In Texas, health care fraud is considered a white-collar criminal offense. Similar to other types of criminal fraud, it occurs whenever an individual uses deception in order to obtain medical benefits that he or she would not otherwise be entitled to. Health insurance fraud can also occur whenever doctors or other health care workers make false statements in order to obtain payment for services. Some examples of behaviors that could be considered fraudulent include:
The punishments for health care fraud are described in Chapter 35 of the Texas Penal Code. The possible consequences depend on the nature of an incident. If it merely involves making false statements, the penalty can be up to five years in prison and a fine of no more than $10,000. If there are repeat violations, a 10-year prison sentence could be imposed instead. In the case of pharmaceutical fraud, an individual could also be charged with drug trafficking, which could essentially increase the length of one’s sentence.
Aside from criminal sanctions, medical workers also face the loss of a professional license. Those convicted of pharmacy fraud may find themselves ineligible for government assistance if the act involved using Medicaid or Medicare.
Building a defense against any type of fraud charge can be complicated, as there are often numerous entities involved. Hospitals and insurance companies may have their own claims investigators who look into these matters, along with law enforcement and government agencies. These groups often compile their records in an effort to determine whether or not there are inconsistencies in any of the statements that are given. For this reason, a person who is the target of an investigation should forego answering questions until they have spoken with a health care fraud lawyer.
Houston attorney Brett A. Podolsky is a former assistant district attorney who knows all too well the tactics used by prosecutors to secure criminal convictions. As such, he’ll carefully craft a defense strategy based upon his ability to anticipate what district attorneys might do. He believes that every person is innocent until proven guilty, and he will not allow his clients to be bullied by the state of Texas.
For a free consultation with Brett A. Podolsky, call 713-227-0087 and schedule an appointment.
