A recent case provides an example of how the government moves forward with a case of health care fraud that may involve an unlikely offender and the types of penalties that can apply. According to the Federal Bureau of Investigation (FBI), the accused in this case was a youth football coach.
How does the government charge a youth football coach with health care fraud?
The FBI states the coach gathered information from children who signed up for football activities. After filling out forms for camp or after-school activities, the coach would use the information to fraudulently bill Medicaid for mental health services.
To further his scheme, the government claims the coach kept rentals that were set up to appear as mental health offices. These offices would contain fake charts to provide support in the event of an audit. The prosecution also accused the coach of interviewing medical providers for jobs. During the interview, the FBI states he would gather the medical provider candidate’s credentials and Medicaid provider numbers. Although he never hired these professionals, he was accused of using their Medicaid provider numbers to bill Medicaid.
How serious was the crime?
According to the FBI, the coach received over $2 million in fraudulent payments from Medicaid. Agents conducted a surprise visit/investigation of one of the coach’s mental health offices and gathered enough evidence to move forward with criminal charges. The coach agreed to plead guilty to health care fraud and identity theft charges. The court sentenced him to 11 years of prison time.
The case is an example of the need to take such allegations seriously. An attorney experienced in health care law can advocate on your behalf if you are accused of similar types of wrongdoing.