When your career involves healthcare, you deal with complicated billing structures. You work with insurance companies and patients, sending out multiple documents and charges. If your paperwork doesn’t seem right to the government, you may find yourself facing health care fraud charges.
Health care fraud can happen in multiple ways. Some providers may deliberately scam money from patients or insurers. But some may just make errors in paperwork. Either way, medical professionals can face stiff punishments. Here are a few examples of what health care fraud is:
- Extra billing for treatment the patient didn’t receive
- Labeling treatments not covered by insurance – like cosmetic or plastic surgery – as medically necessary
- Splitting stages of one procedure into multiple treatments – also known as “unbundling”
- Charging the insurance company for co-pays or co-insurance instead of the patient
- Charging the patient more than the co-pay or co-insurance
- Running unnecessary tests to increase the patient’s bill
- Charging for procedures more expensive than what the patient received
A conviction for any charges can have severe effects
If you face any of these charges, you may find yourself fighting harsh punishments. If you receive a felony conviction, you can spend years in jail. And courts can charge you thousands of dollars in fines. They may even make you pay the amount of money the insurer or patient lost.
A criminal conviction can also threaten your career. You can lose your license, stripping you of the ability to practice medicine.
Health care fraud accusations are a serious issue for any medical professional. Those facing a conviction may want to seek legal advice to see if they can reduce or drop charges. If they don’t, they may find their career in jeopardy.
