Medicare is a federal program that provides health insurance to all American citizens over the age of 65. Passed in the 60's as part of Lyndon Johnson's Great Society program, Medicare is one of the crucial threads of the American social safety net.
Which is why the federal government doesn't like when the program is defrauded. Medicare fraud might be a white collar crime, but federal prosecutors treat it as the serious crime it is.
When you're accused of Medicare fraud, it's important that you move as quickly as you can to find a criminal defense attorney with ample relevant experience. You need to mount a vigorous defense, and the right attorney is crucial.
If you've been accused of Medicare fraud in South Carolina, please call the Law Office of Bill Nettles today at (803) 828-6126.
What Is Medicare Fraud?
Medicare works on what's called a "fee-for-service" model. In theory, it works quite simply: A medical provider performs a service for a patient (a test, a procedure, a consultation), then bills Medicare for the cost. The program then pays the provider for the service.
Medicare fraud, then, is simply a case of billing Medicare when no such payment is legally or medically justified. It's classic fraud.
Specific examples of Medicare fraud include:
- Healthcare suppliers billing Medicare for supplies that were never delivered
- Doctors billing Medicare for procedures and treatments that were never administered
- Fraudulent use of a Medicare card
- Use of a drug plan not approved by Medicare
- "Upcoding" – using more expensive billing codes than the actual procedures performed
As in most cases, the severity of the fraud will play a significant role in determining the severity of the sentence. A longer-running fraudulent scheme, that bilked taxpayers for a great deal of money, will earn a stiff prison sentences.
Federal prosecutors take Medicare fraud quite seriously, and those convicted of such a crime can expect at least some time in prison. A hefty fine is a guarantee, as is disbarment from most federal government programs.
It goes without saying that you want to avoid these sanctions if at all possible. Bill Nettles has ample experience in criminal defense and with Medicare fraud specifically. He understands these cases and knows how to mount a persuasive defense on your behalf.
If you need an experienced criminal defense attorney in South Carolina, please call the Law Office of Bill Nettles today at (803) 828-6126. Mr. Nettles worked for more than five years as the US Attorney for the District of South Carolina, and he understands the intricacies of federal criminal defense.