Healthcare Fraud

healthcare professional in seattle that looks distraught

Healthcare fraud is a serious crime that can have devastating consequences for medical practitioners. A conviction can lead to imprisonment, fines, loss of professional licenses, and lasting reputational damage. With so much at stake, having an experienced healthcare fraud defense attorney is essential. That’s where Jennifer Horwitz Law comes in. 

As a leading criminal defense practice in Seattle, the firm is committed to protecting the rights of healthcare professionals accused of fraud throughout Washington State. Lead counsel Jennifer Horwitz has comprehensive knowledge of the applicable federal and state healthcare fraud laws and the skills to mount an aggressive defense. If you are facing healthcare fraud charges, contact Jennifer today to discuss your options. 

What is Healthcare Fraud?

Healthcare fraud is the intentional deception or misrepresentation by individuals or organizations within the healthcare industry to gain financial or personal benefits. Fraud in the healthcare sector involves various illegal activities, including:

  • Billing fraud – false claims for reimbursement submitted to insurance providers, Medicare, or Medicaid
  • Upcoding – billing for more expensive medical services or procedures than those provided
  • Unbundling – billing separately for services that should be a single unit.
  • Kickbacks – offering or receiving improper financial incentives in exchange for referrals or services
  • False certifications – providing false information or certifications to obtain payments or approvals
  • Identity theft – stealing or using another person’s identity to obtain healthcare services or reimbursement

Washington State and Federal Healthcare Fraud Laws

Both Washington State and the federal government have implemented laws to combat healthcare fraud and protect the integrity of the healthcare system.

In Washington, healthcare fraud is illegal under the Washington Criminal Code, which includes provisions related to fraudulent insurance claims, false statements, and theft. In addition, the Insurance Fraud Protection Act covers fraudulent activities in the insurance industry.

At the federal level, healthcare fraud falls under the False Claims Act (FCA), which prohibits submitting false or fraudulent claims for payment to government healthcare programs, such as Medicare or Medicaid. The FCA imposes substantial penalties, including civil fines and potential exclusion from participating in federal healthcare programs.

Healthcare Fraud Penalties

Healthcare fraud is a serious offense that can lead to severe consequences for medical professionals found guilty of such crimes. The penalties may vary depending on the nature of the offense but can include:

  • Imprisonment – Convicted individuals may face significant prison sentences, ranging from several months to several years.
  • Fines – The fines for healthcare fraud convictions can be substantial, often reaching millions of dollars, including restitution to victims.
  • Professional consequences – A healthcare fraud conviction can result in the loss of professional licenses, suspension, or revocation of medical privileges.
  • Reputation damage – Being accused or convicted of healthcare fraud can tarnish a medical professional’s reputation, leading to a loss of trust among patients, colleagues, and the community.

Potential Defenses Against Healthcare Fraud

As an experienced healthcare fraud defense attorney, Jennifer Horwitz will work closely with you to explore potential defenses. Some common defenses against healthcare fraud allegations include:

  • Lack of intent – Demonstrating that the alleged fraud was a result of unintentional errors or misunderstandings rather than intentional deception.
  • Insufficient evidence – Challenging the prosecution’s evidence and arguments to show that they have not met the burden of proof required for a conviction.
  • Compliance  – Arguing that you followed accepted industry practices and standards, and any deviations were unintentional or justified.

In rare cases, entrapment may also be a viable defense. This involves showing that law enforcement or government agents induced or coerced you to commit healthcare fraud. 

Why Choose Jennifer Horwitz Law? 

The best way to defend against healthcare fraud charges is to have the informed representation Jennifer Horwitz Law provides. When you meet with Jennifer, she will explain the charges against you, and explore all your options. You can depend on her to handle your case with urgency and work to protect the medical career you’ve worked so hard to establish. Jennifer will: 

  • Evaluate the evidence, documents, and any relevant information related to your case to identify potential weaknesses in the prosecution’s case 
  • Conduct an independent investigation to gather additional evidence, interview witnesses, and uncover any information that may be crucial to your defense
  • Review medical records, billing documents, and other relevant documents
  • Engage qualified experts to provide testimony that supports your defense.

If your case proceeds to trial, Jennifer will provide strong and effective representation in the courtroom. She will present your case, cross-examine witnesses, and challenge the prosecution’s evidence to create reasonable doubt in the minds of the jurors. 

Jennifer Horwitz is committed to winning an acquittal; however, in the event of a conviction, she will advocate for you during the sentencing phase and argue for reduced penalties or alternative sentencing options. If you are dissatisfied with the outcome, Jennifer will determine whether you have grounds for an appeal. 

Talk To An Experienced Seattle Healthcare Fraud Defense Attorney Today

Being charged with healthcare fraud is serious; a conviction can doom your career as a healthcare professional. Call Jennifer Horwitz Law today.