lawyer who defend cases against health care company

Why hire our health care fraud defense lawyers?

Find health care attorneys who serve clients with a wide range of health care law-related needs. From health care providers needing assistance with legal compliance issues or defending against claims, to patients who need to speak to an attorney regarding medical record matters or HIPAA privacy issues, the FindLaw lawyer directory can connect you with the health care lawyer best …

What does a federal defense attorney do for health care?

Apr 02, 2022 · Defense of Medicare laboratory against investigations by the Department of Justice and the U.S. Attorney’s Office for alleged Medicare Fraud Result: No civil or criminal liability, case dismissed. Defense of a healthcare services company against an investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and …

What are some of the biggest legal cases brought against doctors?

Free Consultation - Call (973) 621-0333 - Joseph D. Rotella, Esq. aggressively represents the accused against charges in Criminal & Crime cases. Health Care Fraud - Newark Criminal Lawyer Free Consultation: 973-621-0333 Tap Here To Call Us

Why hire our health care lawyers?

Sep 30, 2020 · Chapman Law Group was founded 35 years ago by Ronald W. Chapman, with the goal of creating a national boutique litigation law firm advanced in specific areas of law and capable of providing exceptional personal service to licensed healthcare professionals. Today, Chapman Law Group is an AV-rated litigation firm, representing clients across the U.S., with …

What is the third law used to prosecute health care professionals?

The third law which is often used to prosecute health care professionals is the Stark Law . This is a federal law that applies to physician referrals. This law prohibits “self-referrals” between doctors and other health care providers and stops providers from billing Medicare for referred services.The Stark Law was applied initially to physicians and their relationship with the labs. Nowadays, it applies to all health care agencies. Federal prosecutors commonly use the Stark law in cases against pharmacists, therapists, and other health care providers.

What are the laws that the government uses to take action against health care practices?

These are The Anti-Kickback Statute, the False Claims Act, the Stark Law, and the Criminal Health Care Fraud Statute.

What is a health fraud scheme?

A typical health care fraud scheme involves the medical laboratory industry and revolves around medically unnecessary ordering of tests. Clinical laboratories can run unnecessary tests that are excessive or inappropriate for a patient’s diagnosis. This adds a significant financial burden to the health care insurance benefits and can also put patient’s lives in danger.

What is healthcare fraud?

When a company or an individual makes a false statement or statements against your company and engages in illegal practices for financial gain, this is considered healthcare fraud. Healthcare professionals often find themselves unexpectedly facing fraud charges. This may be due to the actions of an individual employee, a physician, or a pharmacist being accused of misconduct.

What is the False Claims Act?

The False Claims Act was created to guard against false or fraudulent claims submitted under health care benefit programs such as Medicare. This type of investigation can lead to civil or criminal charges being brought against the health care provider or practitioner. You may be subject to an inquiry under the false claims act due to direct government investigation or because your business has had a referral from elsewhere. You could have been referred by a former employee, patient, or competitor who has received compensation in exchange for information about your business.Health care professionals can be held liable for submitting a false claim, either intentionally or by accident. However, to be considered a false claim and, therefore, health care fraud, you must have made the claim with the full intention of defrauding the government. If you or your employee have been negligent or made innocent errors, this is not enough to hold you liable for the fraudulent act.

Is it illegal to defraud Medicare?

This statute states that it is illegal for health care practitioners to defraud a health care benefit program, such as Medicare or Medicaid, or to knowingly make false claims to obtain money from a health care program.

Is Medicare fraud a federal crime?

Medicare fraud constitutes a federal felony and monetary liabilities can be enormous. The possibility of being held accountable for Medicare, Medicaid, Tricare, and other healthcare fraud, should caution you to invest your time and resources intelligently into a strategic and thoughtful defense plan.

How to appeal Medicare?

Medicare appeals take place in the following five steps: 1 Redetermination by a Centers for Medicare & Medicaid Services (CMS) contractor 2 Reconsideration by a qualified independent contractor 3 Hearing before an administrative law judge 4 Review by an appeals council 5 Judicial review in the federal district court

What is a knowingly soliciting, paying, and/or accepting any form of remuneration to

Knowingly soliciting, paying, and/or accepting any form of remuneration to induce or reward referrals for items or services reimbursed by federal healthcare programs, e.g. an arrangement that is not covered by regulatory safe harbors and whereby cash or other benefits are offered or exchanged for referrals. See, 42 U.S.C. 1320A-7b (b).

What happens if you are found guilty of a crime?

If found guilty, targets of investigations may be exposed to recoupment requests, non-payment of future claims, civil fines of up to $ 11,000 per false claim, exclusion from federal healthcare programs, treble damages, attorney fees, criminal fines, criminal indictment, or incarceration in a federal prison.

Why Chapman Law Group?

We Focus on Healthcare#N#Chapman Law Group focuses on the specific legal areas needed to provide sound legal representation to healthcare professionals nationwide.

Practice Areas

We pride ourselves on having strong ethics and values, a hard-working attitude, a dedication to client needs, extensive experience in our chosen areas of law, and, most importantly, the long-term relationships we have built with many of our clients across the U.S.

Healthcare Professionals Blog

Our national DEA attorneys are dedicated to defending prescribers and dispensers against DEA investigations, registration applications and denials, audits and raids. Here’s what healthcare providers should know about the DEA process, from our perspective.

Healthcare Law Case Results

Our healthcare fraud attorneys were able to determine that the government failed to disclose a significant amount of files, which it is required to disclose.

We Practice Nationally

Our healthcare attorneys routinely practice in Federal Courts nationwide. We have four national offices:

What is a lawyer?

A lawyer is an expert and experienced person who sets you in the right direction. He does not use the emotions but takes into account the facts to handle the dispute. The lawyer asks proof and proper documentation if the company does not pay money for medical treatment.

What is the legal responsibility of insurance companies to give written explanations of denials?

The explanation also includes the procedure of appealing to restore the coverage. You have limited time to file an appeal. Provide complete documents to a lawyer so he may represent your case confidently.

Do you need a referral for insurance?

The insured patient should get a referral from their family doctor. It is prerequisite of some insurance companies. The absence of referral on file may cause the rejection of health insurance.

Can you take more than one insurance?

Have you taken more than one insurance plans? Yes! It may cause the rejection of the medical treatment payment. Categorize the insurance companies as primary, secondary, or tertiary to avoid such panic condition.

Can you get health insurance if you are out of network?

People may not get the benefits of health insurance if they utilize out-of-network services. The claim automatically denied when they go against the clauses of the insurance agreement. The insurance company may not facilitate the insured person if he/she is living in a foreign country and fells ill.

What does "denied claims" mean?

Denied claims mean that insured person cannot receive the medical coverage. The firm raises some serious objections. There could be any reason for the claim denial such as wrong or missing information about billing. Insurance firms explain the core cause for insurance denial.

What should be included in an opening statement?

The opening statement should include the purpose of writing. Get the advice of a lawyer to know how to catch the attention of the insurance company. Do not forget to share the medical condition and its history. Mention the medications that you are already taking.

Who initiates false claims investigation?

In many cases, a false claims investigation has been initiated by a whistleblower rather than the government. A whistleblower is usually someone who has an interest in the business and is knowledgeable about their activities. For example, an employee or former employee, a patient, or a competitor.

Who is liable for false claims?

Physicians, health care organizations, and clinics will be held liable if they knowingly submit a false claim. Under this law, an individual or organization will only be held responsible if the false or fraudulent claim was filed with the intent of defrauding the government.

What is the false claims act?

The false claims act is a federal law that applies to any business or individual that has a contract with and is paid for services by the government. The false claims act covers schemes such as Medicare and Medicaid.

What happens if a business is under investigation for making a false claim?

If your business is under investigation for making a false claim, then this is likely to be a very stressful and invasive time. We understand that your business will face many challenges during the investigation.

What are the penalties for fraudulent claims?

In more severe cases, Health care providers will receive criminal liability. The penalties for those who knowingly submit fraudulent or fictitious are critical and will have life-changing effects. If you or your business is found to be making fraudulent claims, this could result in five-year incarceration in federal prison. You may also receive fines of $ 250,000 for an individual or $ 500,000 if your company is found to be guilty of a federal felony. If you receive a misdemeanor conviction, you’re likely to be charged between $ 100,000 and $ 200,000 for each claim.

What is a qui tam lawsuit?

Cases that involve a whistleblower, known as the ‘relator, ’ are called qui tam lawsuits. This is a Latin expression, which means “he who sues for the king and for himself.”. In a Qui Tam lawsuit, the relator can recover money which has been fraudulently taken from the United States government.

What is a kickback case?

Qui tam lawsuits often target those who have been involved in providing unlawful kickbacks such as money or services paid with the intent to provoke Government business. An example of a qui tam lawsuit involving kickback was a $116 million settlement, which was not intervened by the government.

Who is George Tyndall?

George Tyndall, M.D. After a yearlong police investigation, the ex-University of Southern California (USC) gynecologist was arrested in June and charged with the sexual assault of student patients. He has pleaded not guilty.

Why was Husel fired?

Husel was charged after authorities said he deliberately ordered overdoses of fentanyl that were given to patients at Mount Carmel and St. Ann’s hospitals in Columbus to help end their lives. (Getty/LIgorko) Husel was fired after an investigation by the Mount Carmel Health System.

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Types of Health Care Fraud

Health Care Fraud Investigations

Work with Our Health Care Fraud Attorneys

Laws Used to Prosecute Cases of Suspected Health Care Fraud

Contact The Healthcare Fraud Group About Your Case

• Our attorneys work as part of a team to ensure we utilize our combined experience to better serve our clients. Our clients will receive intelligent advice and professional help while they are enduring a federal health care trial. We can offer you a free fraud defense assessment and work with you to resolve your case. If you are a health care practi...

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