Cox & Mazzoli

Federal Healthcare and Physician Fraud

Physicians, hospitals and clinics are frequently sued and/or prosecuted for false billing. Medicare and Medicaid fraud is incredibly prevalent because it is not difficult to manipulate a system in which the third party entity paying for services, e.g., Medicaid, Medicare or private insurance companies, are not the entity providing care.

The majority of healthcare fraud cases involve some element of false billing. They also include physicians who sell pain medication to patients without having an appropriate doctor-patient relationship. Physicians also get prosecuted for prescribing durable medical equipment (DREs) to their patients, such as back braces, and then receive kickbacks from manufacturers of the equipment.

Representing healthcare providers can be a complex task and should only be undertaken by experienced federal criminal defense attorneys. Not only are defense attorneys working with federal agents and federal prosecutors, but they must also always be mindful of state licensure boards and credentialing committees of local hospitals where a doctor has privileges.