Houston Criminal Defense Blog

All About Healthcare Fraud in Houston

Healthcare fraud is a crime that costs America approximately $80 million per year, per FBI statistics. Currently, national healthcare spending tops $2.7 trillion per year and expenses continue to outpace inflation. As a result, many people are tempted to commit healthcare fraud and gather the proceeds of that money for their own benefit. The FBI reports that medical professionals are becoming more willing to risk patient harm in their healthcare fraud schemes.

The FBI is the primary agency for exposing and investigating crimes involving healthcare fraud. Healthcare fraud is considered a white collar crime and normally occurs when a person files a dishonest healthcare claim in order to receive a profit. While this is the general idea for healthcare fraud, healthcare fraud schemes come in a variety of different forms. Some of the different forms of healthcare fraud are:

  • Filing duplicate claims for the same conditions
  • Billing practitioners for procedures they never rendered
  • Obtaining prescription pills and selling them on the black market
  • Altering the identities of members or providers
  • Changing the description of services or altering dates on a claim
  • Billing for a non-covered service as a covered service
  • Modifying medical records
  • Using unlicensed staff
  • Using another person’s insurance card
  • Accepting or giving kickbacks for member referrals
  • Waiving member co-pays
  • Intentionally misdiagnosing an illness to gain larger payment
  • Prescribing additional and unnecessary treatments or procedures
  • Providing false information when applying for programs
  • Fording and selling prescription drugs
  • Using transportation benefits for non-medical purposes
  • Loaning insurance cards

Regardless of the reason you have been charged with healthcare fraud, you will want an accomplished Houston criminal defense attorney to help you. Healthcare fraud is considered a federal crime, which means that if you are charged you may need to deal with this crime in federal court. At Billy Skinner & Associates, we understand that most fraud cases occur due to simple mistakes. If you have been charged or are facing investigation for this crime, then you should not hesitate to contact a skilled Houston criminal defense lawyer at our firm to help you. Call us today to set up your free consultation!