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The Law Offices of Stanley L. Friedman
White Collar Criminal Defense 310-598-2000
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Los Angeles Coding Error Defense Lawyer

Help From an Experienced White Collar Criminal Defense Attorney Practiced in Healthcare and Financial Fraud Cases

At The Law Offices of Stanley L. Friedman, we bring a wealth of experience and a unique perspective to the defense of clients in Los Angeles faced with allegations of healthcare and financial fraud, including those involving billing coding errors. As a former federal prosecutor and now a seasoned white-collar criminal defense lawyer, attorney Stanley L. Friedman possesses a deep understanding of the federal laws surrounding coding errors, which often form the basis of serious legal charges in both the civil and criminal justice systems. If your medical practice is accused of coding errors that defraud the government or private insurers, act quickly to protect your license and your practice and stay out of jail. Call The Law Offices of Stanley L. Friedman to speak with an experienced Los Angeles coding error defense lawyer.

Examples of Coding Errors

In the healthcare sector, billing stems from coding. Coding errors can result in improper payments from private or government payors, leading to serious civil or criminal charges. Common coding mistakes that may be entirely innocent yet appear fraudulent include:

  • Upcoding: Charging for a more expensive service than what was actually provided.

  • Unbundling: Separating charges that should be billed together to increase reimbursement.

  • Duplicate Billing: Charging multiple times for the same service.

  • Misrepresentation of Provider: Billing for services by a different provider than the one who rendered the service.

How Coding Errors Lead to Criminal Charges

Coding errors can lead to criminal charges under various statutes. When these errors result in wrongful reimbursement or financial gain, they may be construed as intentional fraud. This is particularly the case if there’s a pattern suggesting deliberate misconduct rather than isolated mistakes.

Coding Errors and False Claims Act Cases

The False Claims Act (FCA) is a federal law that imposes liability on individuals and companies who defraud governmental programs. In healthcare, coding errors can result in FCA cases if they lead to false claims or statements to secure reimbursement from government health programs like Medicare or Medicaid. FCA cases, also known as qui tam actions, are often brought by an employee who serves as a whistleblower to the government and might even pursue the case in court on behalf of the government for a share in the proceeds of a money judgment.

Potential Penalties Under Criminal Law and the False Claims Act

The penalties for coding errors under criminal law and the False Claims Act can be severe, including:

  • Criminal Penalties: These can include imprisonment, substantial fines, and a criminal record, often leading to the loss of a license to practice medicine.

  • Civil Penalties under the FCA: These may involve treble damages (triple the amount of the government’s loss), civil fines, and exclusion from federal healthcare programs.

Defenses to Coding Errors

Defending against allegations of coding errors requires a sophisticated legal strategy. Some defenses include:

  • Lack of Intent: Demonstrating the absence of fraudulent intent, proving that the errors were unintentional or due to a misunderstanding of complex coding rules. This is a complicated area, as evidence of bad intent is not necessarily required for cases brought under the FCA.

  • Adequate Compliance Program: Showing that the healthcare provider had a robust compliance program in place to prevent coding errors.

How a Criminal Defense Attorney Can Help

At The Law Offices of Stanley L. Friedman, we have a long history of defending physicians and medical practices against allegations of coding errors and healthcare fraud. We work from the start to prevent charges from being filed or get them reduced or dismissed based on the facts and problems we identify with the government’s case. For cases proceeding toward trial, we offer the following support:

  1. Conducting a Thorough Investigation: We meticulously analyze all documentation and coding practices to build a robust defense.

  2. Expert Witness Collaboration: Working with medical and financial coding experts to challenge the prosecution’s allegations.

  3. Negotiating with Prosecutors: Leveraging Stanley L. Friedman’s experience as a former federal prosecutor to negotiate effectively and resolve the charges without jail time or other serious negative consequences.

  4. Litigation and Trial Representation: Offering unmatched advocacy in court to protect clients’ rights and reputation.

Contact the Law Offices of Stanley L. Friedman for Defense Against Coding Error Charges in Los Angeles

If you are facing allegations involving coding errors, it’s crucial to seek experienced legal guidance. Contact The Law Offices of Stanley L. Friedman today to discuss your case and explore your defense options.

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