Health care fraud in Texas comes with serious penalties, including lengthy prison sentences. This is scary, since given the complexities of the U.S. health care system, a simple mistake in any part of the process could lead to a fraud charge.
Two Texas doctors were recently arrested and charged with five counts of healthcare fraud, one count of conspiracy to commit healthcare fraud and one count of unlawful distribution of a controlled substance.
How the alleged fraud scheme worked
The doctors, who run a Dallas based pain management clinic, are accused of allegedly sending false claims to their patients’ insurance companies and claiming they received more corticosteroid injections than they had.
Instead of performing the injections, the doctors allegedly placed the needle on patients’ skin but did not pierce it or gave smaller dosages of the injection to patients’ than they represented.
The allegedly false claims allowed the doctors to bill their patients’ insurance companies more money for the number of injections. The U.S. Attorney’s Office for the Northern District of Texas claims that the doctor’s billed the insurance companies over $50 million and received approximately $12 million.
These are major charges, since if convicted, each doctor could receive up to 40 years in prison and be forced to pay back any funds related to the alleged scheme.
Handling a fraud accusation
Professionals such as doctors suffer more than just the legal consequences if they are convicted of a fraud crime. They could lose their medical licenses and their reputations could be permanently destroyed.
This is why it is vital to act immediately if you are charged with a fraud crime. There are several potential fraud defenses that might be available to you. Perhaps you did not intend to defraud the alleged victim or you were threatened or coerced into participating in the fraud.
The prosecution’s actions can also be scrutinized to see if they engaged in any illegal conduct in their investigation or evidence gathering.
Knowing what defenses apply to your case requires a thorough evaluation of the situation.