Health Care Fraud
Nicole Knox represents healthcare organization owners, officers, directors, doctors, nurses, and other parties accused in complex healthcare fraud cases.
She understands your reputation and livelihood may be at risk and is prepared to launch an aggressive defense to protect your rights and your career.
Trends in Healthcare Fraud Cases
In recent years, the government has redirected its focus on health care fraud investigations. Historically, federal prosecutors focused on prosecuting pharmaceutical manufacturers, medical device manufacturers, and insurers. Today, federal agents focus on criminal investigations of hospitals, home health agencies, hospices, doctors, nurses, and other individuals involved in the administration of health care organizations.
Over the last several years, the federal government recovered more than $2 billion from cases involving false claims submitted to federal programs such as Medicare and Medicaid. The government’s return on investment for investigating and prosecuting healthcare fraud cases guarantees it will continue to focus on aggressive enforcement.
Many cases involve a violation of the False Claims Act (FCA), which allows the government to begin a civil or administrative investigation. The FCA also allows a whistleblower, including current or former employees, to sue an employer and to recover a portion of the funds returned to the government. The government also relies heavily on the False Claims Act to bring criminal charges for illegal kickbacks. FCA investigations may also lead to the discovery of additional criminal violations.
Healthcare Fraud Cases in Texas
Healthcare fraud criminal charges and investigations occur more frequently in Texas than in many other states. The federal government created a special task force called Health Care Fraud Prevention and Enforcement Action Team (HEAT) and placed HEAT task forces in nine cities across America. Two of the nine cities are Dallas and Houston, Texas.
The federal government often brings health care fraud criminal charges for false and fraudulent claims submitted to Medicare. These claims include allegations for services never performed, for treatments never provided, and for medicine never administered to a patient.
Some cases involve allegations of complex conspiracies in which individuals provide kickbacks or bribes in exchange for Medicare beneficiary referrals. Illegal kickbacks also include situations where a pharmaceutical company induces pharmacies to switch manufacturers in exchange for a rebate or discount.
These matters are complex. And, it is not uncommon for a medical professional to be charged with a crime simply because of a misunderstanding or an unintentional mistake. This includes situations when a professional intentionally acted in a manner that benefitted the patient.
Whatever the case may be, Ms. Knox will build a sound criminal defense strategy on your behalf.
