Health Care Violations

Most health care providers work very hard to deliver quality care to their patients and to submit accurate claims for payment to Medicaid and/or Tricare. However, on occasion, the Government may dispute a payment as being improper and illegal. Improper payments can include those made for treatments or services that were not covered by program rules, that were not medically necessary, or that were billed but never provided. There are a number of federal laws that criminalize people and/or organizations who seek improper payments from Medicaid or Tricare. These Federal laws include, but are not limited to, the following:

  • The Health Care Fraud Statute;
  • The False Claims Act;
  • The Anti-Kickback Statute;
  • Exclusion Provisions; and
  • The Civil Monetary Penalties Law.

Health care providers who are accused of one of these violations can be subject to serious consequences ranging from payment of monetary fines and damages to serving prison time and exclusion from future participation in federal health care programs, including Medicaid.

If you are a physician, pharmacist, home health agency, compound pharmacy, urgent care center, chiropractor, or behavioral health facility who has been accused of health care fraud, a violation of the false claim act, or anti-kickback statute, there are potential defenses available to you. Please call the attorneys at Lindsey and Ferry, P.A., now so that we may assist you.