Houston Healthcare Fraud Lawyer

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Houston Healthcare Fraud Attorney

Healthcare fraud results in astronomical losses to the federal government. Because of this, they have made a big push to prosecute healthcare fraud. Healthcare is one of the most susceptible targets of fraudulent crimes. Because of this, penalties for healthcare fraud can be harsh. For those charged with this kind of crime, it can be intimidating to realize the potential penalties and the impact it could have on someone’s life. An experienced Houston healthcare fraud lawyer can help you put together a strong case.
houston healthcare fraud lawyer

Because healthcare fraud is always a federal crime, those who are charged with such crimes need an experienced attorney that understands the implications of a federal crime.  At The Law Offices of Richard Kuniansky, you’ll find a firm with four decades of experience in the courtroom. I’ve seen both sides of the court – both as a prosecutor and as a defense lawyer. I use this experience to help my clients receive the most beneficial outcome for their charges.

Whether you have been accused of federal healthcare fraud or another type of white collar crime, you need a skilled and compassionate lawyer. Medical fraud is taken very seriously by the U.S. government. In fact, the FBI is the primary agency that investigates these crimes. Considering the federal power behind such investigations, you need a strong defense. The Law Firm Of Richard Kuniansky can help.

What Is Medicare Fraud?

Medicare fraud occurs in a wide variety of different ways and is a federal crime. A number of different activities fall under the umbrella of healthcare fraud.

Some of the more common forms of healthcare fraud include:

  • Medicare or Medicaid Fraud. These two government programs are regular targets for health fraud, and are harshly penalized. However, things like false claims and scams to manipulate the reimbursement process still do occur fairly regularly.
  • Billing Fraud. In most situations, this involves charging an insurance company or government program for misrepresented services, unnecessary services, or even services that weren’t provided at all.
  • Phantom Billing. This involves billing for patients that never existed or for procedures or services that never occurred.
  • Upcoding. Healthcare services are usually billed by different codes, which is why the process of charging for a more expensive service is considered fraudulent.
  • Unbundling. Packaging services together usually save patients and insurers money. Selling this separately in order to increase the prices can be considered fraudulent.
  • Kickbacks. Anti-kickback laws make it illegal for someone to offer, solicit, or receive illegal remuneration for patient referrals.
  • Identity Theft. There are some cases where a patient’s or a provider’s information may be used for fraudulent billing.

This list isn’t exhaustive. There are many ways people navigate the healthcare system that are legal avenues. Some people may not even realize their actions were criminal.

Unlike some other types of white collar crimes, healthcare fraud is perpetrated by a variety of people. For instance, doctors can commit healthcare fraud if they accept a kickback, a patient might do so if they file a false Medicare claim, and a medical office employee might do so through billing fraud. Each of these charges has different penalties, but my firm understands the ins and outs of each and can help you regardless of your situation.

Potential Consequences for Healthcare Fraud

The Federal Bureau of Investigation heads healthcare fraud cases, but they work with other state agencies, as well as with the National Insurance Crime Bureau and the Healthcare Fraud Prevention Partnership. The penalties for these crimes can be severe.

However, the exact nature of what someone faces depends on the specific charges that they face. The impact of a conviction will typically result in both financial penalties and jail time. Some of the potential legal repercussions include:

  • Imprisonment. Healthcare fraud is often prosecuted under the Wire Fraud statute, which carries penalties up to 20 years imprisonment. Moreover, the Federal Sentencing Guidelines usually recommend severe terms of imprisonment for healthcare fraud.
  • Fines. The size of the fines that are required will depend on the specifics of the crime and the assessment of the court; however, they can often be substantial.
  • Restitution. Restitution is mandatory and those convicted are required to repay the victims of their fraud the same amount that the fraud caused them to lose. This could be to individuals, insurance companies, medical providers, or the government.
  • Asset Forfeiture. Any assets that were acquired as a result of the fraudulent activity may be required to be forfeited to the government.
  • Civil Penalties. In addition to criminal penalties, it is also possible that civil penalties could be imposed as well.

In addition to the criminal penalties that are involved with a healthcare fraud conviction, it could also impact a person’s professional life and future career. Many of these stem from the fact that a conviction will involve a criminal record. Potential penalties include:

  • Inability to Work in the Healthcare Industry. A person convicted of healthcare fraud is routinely barred from working for a company that bills Medicare. This is true even if they have no connection to billing, such as a Nurse.
  • Loss of License. There are many situations where a healthcare license will be suspended or even revoked if someone is convicted of having committed a fraudulent act.
  • Employment Challenges. Beyond the potential loss of a license, there can be other employment challenges created by a criminal record that employers will see before making a hiring decision. In particular, it may be impossible to get a job that involves the management and handling of sensitive information or finances.
  • Problems With Other Licenses. Getting a new professional license may also prove to be impossible with a criminal record, particularly with a white collar crime like fraud.
  • Educational Difficulties. A criminal record could lead to some challenges in getting accepted into different educational programs.
  • Financial Limitations. A criminal record, particularly with any form of fraud, is going to lead to challenges in getting loans and credit. Lenders are going to look at borrowers with these kinds of profiles as having a greater risk of not making repayments. Some programs may automatically disqualify someone with a criminal record.
  • Social Stigma. Another indirect result of criminal conviction is the social stigma of being convicted of a crime. In some cases, even existing friendships and family relationships can be negatively impacted.

How a Houston Healthcare Fraud Attorney Can Help

With as much at stake as there is in a healthcare fraud case, it’s important that you have a knowledgeable, experienced healthcare fraud defense lawyer on your side. It will be my job to put together a defense on your behalf and to execute a strategy that ensures minimal repercussions – if any.

If you’ve been arrested or expect to be, contact my firm. In the meantime, it’s important to maintain your rights against self-incrimination by staying silent until an attorney is with you.

Planning a Defense

A strategy for defending against healthcare fraud charges will need to fit the evidence available in the case. The burden of proof is on the prosecution to demonstrate that you are guilty beyond a reasonable doubt. Because of this, a defensive strategy will likely involve demonstrating the weaknesses and holes in the prosecution’s case and magnifying those for the jury.

However, that may not be an appropriate strategy for every case. The process of discovery allows a criminal defense attorney to see what evidence and information the prosecution has to make their case. What my office may find is that there is so much evidence that a particular action occurred, such as billing for particular services, that it wouldn’t make sense to challenge that point. In those situations, though, there may be other strategies that are more effective.

Pre-Trial Process

Some of the most important work that occurs comes before the trial. This could consist of a variety of different vital tasks depending on the specifics of the case. One of these could involve the possibility of a plea deal. There are some situations where the evidence is so significant and the risks of going to trial so great it makes sense to agree to a plea deal instead of facing a judge or jury. If that’s the case, then my firm can make every effort to negotiate a deal that works in your favor.

If a plea deal is not going to be a desirable option, there are a number of critical pre-trial actions that help lay the foundation for your defense. In particular, these involve a variety of different motions. If there is a reasonable argument to be made for the case to be thrown out on good grounds, I will certainly make that motion.

However, even if it is not possible to get the case dismissed, there may be an opportunity to challenge certain pieces of evidence. So much in a fraud trial depends on the reliability of the prosecution’s evidence. If those pieces can be challenged on sufficient grounds, such as having been obtained improperly or in violation of your rights, then the court may choose not to allow it to be introduced into the case.

In some cases, if a vital piece of evidence is not allowed, the prosecution may even choose to withdraw the charges without a trial.

What to Expect From a Trial

With experience as a federal prosecutor as well as a defense attorney, the Law Offices of Richard Kuniansky knows what to expect if you happen to face trial. I understand the strategies behind how prosecutors try a healthcare fraud case because I’ve used them myself.

Regardless of which defense strategy works for your situation, I will work toward the most optimal outcome for your case, communicate with you at every stage, and protect your rights throughout the process.

What to Do If You Are Suspected of Healthcare Fraud

If you’re suspected of healthcare fraud or anticipate being charged, then it is critical that you get in contact with a Houston healthcare fraud lawyer and law firm. The earlier you begin your defense, the longer you have to develop a well-constructed strategy.

Unfortunately, some people are caught unaware that they are suspected of healthcare fraud. It can seem overwhelming if you’re arrested in such a circumstance, especially if the arrest wasn’t anticipated.

If this happens to you, the primary thing to remember is to remain calm. It can be easy to act rashly under the stress of an arrest, but such reactions are never good for your case. In fact, they could cause greater challenges for you. You are going to be better off by remaining calm and allowing the system to work. Make sure to use your right to remain silent. It can be tempting to explain yourself to arresting officers or prosecutors, but you may incriminate yourself or make the charges worse by doing so.

Once you have the chance to speak to your attorney, you can build a case that will be to your advantage rather than the prosecution’s.

A Houston Healthcare Fraud Lawyer

Fraud is a serious crime, and the charges can often involve significant penalties. For those charged with healthcare fraud crimes, the situation can often be frightening. Being charged is not the same as a conviction. When you work with the Law Offices of Richard Kuniansky, it is not a foregone conclusion that you will be found guilty. My defense strategy is client-first, and I work to achieve an outcome that is right for you.

A Houston healthcare fraud lawyer can be critical to ensuring that a strong defense is made on your behalf. Trust The Law Offices of Richard Kuniansky if you are facing healthcare fraud charges. I have experience prosecuting and defending against all manner of federal white collar crimes and healthcare fraud in particular.

It’s that range of experience and understanding that helps me put together a formidable strategy for a defense that matches the particulars of your case. Contact my firm to discuss your healthcare fraud situation.



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