, Esq. know how to achieve success for our clients.

As experienced criminal defense attorneys we know how best to defend our clients against the government.

Call our office for a consultation (949) 261-2700, or email us