how much does a medicaid fraud lawyer cost

The answer is $0 out of pocket to you. You will pay nothing out of pocket. We track our time on an hourly basis and seek payment of those fees from the dealer. If we are unsuccessful, our clients do not have to pay the fees.

Full Answer

What is the difference between Medicaid fraud and Medicaid abuse?

While Medicaid fraud involves knowingly misrepresenting the truth to obtain unauthorized benefit, abuse includes any practice that is inconsistent with acceptable fiscal, business or medical practices that unnecessarily increase costs.

Is Medicaid fraud costing States billions?

Fraud, abuse and waste in Medicaid cost states billions of dollars every year, diverting funds that could otherwise be used for legitimate health care services.

How much does it cost to hire a Medicaid lawyer?

Some Medicaid lawyers offer free consultations, while others charge an initial consultation fee or offer Medicaid planning conferences that range in cost from approximately $175 – $500. After the consultation / planning conference and gathering of the facts and needs, a price for services can be quoted.

Are abusive and fraudulent medical practices costing you money?

Not only do fraudulent and abusive practices increase the cost of Medicaid without adding value – they increase risk and potential harm to patients who are exposed to unnecessary procedures.

What is Medicaid fraud?

Medicaid fraud involves falsifying information to benefit from reimbursements beyond the actual cost of what services were provided. Several penal codes have been put in place to protect American citizens and punish those who try and defraud Medicaid. Unfortunately, some people get accused of crimes they didn’t commit.

How long do you have to be in prison for Medicaid fraud?

If the healthcare professional is convicted, they will spend a minimum of five years in a government correctional facility.

What is upcoding in Medicaid?

Upcoding. One of the most popular forms of Medicaid fraud is Up coding. It occurs when procedures get billed more than they should cost. Because the Medicaid billing process is extremely complex, it is oftentimes hard to detect errors.

Why is it important to handle Medicaid fraud cases?

It is important that Medicaid fraud cases get handled timely and accurately. In the absence of a skilled and knowledgeable Medicaid attorney, healthcare professionals will oftentimes lose a case against them.

How to defend yourself against Medicaid fraud?

One of the only ways to properly defend yourself is by working with an Attorney General’s Medicaid Fraud Unit.

What happens after the government investigates a Medicaid fraud case?

After the government investigates the case on Medicaid False Claims Act, it decides on whether or not to pursue or drop the case. In case the government continues with the case, it serves the defendant with a complaint.

What is Medicaid fraud investigation?

Medicaid Fraud Investigation Process. As the government investigates during the interview, the case on false claims is examined. The prosecutor handling the case engages the government agency responsible for getting its opinion on the matter.

How to defend against Medicaid fraud?

A Medicaid Fraud Attorney can be helpful in several different ways; they can defend you if you have been arrested for Medicaid fraud, and they can also help you report fraud to the government. If you have been arrested or are being investigated for Medicaid fraud, you will want to speak to a criminal defense attorney specializing in this type of defense. On the other hand, if your employer is defrauding Medicaid, Medicare or some other type of federally funded program, you will want to speak to a Whistleblower lawyer who handles Qui Tam lawsuits.

What is a Qui Tam lawyer?

Qui Tam attorneys specialize in Whistleblower lawsuits that are brought on behalf of individuals who wish to report the defrauding of government programs. These individuals, or in some cases small groups, are usually employees of a company that is conducting the fraud, and their job gives them firsthand access to information pertaining to it. In the case of Medicaid fraud, the person may be employed by a hospital, urgent care center, radiology clinic or any other type of facility that accepts Medicaid and Medicare. In cases like these, billing is usually falsified in some manner to reflect services that were not performed in order to facilitate higher reimbursement rates from Medicaid. Often times the bills are inflated to reflect higher rates of care that were not administered to the patient. There are many devious ways in which unscrupulous people can defraud Medicare or Medicaid. If you work in a billing department of one of these facilities and a supervisor instructs you to perform billing in a way that doesn’t coincide with the actual services rendered, you may want to consider making a confidential call to a Medicaid fraud attorney specializing in Qui Tam /Whistleblower Lawsuits.

Medicaid Fraud

Medicaid fraud varies from state to state and includes a variety of actions that can lead to the investigation and eventual prosecution of the crime. You may find yourself in the midst of a Medicaid fraud case and not even realize it.

What Is Medicaid Fraud?

Medicaid fraud occurs when an individual or entity participates in an intentional defrauding of Medicaid. Common participants include health care practitioners such as doctors, nurses and administrators, as well as individual patients or people misrepresenting themselves as eligible patients.

What Happens in a Medicaid Fraud investigation?

Under the jurisdiction of the Department of Health and Human Services, Medicaid Fraud Control Units (MFCUs) investigate claims of fraud within the Medicaid system. The stated goal of MFCUs is not only to detect willful fraud but also to protect vulnerable individuals who may be placed within the system and are subjected to abuse or neglect.

Is Medicaid Fraud a Federal Offense?

Medicaid fraud is a serious federal offense. If you are convicted of Medicaid fraud, you could face up to life imprisonment if your fraudulent behavior results in the death of another, up to 20 years imprisonment if the fraud causes serious bodily harm to a victim or up to 10 years behind bars if the offense was limited to financial fraud only.

Medicaid Fraud Penalties

Most states break down the penalty for Medicaid fraud into several categories of felony offenses. Florida, for example, punishes Medicaid fraud amounting to over $100,000 in costs as a first-degree felony, resulting in a potential prison sentence of 30 years if you are convicted in addition to steep fines.

How to Prove Medicaid Fraud

Medicaid fraud charges are based on a thorough examination of the physical evidence such as records of appointments, billing sheets and receipts, records of surgeries or prescriptions, as well as interviews with all relevant parties.

Medicaid Fraud Defense Strategies

As with many criminal cases involving fraud, there are several common strategies deployed by defense attorneys.

Why was my first Medicaid application rejected?

Many, perhaps most are rejected because of inadequate documentation, unreported assets, incomplete spend down or gifting of assets within 5 years of application.

Can you keep your home on medicaid?

They don’t tell you at the Medicaid department that you can keep your home and be on Medicaid, but after you die they want your estate to sell it and give the money to the government as payback. They call it “estate recovery.”

Does the Department of Health and Human Services answer questions?

You can expect that nobody at Department of Health and Human Services, the Medicaid department, will answer your questions. They are not there to answer questions. There job is to review your application and accept it or deny it. When your application is denied you have to start over.

In addition to costing taxpayers billions of dollars, Medicare fraud also lowers the quality of healthcare

Medicare processed more than $909 billion in Medicare benefits in 2020. That's millions of claims, and sifting through that data to find examples of fraud can be a challenge.

What is Medicare fraud?

Medicare fraud is when someone knowingly does something to deceive Medicare in order to receive a payment when they shouldn't be paid, or to get a higher payment than they are supposed to.

How much does Medicare fraud cost the government?

In 2020, CMS estimated that improper payments to Medicare cost billions of dollars each year. While improper payments don't necessarily mean fraud, they are payments that did not meet statutory, regulatory, administrative, or other legally applicable requirements.

How does Medicare fraud impact beneficiaries?

Medicare fraud can impact beneficiaries both physically and financially.

How to help prevent Medicare fraud

One of the best ways to help prevent Medicare fraud is to know what it is and recognize when it happens.

How much does it cost to hire an elder care attorney?

Some Medicaid lawyers offer free consultations, while others charge an initial consultation fee or offer Medicaid planning conferences that range in cost from approximately $175 – $500.

What is the role of a Medicaid attorney?

On the other hand, Medicaid attorneys often focus more on the legal aspects of Medicaid planning, such as creating Medicaid asset protection trusts or Qualified income trusts, which makes them the better option for this type of assistance.

How does Medicaid annuity work?

This strategy reduces one’s countable assets, while at the same time , protecting some of them for family. Essentially, Medicaid applicants gift approximately half of their “excess” assets (assets over Medicaid’s limit) to their loved ones and then purchase an annuity with the remaining “excess” assets. (An annuity turns countable assets ...

What is Medicaid asset protection trust?

One such strategy that elder law attorneys can implement is a Medicaid asset protection trust (MAPT). This type of trust not only prevents one from becoming ineligible for Medicaid due to gifting assets ...

How long does it take for Medicaid to pay for long term care?

Medicaid attorneys and specialists also assist with crisis planning, which occurs when a senior needs Medicaid benefits within 30-60 days.

What is a medicaid planner?

For persons who have Medicaid cases that are fairly simple and straightforward, a Medicaid planner, also called a Medicaid specialist or a Medicaid Advisor, might be a good option. Working with a professional Medicaid planner can be a lot more cost efficient than working with a Medicaid attorney.

How long does Medicaid look back?

The look back period is 5 years in all states except California (Medi-Cal has a 2.5 year look back).