Orlando Medicare/Healthcare Fraud Lawyer

What This Page Covers:

• Medicare/healthcare fraud involves deceitful practices such as billing for services not provided, falsifying records, or inflating service costs.
• Common fraud types include billing fraud, false claims, and fraudulent documentation.
• Defense strategies often focus on errors or misunderstandings, challenging the intent to defraud, and negotiating with prosecutors.
• The Wiseman Law Firm offers over 23 years of experience, led by a former prosecutor, to help you protect your rights and career.

Being investigated or charged with Medicare or healthcare fraud can be life-changing. These complex cases often involve extensive investigations into billing practices, patient care, or improper financial relationships. Fortunately, you have legal options to fight back against the charges and protect your future.

Whether you are a healthcare provider who accidentally overbilled or someone facing accusations of fraudulent activities, The Wiseman Law Firm can provide you with the guidance you need. Criminal defense attorney Simon Wiseman and his team will work closely with you to investigate the allegations, build a solid defense, and strive for the best possible outcome.

What Constitutes Medical/Healthcare Fraud in Orlando?

Medical and healthcare fraud involves deceitful practices aimed at obtaining financial gains through false claims or misrepresentations within the healthcare system. In Orlando, medical and healthcare fraud can include:

Billing Fraud

Submitting bills for more expensive services or procedures than those actually performed is a common form of billing fraud. Upcoding a routine office visit as a complex consultation can result in higher reimbursement from insurance providers.

Unbundling or breaking down a comprehensive procedure into multiple, separate codes to increase reimbursement can also lead to fraud charges. For example, charging for each component of a surgical procedure individually rather than as a single bundled service can mislead insurers into paying more than they would for the entire procedure.

Charging for services or procedures that were never provided is another form of fraud. This might include billing for treatments or appointments that did not occur or inflating the quantity of services rendered.

False Claims

Claiming reimbursement for services that were not provided or misrepresenting the nature of the services rendered constitutes a false claim. This includes falsifying patient records to justify unnecessary tests or procedures.

Offering or accepting bribes or kickbacks in exchange for patient referrals or the use of certain products or services is also illegal. This form of fraud can distort medical decision-making and compromise patient care.

Fraudulent Documentation

Altering or creating false medical records to support fraudulent claims is a serious offense in Florida. This includes documenting unnecessary procedures or inflating the severity of a patient’s condition to justify higher billing.

Providing inaccurate or misleading information about a patient’s condition, treatment options, or prognosis to secure additional funds is also considered fraud. This can include exaggerating the need for certain treatments or services.

Eligibility and Enrollment Fraud

Providing false information to enroll patients in health programs or insurance plans can constitute fraud. This includes misrepresenting a patient’s eligibility or eligibility status to gain access to benefits. Rendering services outside of your qualifications or scope of practice while billing as if you are fully qualified can also be a form of healthcare fraud.

How Our Firm Can Help You Fight Medicare/Healthcare Fraud Charges

With our thorough understanding of Florida law and extensive experience handling fraud cases, The Wiseman Law Firm is prepared to develop a strategic defense to help protect your rights and your future. Here’s how we can help you fight the charges:

Thorough Investigation into Your Case

We start by conducting a thorough review of all the evidence against you, including billing records, patient files, and communication with Medicare. We dig deep to find inconsistencies, errors, or any indication that the accusations against you are unfounded.

Often, healthcare fraud allegations arise from simple billing mistakes or misunderstandings rather than intentional wrongdoing. We’ll investigate whether any discrepancies were unintentional, such as coding errors or clerical mistakes, and use that to build a defense.

Build a Strong Defense Strategy

Our team will craft a personalized defense strategy that addresses the unique facts of your case. Whether it’s challenging the evidence, disputing the intent to defraud, or presenting alternative explanations, we will work to expose any weaknesses in the prosecution’s case and fight for the best possible outcome.

Negotiate with Prosecutors

In some cases, negotiating with prosecutors can lead to reduced charges or even a dismissal of the case. At the Wiseman Law Firm, we leverage our experience and relationships within the legal system to seek favorable agreements on your behalf. We’ll explore every available option to lessen the impact of the charges against you.

Exploring Plea Deals and Alternatives

If a complete dismissal isn’t possible, we can negotiate for lesser charges, reduced penalties, or alternative sentencing options. By working closely with the prosecution, we aim to secure a resolution that minimizes the consequences for you and your career.

Courtroom Representation

If your case goes to trial, you need an aggressive legal team on your side. Having started his legal career over 23 years ago, Attorney Simon Wiseman is well-versed in representing clients in court, and he will advocate fiercely on your behalf. From cross-examining witnesses to presenting evidence that casts doubt on the charges, Mr. Wiseman will do what it takes to protect your rights and challenge the case against you.

Expert Testimony and Evidence Presentation

Medicare and healthcare fraud cases often involve highly technical medical and billing records. We can work with experts in healthcare and billing to testify on your behalf, explaining complex processes to the court and presenting alternative interpretations of the evidence. This can play a critical role in dismantling the prosecution’s case.

Minimizing Collateral Consequences

An accusation of Medicare or healthcare fraud can have lasting effects on your career, even if you’re ultimately cleared of the charges. Beyond the legal penalties, we’ll help you manage any potential consequences from licensing boards, employers, or professional organizations. Our goal is to ensure that your career can continue without the lasting shadow of fraud accusations.

Protect Your Future with The Wiseman Law Firm

Facing Medicare or healthcare fraud allegations can be a daunting experience, but you don’t have to navigate it alone. At The Wiseman Law Firm, we understand the complexities of these cases and will provide you with the dedicated legal representation you deserve. Our team will conduct a thorough investigation, scrutinize all aspects of the charges, and build a defense strategy tailored to your situation. With over two decades of legal experience, including time spent as a former prosecutor, Attorney Simon Wiseman is prepared to leverage his deep knowledge of both sides of the legal process to seek the best possible resolution for your case.

Whether your charges stem from simple billing errors or more serious accusations, we are committed to helping you minimize the consequences and protect your livelihood. We may be able to negotiate with prosecutors, challenge the evidence against you, and work toward a favorable outcome that helps safeguard your future. Contact us today at (407) 420-4647 or fill out our contact form to schedule a consultation and learn more about how we can assist you.