The Heights Boulevard Law Building 1545 Heights Blvd., Ste 700 Houston, TX 77008

Houston Area Healthcare Fraud Defense Lawyer

Whether they are civil or criminal charges, health care fraud charges can be very serious, resulting in severe punishments either way.

Health care fraud is a serious, if sometimes unfounded, charge.


Health care fraud charges can be civil charges or criminal charges. An early response from your Houston health fraud attorney can keep a civil investigation from becoming a criminal investigation leading to much harsher penalties.

If you face a charge of health care fraud in the Houston area and need a legal defense, notify veteran Houston white collar crime defense lawyer Neal Davis for a free and confidential legal review of your case.

SCHEDULE YOUR CASE CONSULTATION TODAY

healthcare fraud defense


Punishments for Health Care Fraud

With civil charges, physicians and other health care providers may lose their hospital privileges and their license to practice. Other civil case penalties may involve exclusion from federal healthcare programs, non-payment of future claims and repayment of existing claims.

As for criminal punishments for health care fraud, persons who are charged and convicted can be fined hundreds of thousands of dollars. They also face a criminal record and may have to serve time in a federal prison.

Enforcing prison time as a punishment for health care fraud is dependent on a number of elements in the case. These include the government’s reason for investigating the fraud, the prosecution’s intent when it comes to criminal charges and whether a patient suffered a severe injury or death due to health care fraud.

Important

Keep in mind that about one-fourth of healthcare fraud cases involve individual health care practitioners - with the remaining three-fourths involving individual health care businesses. In any event, contact the Neal Davis Law Firm for help.


If a federal prison sentence is handed down, it can involve:

  • As much as 20 years in prison for each count of health care fraud causing a patient’s serious injury
  • As much as 10 years in prison for each count of health care fraud
  • A life sentence in prison if a patient died due to health care fraud

Texas Health Care Fraud Cases

Throughout America, agents of the federal government are making sweeping arrests alleging misuse of the health care system. Some of these cases involve millions of dollars in alleged health care fraud, and often the federal focus is in Texas.

In fact, the Houston area reportedly is among nine places in the U.S. being monitored closely by federal authorities for alleged increases in health care fraud. That stems from the Houston area having a vast number of residents relying on federal healthcare programs and making claims for reimbursement.

Among last year’s health care fraud investigations in the Southern District of Texas (SDTX), including Houston, were charges against 22 persons in 11 different cases. The Department of Justice Medicare Fraud Strike Force and the U.S. Attorney’s Office (USAO) made these charges while alleging more than $135 million in health care fraud.

The defendants included a Houston physician charged with four counts of conspiracy to commit health care fraud by billing Medicare for Medicare beneficiaries’ home health services which were not medically necessary and often were not provided. This alleged scheme involved Medicare paying more than $15 million to many services which made claims to Medicare for fraudulent home health referrals.

In another case, charged with one count of conspiracy to commit health care fraud was the owner of a Houston clinic who allegedly sold signed certifications to home health agencies. These agencies then billed Medicare for home health services which were not medically necessary, were not provided, or both.

The USAO also prosecuted another Houston area case involving a rehabilitation center in Missouri City. That case alleged a $15 million health care fraud conspiracy.


Types of Health Care Fraud

Health care fraud can mean many things.


Among the different kinds of health care fraud are the following:

  • Stark Law violation: Also called the Self-Referral Law, the Stark Law prohibits physicians from referring patients to health care services of the physician or a member of his or her family who has a financial stake in such claims. (Stark is the name of a U.S. congressman who introduced the bill in 1988.)

  • Errors in certification: A frequent allegation by federal authorities is fraudulent certification in the hospice and home health care industry.

  • Billing fraud: One example of this is when claims are upcoded. That means the federal government is billed for the next higher amount. Billing fraud can also involve billing for services which were not needed medically, billing for services which were not provided (phantom billing) and billing for patients who do not exist (ghost billing).

  • Violating the False Claims Act: Inaccurate claims to federal healthcare programs are violations of the False Claims Act. Authorities may explore billing procedures to determine if the act’s criminal provisions have been violated. Fines can be three times the total amount of the false claims and another $5,500 to $11,000 for each false claim.

  • Prescription fraud: When health care providers prescribe an unusually large amount of narcotic drugs, federal officials often investigate. It then can be determined if the providers are violating dispensation rules of the Drug Enforcement Administration and are conducting a “pill mill” operation.


Defending Against Health Care Fraud Charges

The Neal Davis Law Firm can lead your attack in defending against charges of health care fraud. Such defense requires an in-depth knowledge of the intricate and elaborate federal laws pertaining to health care fraud.

Your Houston area health care fraud lawyer also must grasp the pertinent criminal statutes, Medicare guidelines and Health and Human Services regulations involved in such charges.

Also crucial is a keen understanding of the notification requirements, deadlines and collateral consequences resulting from a health care fraud charge.

In addition, defending against a charge of health care fraud may involve an attorney scouring hundreds of records and engaging experts. Such defense is especially important in the early stages of an investigation, in order to preempt or even prevent formal charges being made.

Named a Best Lawyer in America for criminal defense and ranked among the top of Texas attorneys in white collar fraud, Houston criminal defense lawyer Neal Davis is known for getting results. For many defendants who have faced various charges, Neal Davis has succeeded in getting the charges dropped or preventing them from being filed in the first place.

If you are looking for a qualified attorney, contact health care fraud lawyer Neal Davis today for a free legal review of your case.



Related Articles From our Criminal Defense Blog

illegal snapchat activity
Can Snapchat Posts Get You Arrested?

To answer this question: Yes, Snapchat can get you arrested. […]

cyberbullying law in Texas
Is Cyberstalking & Cyberbullying a Crime in Texas?

You may have heard about Texas laws against cyberstalking and […]

Spacey self-defense YouTube video
Kevin Spacey Video Shows Why a Defense Attorney is Necessary

The Internet is buzzing about actor Kevin Spacey’s bizarre Christmas […]

criminal justice reform bill
Will the New Criminal Justice Reform Law Unclog American Prisons?

A bipartisan criminal justice bill supported overwhelmingly by both houses […]

best defense lawyer in Houston, Texas
Who is the Best Houston Criminal Defense Lawyer?

If you face a criminal charge in the Houston area, […]

double jeopardy supreme court case
Double Jeopardy Exception May Be in Jeopardy

You probably know that you have a constitutional right against […]

TX Personal Injury Law


5-star review image
Muy satisfechos con su trabajo
Dismissal of two online charges

" Estamos muy satisfechos con su representacion en el caso de nuestro sobrino. Siempre obtuvimos respuestas a todas nuestras preguntas, y acceso a ustedes sin ningun problema. El caso se resolvio satisfactoriamente y en una forma muy rapida. Gracias!"

Online Solicitation • Conroe • Rating: 5.0/5
5-star review image
Got my life back
Positive outcome in online solicitation case

" Words cant express how grateful i am for having Neil on my side. I was involved in a police sting for online solicitation. When i though my life was over i contacted Neil. He told me he would do everything he could to get me out of my situation. He kept me up to date and answered when i called. In the end my case ended with a no bill and i can finally start living my life again."

Online Solicitation • Houston • Rating: 5.0/5
5-star review image
He doesn't give up, no matter what you're up against
Client's child sex abuse case was dismissed

" This man saved my life from false imprisonment. Neal's belief in 'liberty and justice for all' as laid out in the Constitution of the United States, and especially as that principle relates to constitutional rights regarding the receipt of a fair trial, coupled with his refusal to quit fighting, are attributes of a noble spirit and a man of high character. When I interviewed Neal to defend me against very serious false accusations and criminal charges that followed, his candor about what I was up against and his real interest in my general welfare made choosing him to defend me a 'no brainer.' Hiring Neal after hearing Dick DeGuerin say 'Neal is a real fighter' was the best decision I could have made and this was after interviewing a number of attorneys. He cares about people, truth, and justice; an attorney who will not give up; a man who will defend the rights of anyone accused of a crime with every fiber of his being to ensure fairness and the protection of our legal rights."

Sex Crimes • Houston • Rating: 5.0/5

Read All Reviews

5/5 based on 50 reviews.