Medicare/Medicaid Fraud

Medicare/Medicaid Fraud: How Josh Tomsheck of Hofland & Tomsheck Can Defend You Against Federal Medicare/Medicaid Fraud Charges

Medicare and Medicaid fraud are serious federal offenses involving the submission of false claims or the provision of medically unnecessary services to receive payments from government healthcare programs. The federal government aggressively prosecutes Medicare and Medicaid fraud under statutes such as the False Claims Act (31 U.S.C. § 3729) and the Health Care Fraud Statute (18 U.S.C. § 1347). Convictions for Medicare and Medicaid fraud can result in long prison sentences, significant fines, and exclusion from federal healthcare programs.

If you or someone you know is facing federal Medicare or Medicaid fraud charges, it is essential to have an experienced attorney who understands healthcare fraud laws and can build a strong defense. Josh Tomsheck, a nationally Board-Certified criminal defense attorney with Hofland & Tomsheck, has successfully defended clients against federal healthcare fraud charges. His expertise in healthcare law and commitment to his clients make him a trusted advocate in these complex cases.

Understanding Federal Medicare/Medicaid Fraud Laws

• Medicare and Medicaid fraud typically involve healthcare providers submitting false or fraudulent claims to government healthcare programs for reimbursement. These schemes can include billing for services not provided, inflating claims, and performing unnecessary medical procedures.
• Health Care Fraud (18 U.S.C. § 1347): This statute makes it a federal crime to knowingly execute or attempt to execute a scheme to defraud a healthcare benefit program. This includes submitting false claims to Medicare or Medicaid or inflating bills for services provided.
• False Claims Act (31 U.S.C. § 3729): The False Claims Act is one of the most powerful tools used by the federal government to combat healthcare fraud. It allows the government to impose substantial penalties on individuals or entities that submit false claims to government programs like Medicare or Medicaid.
• Anti-Kickback Statute (42 U.S.C. § 1320a-7b): This statute prohibits offering, soliciting, or receiving kickbacks, bribes, or other forms of payment in exchange for referrals or for the provision of services that are reimbursed by federal healthcare programs.
• Stark Law (42 U.S.C. § 1395): The Stark Law prohibits physicians from referring patients to entities with which they have a financial relationship for certain services reimbursed by Medicare or Medicaid, unless an exception applies.

Penalties for Federal Medicare/Medicaid Fraud Convictions

Federal Medicare and Medicaid fraud convictions can result in severe penalties, including long prison sentences, significant fines, and exclusion from federal healthcare programs. The severity of the penalties depends on the amount of money involved in the fraud, the defendant’s role in the scheme, and whether the fraud involved patient harm.

• Imprisonment: Convictions for Medicare/Medicaid fraud can result in prison sentences ranging from 5 to 20 years, depending on the scope of the fraud and whether it involved patient harm or injury.
• Fines: Medicare and Medicaid fraud convictions can result in substantial fines, often reaching into the millions of dollars, particularly in cases involving large-scale fraud or false claims submitted to government healthcare programs.
• Restitution: Defendants convicted of Medicare or Medicaid fraud are often required to pay restitution to the government to compensate for the financial losses resulting from the fraud.
• Exclusion from Federal Healthcare Programs: Healthcare providers convicted of Medicare or Medicaid fraud may be excluded from participating in federal healthcare programs, effectively ending their ability to bill for services under those programs.

Common Defenses in Federal Medicare/Medicaid Fraud Cases

When defending against federal Medicare and Medicaid fraud charges, Josh Tomsheck uses a variety of defense strategies tailored to the facts of each case. Some common defenses include:

• Lack of Intent to Defraud: One of the key elements of Medicare/Medicaid fraud is the intent to deceive the government. Josh Tomsheck will argue that the defendant did not intend to submit false claims or engage in fraudulent conduct, and that any errors were unintentional or administrative mistakes.
• Challenging the Evidence: Medicare and Medicaid fraud cases often rely on billing records, medical charts, and testimony from co-workers or patients. Josh Tomsheck will thoroughly review the evidence to determine if it was lawfully obtained and whether it supports the charges. He may file motions to suppress improperly obtained evidence or challenge the credibility of witnesses.
• Medical Necessity: In cases involving claims of medically unnecessary procedures or treatments, Josh Tomsheck may argue that the services provided were necessary for the patient’s health and that the claims submitted were valid under the terms of the Medicare or Medicaid program.
• Lack of Knowledge: In some cases, healthcare providers may unknowingly submit false claims due to clerical errors, billing mistakes, or a lack of knowledge about Medicare or Medicaid billing regulations. Josh Tomsheck will work to demonstrate that the defendant was not aware of the fraudulent conduct and did not intentionally participate in the scheme.

How Josh Tomsheck Can Help You in Federal Medicare/Medicaid Fraud Cases

Federal Medicare and Medicaid fraud cases are complex and require an attorney with a deep understanding of both healthcare regulations and criminal law. Josh Tomsheck is an experienced, nationally Board-Certified criminal defense lawyer who has successfully defended clients against a wide range of federal healthcare fraud charges.

Here’s why Josh Tomsheck is the best choice for your defense:

• Expertise in Federal Healthcare Fraud Law: Tomsheck’s knowledge of 18 U.S.C. § 1347, the False Claims Act, the Anti-Kickback Statute, and other federal statutes allows him to build strong defense strategies tailored to the specific facts of each case.
• Proven Track Record in Federal Court: Josh Tomsheck has extensive experience defending clients in federal court and has successfully secured reduced sentences, dismissals, and acquittals for his clients in Medicare/Medicaid fraud cases.
• Personalized Defense Strategy: Every case is different, and Josh Tomsheck takes the time to understand the specific facts and circumstances of each client’s case. He develops a personalized defense strategy aimed at minimizing penalties and protecting your rights.
• Aggressive Defense: Known for his dedication and tenacity, Josh Tomsheck will fight for you at every stage of the case, from pre-trial motions to trial and sentencing. He is committed to securing the best possible outcome for his clients.

Contact Josh Tomsheck for a Consultation

If you or a loved one is facing federal Medicare or Medicaid fraud charges, don’t wait to seek legal representation. Contact Josh Tomsheck at the Law Firm of Hofland & Tomsheck today for a consultation. With his experience, knowledge, and commitment to his clients, you can trust that your case is in capable hands.