It seems to be a trend that doctors and healthcare organizations are either fraudulently billing or overbilling Medicare and other government healthcare agencies. Such practices constitutes fraud and can lead to extensive fines and time in jail for those who are found guilty.
Recently, Dr. Arthur Davida, MD, one of the owners of Home Care Physicians, Inc., pleaded guilty this week to causing some $4 million in healthcare fraud. Davida allowed healthcare agencies to fraudulently bill Medicare in-home treatment that was medically unnecessary. Davida requested that the agencies certify that patients had been combined to a home setting with the knowledge that a minimum of 20 percent of patients were not confined to their homes. The Department of Justice indicated that Davida provided the certifications fearing that if he didn’t do so, he would no longer receive referrals.
The Medicare mandate requires that a patient is required to be certified as being confined to their homes before such specialized care will be paid for. As a result of Davida’s signed orders, Medicare paid over $20 million to home-health agencies. Davida admitted to the DOJ that he had been the cause of over $4 million in Medicare losses as a result of his actions.
Healthcare fraud costs everyone in terms of higher taxes and insurance rates. The actions of a few who attempt to profit from cheating the system is something that the federal government has turned its focus on even more in recent years. Because of such dishonest claims, Medicare and Medicaid officials are looking more closely at the details of such claims.
If you suspect that there may be health care fraud when dealing with any medical procedure or claim, contact the law offices of Bottar Leone PLLC today. We are here for you and to protect your rights. Call to schedule a free consultation and legal analysis to discuss your case.