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3 common consequences for those convicted of Medicare fraud

On Behalf of | Aug 11, 2023 | Health Care Fraud And Abuse Audits |

Medicare benefits are available to most adults who are over the age of retirement. Many modern medical practices specifically accept Medicare to tap into this massive market of prospective patients. However, Medicare has very strict billing rules, and professionals can easily end up accused of violating billing laws if they aren’t careful.

Those accused of Medicare fraud can face numerous penalties should they plead guilty or get convicted of such offenses. Although physicians and their support staff may view such allegations as minor, victimless crimes, the reality is that the following penalties are possible in the event of a conviction.

Jail time

It is quite common for Medicare fraud charges to result in federal criminal charges and then incarceration in federal facilities. Those accused of violating billing rules for the Medicare program could face months or even years in state custody after a conviction. Federal charges might even mean that someone will serve their sentence in a facility in another state and have very limited contact with friends and family.

Financial consequences

It is very common for Medicare billing fraud charges to result in both fines and an order of repayment. Those that engaged in fraud or financially profited from it may have an obligation to repay the state. After serving a prison sentence, the individual convicted may have to commit a large amount of their income to repay the full amount of the benefits fraudulently received from the Medicare program.

Licensing and career consequences

Typically, those accused of Medicare fraud will have a very hard time securing a professional license in the future. State licensing authorities will often impose penalties on those convicted while they have a license and may refuse to grant a license to those with offenses related to the medical profession on their record. Additionally, any prospective future employers will very likely perform a background check and may choose to not hire someone who has a criminal record related to Medicare fraud. Those who have invested years of their lives and tens of thousands of dollars in their education can find themselves unable to secure employment or licensing in their chosen profession after a conviction.

The only sure way to avoid these life-altering penalties is to successfully defend against the criminal allegations someone faces related to medical billing practices. Fighting Medicare fraud and other white-collar criminal charges can give a professional a chance to preserve their freedom, their reputation and their career.


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