Federal investigators and prosecutors work hard to combat healthcare fraud, waste, and abuse in Colorado Springs and throughout the country. That means many hospitals, companies, doctors, pharmacists, marketing representatives, and others in the healthcare industry can easily come under scrutiny and face potential civil and criminal sanctions for alleged fraud.
At Peakstone Law Group, formerly known as Patterson Weaver, our healthcare fraud defense attorneys understand how even professionals with strong compliance programs in place can still face a federal investigation. With his background as a prosecutor, our founding attorney can use his insider’s knowledge of how white-collar crimes such as healthcare fraud are investigated and prosecuted to craft an effective defense strategy for you.
Because of the serious civil and criminal consequences of a healthcare fraud investigation in Colorado Springs, you need to contact us today to discuss your case in a free and confidential consultation.
The Role of a Medicare/Medicaid Fraud Defense Lawyer
If you face allegations involving the False Claims Act (18 U.S.C. § 1347) or other forms of healthcare fraud, our criminal defense attorneys in Colorado Springs can play an important role in your future by:
- Helping you respond to an audit, civil investigative demand (CID), or subpoena that carries the potential of leading to civil penalties and criminal charges against you.
- Conducting a thorough investigation and all necessary legal research, consulting with experts where needed, and drawing on our experience on the prosecutor’s side of fraud cases and as criminal defense attorneys to craft a solid defense strategy for you.
- Fully protecting your rights and vigorously defending against the charges against you while dealing with federal authorities from the Office of the Inspector General (OIG), Federal Bureau of Investigation (FBI), Drug Enforcement Administration (DEA), Department of Justice (DOJ), and other investigators and federal prosecutors.
- Seeking a dismissal or reduction of your charges, providing you with a straightforward assessment of any plea offers that you receive from the federal government, and if necessary, presenting a highly prepared, compelling defense on your behalf in court.
As attorneys with extensive experience defending clients charged with white-collar crimes such as healthcare fraud, we believe it is important to have a knowledgeable criminal defense team on your side. It is especially crucial to seek legal help if you have received notice that you are under investigation for alleged misconduct.
Common Types of Healthcare Fraud Charges in Colorado Springs
A federal healthcare fraud investigation commonly arises from potentially fraudulent billing practices or other illegal activity being detected in an audit or as the result of the allegations made by a whistleblower in a qui tam action. The investigation could lead to charges such as those under:
- False Claims Act (18 U.S.C. § 1347) — When someone knowingly and willfully attempts or executes a scheme to defraud any healthcare benefit program such as Medicare, Medicaid, or TRICARE. A violation of the law can lead to fines and imprisonment. Typically, the alleged fraud involves upcoding a medical procedure to be paid at a higher rate or phantom billing for services that were never provided.
- Anti-Kickback Statute (42 U.S.C. § 1320a-7b) — When someone knowingly and willfully solicits, receives, offers, or pays any kickback, bribe, or rebate, directly or indirectly, openly or secretly, in cash or in any other form in exchange for a patient referral.
- Stark Law (42 U.S.C. § 1395nn) — When a physician engages in a form of self-referral by referring a patient to a healthcare services provider with whom they or an immediate family member has a financial interest, including an ownership interest.
A healthcare fraud investigation could also lead to other charges, including conspiracy, drug distribution and trafficking (based on prescriptions of opioids and other commonly abused drugs), wire fraud, or mail fraud, for example.
Potential Consequences of Healthcare Fraud Convictions
If you are accused of healthcare fraud, it could lead to civil and criminal consequences, including suspension or revocation of your professional license and overall harm to your personal and professional reputation. Those consequences will depend on the type of fraud alleged and the extent to which the fraud was committed.
The civil penalties for healthcare fraud can include fines, treble damages, attorney fees, review of any future claims for Medicare and Medicaid or TRICARE payments, and exclusion from federal healthcare programs.
If convicted of criminal healthcare fraud, you could face not only the civil penalties above but also the risk of imprisonment for up to life, depending on the circumstances of your case.
Legal Strategies for Defending Healthcare Fraud Allegations
Whether you are facing investigation or charges for fraudulent billing, kickbacks, self-referrals, fraudulent prescriptions, conspiracy, mail fraud, wire fraud, or other forms of healthcare fraud, you can count on Peakstone Law Group to aggressively defend you. Depending on your case’s unique circumstances, the defenses available to you may include:
- Constitutional violations — If any evidence was seized, statements obtained, or evidence withheld from your defense team in violation of your constitutional rights, it could lead to the evidence being excluded and, potentially, the dropping of the charges against you.
- Lack of evidence — In some cases, the federal government cannot provide sufficient evidence of criminal intent to defraud a health care benefit program or engage in unlawful conduct. The reality is that many healthcare fraud investigations spring from simple mistakes.
- Affirmative defenses — In some circumstances, the evidence may show conduct that, on its face, violates a federal statute. However, the conduct may have nonetheless been permitted under an exception.
As dedicated criminal defense attorneys, we will work tirelessly to investigate and research your unique case and craft a defense strategy that meets the federal government’s case head-on and seeks the best possible outcome for you.
Get Help from Our Colorado Springs Medical Fraud Defense Lawyers
With our insight from the prosecutor’s side of criminal cases, experience as criminal defense attorneys, and dedication to providing our clients the highest level of service, you can trust Peakstone Law Group to provide the representation you need when facing medical fraud charges.
We can get to work on your defense right away. Contact us today to get started with a free and confidential consultation with an experienced criminal defense attorney in Colorado Springs.