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There are thousands of individuals in Lincoln and throughout the state that rely on financial benefits from Medicaid. Due to its widespread popularity, there are many allegations of fraud in the Medicaid system each year.
Medicaid fraud can vary, with some allegations involving providers and others targeting claimants. In either case, the consequences could be steep. If law enforcement have accused you of this type of crime, a dedicated fraud attorney can inform you of what is at stake. The guidance of a Lincoln Medicaid fraud lawyer can be invaluable in your effort to fight your charges.
Understanding Medicaid Fraud
Medicaid fraud accusations can be leveled at medical providers and patients alike. While some forms of fraud are exclusive to one group or the other, certain instances could lead to claims against both parties. An attorney in Lincoln can help you identify the basis of most Medicaid fraud allegations.
Sharing Benefits
A common type of Medicaid fraud involves the unlawful sharing of benefits. Commonly referred to as “card sharing,” this form of fraud typically involves multiple patients seeking benefits on the same policy. Card sharing could result in a patient receiving benefits he or she was not entitled to.
Unbundling
Unbundling is a form of Medicaid fraud perpetrated by medical providers. This is a type of fraud that involves breaking up bundled medical procedures into individual claims. By unbundling a series of claims that insurance companies provide a single global code for, the medical provider could bill someone for the same procedure twice.
Upcoding
Upcoding is another type of Medicaid fraud that is unique to medical providers. This type of offense involves a medical provider billing a procedure as something more complicated than it was. This results in substantially higher reimbursement for relatively minor procedures.
Kickbacks
In some limited cases, Medicaid fraud could involve collusion between care providers and their patients. This type of fraud commonly involves kickbacks between patients and care providers. One example could involve a patient fraudulently seeking benefits through Medicaid.
In exchange for providing a fake diagnosis for the patient, the medical provider would then receive a kickback of any benefits obtained through the fraud. Whether you are a medical provider or a patient, a skilled attorney can help you understand the nature of your Medicaid fraud charges.
Defending Against Fraud Accusations in Lincoln
With each type of Medicaid fraud comes a different potential defense. For example, claims of unbundling or upcoding could be blamed on simple administrative errors. However, a mistake defense would not be as effective in cases that involve card sharing.
The defense that spans across all potential Medicaid fraud claims is the lack of intent. Prosecutors must establish that the defendant intended to defraud Medicaid in order to obtain a conviction. An aggressive lawyer can help you show a lack of intent to commit Medicaid fraud.
Seek Legal Help from a Lincoln Medicaid Fraud Attorney
There are serious consequences associated with a conviction for Medicaid fraud. If convicted, you could face steep fines and years in a federal facility. For medical providers, a conviction could also make it difficult to find work in the healthcare field again.
A Lincoln Medicaid fraud lawyer can help your fight allegations. At Berry Law, our dedicated attorneys will build a strategic defense to help you achieve the best possible outcome. Call our firm right away to schedule a confidential consultation and discuss your case.