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Miami Healthcare Fraud Attorney

Effectively Handling Healthcare & Medicaid Fraud

Jeffrey S. Weiner has represented physicians, veterinarians, medical professionals, and healthcare organizations and employees since 1974. Laws relating to the medical profession, federal programs, billing, and prescribing medications are confusing, constantly changing, and fraught with peril for the unwary, leaving physicians, veterinarians, pharmacists, chiropractors, nurses, and healthcare organizations and their employees vulnerable to criminal investigations and serious charges. For over 45 years, our Miami healthcare fraud attorneys have represented people being investigated for or who have been charged with a wide variety of healthcare-related offenses.

We are intimately familiar with:

  • Overbilling
  • Insurance Fraud
  • Tax Fraud Violations
  • Medicare / Medicaid Fraud
  • Internet Pharmacy Violations
  • Improper Solicitation of Patients
  • Inappropriate contact with patients
  • Over-prescribing controlled medication
  • Criminal negligence in the practice of medicine

The penalties for even minor violations can be substantial, including the loss of your professional license and professional sanctions, along with criminal charges. When facing charges, it is important to remember that the stakes are high and incarceration is a possibility with strict sentencing guidelines which must be considered by your trial judge. Please keep in mind that parole is not available any longer in the federal criminal justice system or in the state of Florida. Miami health care fraud attorney Jeffrey S. Weiner has extensive experience helping medical professionals and healthcare organizations navigate the criminal justice system. He will vigorously defend your rights during criminal investigations and trial and in professional regulatory proceedings.

Miami Healthcare Fraud

Why would a physician risk his or her career and reputation by committing criminal acts?

We have successfully represented many physicians in Medicare and other types of healthcare fraud cases brought in federal court. Some were physicians, who were allegedly part of conspiracies to rip-off the federal government by making false diagnoses and prescribing treatment, home health care, home visits, physical therapy, medical devices, and medication when not medically necessary, all to make a profit. Often, these physicians did not properly plan financially for their retirements and found themselves in need of money. It was easy for them to be employed by unscrupulous clinic operators, or in their own practices, knowing that word would quickly get around that they were available for unnecessary prescriptions, home health care, and other such services.

Sometimes, physicians, dentists, and veterinarians from foreign countries who move to the United States do not want to take the time and effort to become properly licensed, so they practice without a license – often out of their homes – and in less than ideal conditions for their patients. State courts often charge these types of crimes – always felonies.

We have represented physicians and dentists who have allegedly molested their patients, sometimes with the knowledge or suspicion of misconduct by fellow physicians or nurses, who have not reported it. Some physicians have been suspected of practicing medicine while intoxicated or high on drugs.

Jeffrey S. Weiner has found in his 45 years as a criminal defense attorney that physicians who are used to having the respect of the public typically react to a visit by federal investigators by giving statements without the benefit of criminal defense counsel. As a result, in many of those instances, the physician – whether intentionally or otherwise – gave inaccurate or intentionally false statements which were later used against him or her.

It is essential that physicians, like everyone, understand that attempting to prove their innocence to investigators or law enforcement officers, without consulting with competent federal criminal defense counsel, is almost always a mistake – sometimes so serious that their license to practice medicine is placed in greater jeopardy than if they simply stated, “Under the circumstances, I respectfully decline to make a statement until I consult with counsel.”

Contrary to popular belief, such action will not make you appear “guilty.” Rather, it will let the investigators and law enforcement officers know that you are intelligent, that you care about your license and profession, and that you are smart enough to insist upon counsel to guide you through the horrible experience of being accused of something that could irreparably damage your reputation and result in your being prevented from practicing your learned profession or, worse, place you at risk of losing your freedom by being convicted of a crime, almost always a felony – the most serious category of crimes.

So, whether you recall the incident in question or the patient(s) being inquired about; whether you are innocent or guilty of misconduct; our absolute best advice to you is not to speak with law enforcement agents, other than to say what we have suggested above.

Though most people, especially medical professionals, believe they will never fall under the scrutiny of law enforcement, the reality is that innocent physicians, nurses, physical therapists, and other healthcare providers are often falsely accused. Therefore, prudent healthcare professionals will seek out and meet with an experienced criminal defense attorney, ideally before you are a suspect, but certainly immediately upon being contacted by police or federal agents. Interview several criminal defense attorneys if you wish, but find one with experience representing professionals such as you and establish an attorney/client relationship with that attorney. Then, should that dreaded day ever arrive, you will have an attorney to call who is competent, who knows you, and who will be ready to act at a moment’s notice.

Federal crimes, including healthcare fraud, are prosecuted by prosecutors from the Department of Justice in Washington, D.C., and by local federal prosecutors known as Assistant United States Attorneys. Since federal healthcare fraud involves millions and possibly billions of dollars in loss to the federal government, federal prosecutors have been specially trained to prosecute healthcare fraud cases. The prosecutors from the Department of Justice in Washington, D.C., almost always work directly with the local prosecutors and agents on these cases. There are certain cities and counties that have received special focus from the federal government because of the prevalence of healthcare fraud. Miami, Miami Beach, Coral Gables, Hialeah, Doral, and other cities and unincorporated areas of Miami-Dade County, Fort Lauderdale, Hollywood, Pembroke Pines, Margate, and other cities in Broward County, and the many municipalities in Palm Beach County are among those targeted areas. Very highly trained prosecutors are assigned to handle these cases, and those prosecutors typically focus only on healthcare fraud cases. These prosecutors are experienced. They know what to look for when deciding whether to charge healthcare crimes. They also will make important decisions as to who they want to be a witness, as opposed to a defendant. Ideally, your Miami healthcare fraud attorney will be able to have a friendly, professional relationship with the agents, and especially the prosecutors, to get you the best possible result – which, hopefully, means avoiding criminal charges for you.

In the past several years, many agents of the Federal Bureau of Investigation have been assigned to investigate terrorism and related activities, including money laundering. However, even with this diversion of agents, the FBI has been actively involved in investigating healthcare fraud. Many of these agents are also specially trained, so they understand the nuances of how federal healthcare fraud is often committed. These days, virtually all FBI field offices investigate healthcare fraud.

Most federal criminal healthcare prosecutions involve Medicare. Medicare is a program exclusively operated by the federal government. Medicaid, on the other hand, are programs administered by individual states, while following federal requirements. As a result, most Medicaid fraud prosecutions are state prosecutions. Florida has been very active in prosecuting Medicaid fraud, often after investigations by the Florida Department of Insurance, and with specially trained agents, accountants and auditors, who work exclusively on healthcare fraud cases. The state of Florida investigates these crimes through detectives, agents, investigators, and prosecutors from many agencies, including the Florida Department of Law Enforcement, the Florida Department of Insurance, and local State Attorney offices. Florida does not have District Attorneys, as many states do. In Florida, local state prosecutors are known as Assistant State Attorneys. On state-wide crimes, the prosecutors are known as Assistant Statewide Prosecutors.

Kickbacks

Congress has enacted legislation popularly known as the “anti-kickback statute.” Interpretation of that criminal felony statute encompasses acts much broader than simple money kickbacks or bribes. Sophisticated schemes have been prosecuted under prosecutorial theories that they amount to kickbacks. For example, the acquisition of physicians’ practices, consultant and management contracts, leases, purchases of equipment, partnerships and joint ventures, and others, for the purpose of illegally facilitating kickbacks, have all been subjects of successful prosecutions.

The gist of the “anti-kickback statute” is that it is a crime for anyone to willfully and knowingly solicit or receive remuneration, indirectly or directly, in cash or in kind, for referring a person to receive any item or service for which payment may be made in whole or part under a federal healthcare program, or in return for arranging for, ordering, leasing, purchasing, or recommending the above for any good, facility, or service, for which payment may be made under a federal healthcare program. Upon conviction, the penalty can be severe: Imprisonment for up to 5 years and a fine of up to $25,000.00. The same punishments apply to anyone who is convicted of offering or paying remuneration in any of the situations set forth above.

Although most people assume that healthcare fraud is limited to Medicare and Medicaid matters, the federal government has assumed jurisdiction over almost all healthcare programs, including state healthcare programs involving federal funding.

Of course, as for every prohibited act, there are exceptions and defenses. Your Miami healthcare fraud attorney can explain them to you, depending on the facts of your case. For example, discounts properly disclosed are acceptable under certain circumstances. Payments made by an employer to an employee for legitimate employment is perfectly legal, even when the government reimburses the employer for those services.

The purpose of this section of my website is not to teach a course on healthcare fraud. It is to alert interested persons to the pitfalls and some of the main issues involved in healthcare fraud investigations and prosecutions.

We have been involved for many years in representing physicians, physical therapists, home healthcare providers, chiropractors, administrators, nurses, physicians assistants, and others who have been investigated and/or prosecuted for healthcare fraud. Those persons represented by us have fared well, considering the circumstances in each case. If we can be of service to you, please do not hesitate to call early on. Proper representation makes all the difference in the world when you are being prosecuted or investigated for healthcare fraud.

Please don’t make the mistake of expecting your civil attorney to advise you on potential criminal matters. It is unfair to them, and not beneficial to you. Attorneys who represent your professional corporation (your P.A.) or your family attorney, are, in all probability, not experienced as a criminal defense attorney handling these types of cases. Even if your attorney has been your attorney for a long time, or if he or she is your best friend, it is unreasonable to ask them to represent you under circumstances which may lead to your arrest and indictment. If you wish, we will be pleased to talk with you about your unique circumstances, and we will advise you. Simply call our law firm at (305) 670-9919 and ask for an appointment with Jeffrey S. Weiner. Then, drive to our office for an initial, no-charge consultation.

Contact our Miami healthcare fraud attorneys today for a free consultation at (305) 670-9919.

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