Allegations of Medicare fraud can extend beyond doctors, nurses and hospital executives. Those in other professions can also find themselves accused of abusing this system. A recent example involves a case out of the Southern District of New York.
Government accuses a dentist of healthcare fraud: The Department of Justice (DOJ) recently accused a New York man of completing dentistry work without the appropriate license. Prosecutors claim the man performed minor dental work on patients and billed insurance for procedures never completed.
In return, patients would allegedly receive $25 cash for their time.
The alleged scheme involved three individuals: a receptionist, the unlicensed dentist and a licensed dentist. The complaint states the licensed dentist would provide the funds for the $25 kickback payment to patients. These patients were then encouraged to refer other individuals that would also qualify for Medicare coverage to receive dental care at their facility.
The DOJ states the scheme began in 2012 and lasted for approximately five years. During this time, the scheme allegedly resulted in $2 million in ill-gotten gains.
Man maintains innocence, goes to court: The man denied the charges and went to trial. After a two-week trial, the jury convicted the accused of health care fraud, conspiracy to commit health care fraud and conspiracy to violate the Anti-Kickback statute.
These crimes can lead to a prison sentence of up to 25 years. He currently awaits sentencing.
Lesson from case, build a strong defense: Anyone that bills services with Medicare or Medicaid can face allegations of healthcare fraud. As noted with this case, the allegations can lead to more than just a fine — they can result in prison time.
Take the allegations seriously. Contact an attorney to begin building a defense