DC Federal Healthcare Overbilling Lawyer

The government requires healthcare providers to only bill for services rendered. Healthcare providers bill for medical treatments based on the Current Procedural Terminology (CPT) code. When the government suspects that a healthcare provider is overbilling then they will investigate the provider for healthcare insurance fraud.

Any healthcare provider that is currently facing charges should contact a DC federal healthcare fraud lawyer to help work with them to refute the government’s claims.

Healthcare Overbilling in Washington, DC

Overbilling is overcharging for goods or services in order to make an illicit profit. When a healthcare provider is charged with overbilling, they may be accused of one or more of the following:

  • Upcoding
  • Unbundling
  • Duplicate claims (being paid twice for one service)
  • Excessive services (giving daily medical visits when monthly would suffice)
  • Medically unnecessary services (giving an EKG to someone without heart trouble, for example)

Basically, anything that unnecessarily inflates the cost of medical services or items and results in profit at the expense of the insurance company (or federal government, in the case of Medicare and Medicaid) qualifies as overbilling. If you made a good-faith decision about the medical services necessary for your patient and are being accused of fraud, a federal healthcare overbilling lawyer in DC can work help you refute any fraud charges.

The terms “knowingly” and “willfully” are included in Section 1347 of the U.S. Code. If you had no knowledge of fraud and did not commit it intentionally, the penalties enumerated in Section 1347 may not apply to you. One of our attorneys may be able to help establish your lack of ill intent by providing the court with evidence that demonstrates the procedures you provided were necessary and that any instance of duplicate billing was clearly a clerical error and not an instance of knowledgeable and willful fraud. A lawyer will also demonstrate that the overbilling that occurred was a mistake of poor scheduling and miscommunication.

Penalties for Overbilling

If a person charged with overbilling is found guilty, they will have to pay a fine and probably even face a prison sentence. Even just attempting to overbill can result in a charge. For basic fraud involving overbilling, the fines can range from $500-$5,000. This can increase based on many factors.

The term of imprisonment for overbilling is up to 10 years. An overbilling fraud investigation does not just involve basic fines and jail time. Even if you are innocent, the federal government has the power to freeze your assets once you have been officially accused of fraud. The inconvenience of a frozen account can create upheaval in your life and can even affect how you are able to defend yourself.

DC Federal Healthcare Overbilling Attorney Today

A federal fraud conviction carries stiff penalties, but a knowledgeable and helpful DC federal healthcare overbilling lawyer will be able to help you prepare an aggressive defense to help you protect yourself from those penalties. Call our office today for your free consultation with an experienced DC federal healthcare overbilling attorney.