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Florida health care fraud case gets headlines

Medical practitioners and others involved in the health care field deserve compensation for their work. Billing their patients’ health insurance providers for services performed allows many to receive payments. The billing must be legitimate, or those who file allegedly fraudulent claims in Florida could face health care fraud charges. If found guilty, the penalties might involve fines and a prison sentence.

$38 million health care fraud case draws attention

In December of 2021, the U.S. Attorney’s Office from the Southern District of Florida charged a Miami resident with health care fraud. The federal grand jury indictment focuses on the alleged defrauding of insurance companies out of “$38 million in false and fraudulent claims.”

The charges center on billings for infusion of an immunosuppressive drug when not medically necessary. Per the indictment, some patients were billed for the drug but never received it. The alleged false billings supposedly occurred between February 2015 through July 2021. All parties are considered innocent until proven guilty.

Facing health care fraud charges

Health care fraud involves intentionally submitting illegitimate claims to insurance companies or bills to patients for profit. The Miami case garners attention because of the massive sum, $38 million. However, someone could get into legal trouble for far less of an amount.

Fraud charges are defensible, and lack of intent might be a viable defense. People make mistakes and may send bills out in error and collect the payments. Hopefully, such errors end up straightened out before a criminal investigation commences.

In some cases, false accusations could lead to an indictment. Proving a witness lacks credibility and a prosecutor’s case is weak could undermine the charges.

Law enforcement cannot procure evidence illegally, either. A lack of a proper warrant may result in evidence not being admissible in court. These and other defenses might help someone facing many counts of fraud.