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How physicians can avoid health care fraud

On Behalf of | Aug 31, 2022 | Health Care Crimes |

Most health care professionals in Florida don’t go into the field with the intent to defraud their patients. However, several laws apply to physicians and those who work for them. It’s not only important for doctors to know about these laws but also to understand that violating them could result in severe criminal penalties.

Fraud and abuse laws that cover physicians

Several governmental agencies are responsible for enforcing health care fraud laws, including the Department of Health and Human Services Office of Inspector General, the Centers for Medicare and Medicaid Services, and the Department of Justice. With some of these laws, no intent to defraud is required. You and your practice may end up guilty even if you accidentally violate one of the statutes through carelessness.

One of the most common violations involves filing false billing claims. Falling under the False Claims Act, each instance of filing false claims for payment from Medicare or Medicaid could cost you up to $11,000 in fines. If you knowingly file false claims, you could face criminal penalties. Taking money from a drug company to prescribe their medications is a violation of the Anti-Kickback Statute, while the Physician Referral Law prohibits you from referring patients to health services where a relative works.

Minimizing fallout from fraud charges

Fraud charges can have a significant negative impact on your medical practice. Therefore, it’s in your best interests to keep comprehensive records that corroborate our version of events. In some cases, you may also be able to reduce the penalties.

Health care laws are complex. Putting health care compliance programs in place that educate employees and regularly updating these programs can go a long way toward avoiding violation of multiple statutes. Ensuring that you and everyone in your organization understands these issues is crucial.