On June 22, federal authorities announced that 60 licensed medical providers allegedly created false billings that cost Medicare and Medicaid $900 million. Of those medical providers, 30 were doctors, and the overall scope of the fraud included 300 people in more than 25 states. The billings were for a combination of services that weren’t medically necessary and for services that weren’t rendered at all.
Five people were taken into custody in Brooklyn in a scheme that alleged involved $86 million in questionable expenditures. Patients were given kickbacks in exchange for undergoing unnecessary physical and occupational therapy. Attorney General Loretta Lynch stated that the crackdown was done to show that health care fraud is not a minor offense. Additionally, she said that fraud broke the trust between patients and their doctors as well as the government and those who pay taxes.
Defrauding the federal government is generally considered to be a white-collar crime as it involves financial wrongdoing as opposed to violent or physical crime. However, the penalties can still be rather severe. For instance, individuals convicted of white-collar crimes could face lengthy prison sentences as well as steep fines and a requirement to pay restitution.
An attorney may be able to offer a defense to the charges an individual may face. First, it may be possible to argue that there was no intent to defraud and that all charges were for legitimate and necessary expenses. It may also be possible to argue that a participant in a scheme was forced or compelled to take part under duress or threat of retribution if the defendant refused to become involved.