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Tips to reduce the risk of a health care fraud investigation

The United States Department of Justice Medicare Fraud Strike Force is a government group put together with one focus: take down medical professionals and others that are committing health care fraud. As noted in a recent publication by the New York Law Journal, this group is very successful at this task. It is responsible for the conviction of thousands of medical professionals across the nation.

As such, medical professionals are wise to take a moment to review common practices. There are certain actions that will draw the attention of this strike force and can lead to a thorough investigation.

How serious is an investigation? These investigations are more than just concerning, they can be disruptive. Proactive steps at the onset of the process can help mitigate disruption to your medical practice. An attorney can help.

How can I reduce the risk of an investigation? Although you can reduce the impact of an investigation when it starts, it is best to avoid becoming a target of the strike force in the first place. You can help reduce your risk by avoiding these three red flags:

  • Opioid prescriptions. It is very important to carefully review the group’s opioid prescription practices. Any group that prescribes a high number of opioid medications is at an increased risk of an investigation. Make sure the prescriptions are only used when medically necessary.
  • Home health care. The government is keeping a close watch over the use of home health care services to abuse the Medicare and Medicaid programs. Use this form of treatment only when necessary and make sure the services are completed as prescribed.
  • Kickbacks. The group also continues to focus on the illegal use of benefits to patients or other medical professionals in exchange for medical care.

Any of these offenses are serious. Federal judges in New York are known to give prison sentences for health care fraud convictions.

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