There are several laws governing you as a medical professional. Since you are involved in healthcare, you are probably familiar with the False Claims Act (FCA), which serves to protect the government from being provided poor-quality goods or services. In your field, you might deal with the FCA more as it relates to the illegality of knowingly submitting fraudulent claims for Medicare and Medicaid reimbursement.
If you are accused of violating the FCA, the potential consequences you could face include fines up to an amount three times greater than the programs’ loss, imprisonment and additional $11,000 penalties for each claim filed.
Recent convictions in Minnesota
In the state’s largest Medicaid fraud case, two Minneapolis women were recently convicted of swindling the program out of $7.7 million. While the federally funded program is meant to assist people with disabilities, the women set up illegal agencies and allegedly took advantage of those who are especially vulnerable to abuse.
Matters involved in the case included:
- Billing for services that people did not receive
- Using identities of nonresidents
- Check-splitting agreements
The women were each found guilty of eight counts of aiding and abetting theft and one count of racketeering.
The FCA protects the government – use it to protect yourself as well
Allegations of violating state and federal health care laws could result in losing your medical license and could cost you your freedom. Bearing in mind the amount of time, money and effort you invested into your career, you might be wise to carefully consider your billing practices, so you do not put your future at risk.