Working in the health care industry puts you in contact with a lot of people, a lot of money and a lot of controlled substances. As a result, many people in your profession receive a great deal of respect, and others often hold you and other medical professionals to a high standard in various regards.
Because you do have dealings with a considerable amount of sensitive information, it is important that you conduct yourself in a manner that would not cause suspicion to come against you. Unfortunately, despite your best efforts, you could still find yourself under investigation for health care fraud.
What does this mean for you?
Even if authorities have not charged you with a crime, coming under suspicion of any type of fraud is a serious matter. Your reputation could take a hit, and your career could end up on the line. Additionally, if charges do come about, you could also face the risk of repercussions like fines, jail time and other serious penalties.
What does health care fraud involve?
Though you may do your best to conduct yourself professionally and help your patients as best as possible, others may wonder about the intentions behind your actions. In some cases, another person's accusations of wrongdoing could result in investigators looking at you. Some actions that authorities could look for to determine whether health care fraud has occurred include the following:
- Accepting kickbacks or benefits for patient referrals
- Carrying out medically unnecessary procedures in order to obtain insurance payments
- Billing for services you did not complete
- Falsifying a patient's diagnosis in order to run unneeded tests or procedures
- Waiving a patient's co-pay or deductible in order to overbill the insurance company
- Billing steps of a procedure separately in order to generate a higher bill rather than billing the procedure as a whole
Of course, this list represents only a few examples of what could potentially come across as health care fraud.
What can you do?
As soon as you learn that investigators are looking at you for potential health care fraud, you may want to take action. Speaking with a Cincinnati attorney about what this type of white collar crime involves, how it could affect you and what defense options you have could go a long way in helping you prepare for the investigation and possible charges if any should result.