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White Collar Criminal Defense 310-598-2000
Home / Healthcare Fraud Defense / Understanding Healthcare Fraud in California

Understanding Healthcare Fraud in California

Female Doctor or Nurse In Handcuffs Wearing Lab Coat and Stethoscope.At The Law Offices of Stanley L. Friedman, we are dedicated to defending the rights of individuals and healthcare providers accused of healthcare fraud in California. With extensive experience in criminal healthcare law, including as a former federal prosecutor (Assistant United States Attorney) and as a Board-Certified Criminal Law Specialist, attorney Stanley L. Friedman possesses a high level of knowledge and capability when it comes to defending people charged with healthcare fraud in California. If you are under investigation or facing charges of healthcare fraud in California, contact The Law Offices of Stanley L. Friedman for advice and representation from an experienced and successful Los Angeles healthcare fraud defense lawyer.

What Is Healthcare Fraud?

Healthcare fraud is a serious offense that involves the intentional deception or misrepresentation of information to receive unauthorized benefits or payments from healthcare programs. This fraudulent activity can be committed by healthcare providers, patients, or other entities involved in the healthcare system.

Government prosecutors can charge individuals with healthcare fraud based on many different activities. Some of the most common actions that lead to charges of healthcare fraud include:

  1. Billing for Services Not Rendered: Submitting claims for medical services or treatments that were never provided to the patient.

  2. Upcoding: Billing for more expensive services or procedures than those actually performed.

  3. Kickbacks: Receiving or offering financial incentives in exchange for referrals or the promotion of certain medical services or products.

  4. Unbundling: Separating a bundled procedure into individual components to increase billing.

  5. False Claims: Submitting claims for unnecessary medical services or procedures, or for services that do not meet the required medical standards.

Laws Governing Healthcare Fraud in California

Healthcare fraud is regulated by both federal and state laws. In California, healthcare fraud is primarily governed by the following statutes:

  1. California Penal Code Section 550: This section prohibits various forms of healthcare fraud, including submitting false claims, making false statements in support of a claim, and presenting multiple claims for the same service with the intent to defraud.

  2. California Insurance Code Section 1871.7: This statute, known as the California Insurance Fraud Prevention Act, allows whistleblower lawsuits based on the act of allegedly presenting fraudulent claims to insurers.

  3. Federal Laws: In addition to state laws, individuals accused of healthcare fraud in California may also face charges under federal statutes, such as the False Claims Act, the Anti-Kickback Statute, and the Health Insurance Portability and Accountability Act (HIPAA).

Defending Against Healthcare Fraud Charges

The consequences of a healthcare fraud conviction can be severe, including hefty fines, restitution, and imprisonment. If you or your healthcare practice is under investigation or has been charged with healthcare fraud, it is crucial to seek experienced legal representation immediately.

The burden is on the prosecutor to prove every element of the alleged offense beyond a reasonable doubt in order to secure a conviction. A skilled defense attorney will challenge the prosecution’s case at every turn, raising reasonable doubt as to whether the offense has actually been committed. In addition, persons accused of healthcare fraud may have any number of defenses to the alleged crime. Finally, the government may have committed errors in its gathering of evidence or handling of the case so that evidence should be suppressed, or charges dropped and the case dismissed altogether.

At The Law Offices of Stanley L. Friedman, we understand the nuances of healthcare fraud defense and are committed to protecting your rights and reputation. We will thoroughly investigate the allegations against you, develop a robust defense strategy, and advocate tirelessly on your behalf.

Contact Us for a Consultation

If you are facing healthcare fraud allegations in California, call The Law Offices of Stanley L. Friedman at (310) 598-2000 today for a confidential consultation. Our experienced criminal defense team will provide you with the guidance and representation you need to navigate this challenging legal landscape and find your way to a positive outcome.

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