Medicare Fraud Lawyer San Francisco, CA
The majority of doctors and other medical providers in California accept payments from Medicare for the services they provide to patients. In order to be allowed to do so, there are stringent requirements the government has put into place that these providers must adhere to. In order to ensure that the rules and regulations are being followed, the Centers for Medicare and Medicaid Services (CMS) will conduct audits on providers if they suspect any issues of noncompliance, such as problems with record-keeping or irregularities in billing. During a CMS audit, a provider could be accused of Medicare fraud. If this has happened to you, you need to contact a San Francisco, CA Medicare fraud lawyer immediately.
Medicare is a healthcare program created by the federal government for senior citizens 65 and over. It includes a variety of healthcare services to ensure that seniors have access to quality care regardless of their income or pre-existing conditions. Though it is mainly geared towards seniors, it also serves younger individuals with disabilities and End-Stage Renal Disease.
Providers who are suspected of violations may be contacted by the CMS notifying them that they have been chosen to be audited. An audit can be concerning to many providers, however there are ways to prepare and ensure that you go through the process smoothly. If you have been contacted by the CMS and informed that they will be conducting an audit of your practice, you likely are unsure of what this process will involve. In most cases, an audit will involve the following steps:
- The medical provider is notified in writing regarding what information the CMS is requesting. This letter is referred to as an “engagement letter.” After the provider submits the requested data, the agency will examine all the information and determine if they need any further documentation from the provider. This step can take up to six weeks before completion.
- The agency will have its auditors evaluate sample data from the information the provider has submitted. If they find any non-compliance issues, there may be additional information requested. In some cases, auditors may conduct on-site examinations. This step can take up to three weeks before completion.
- The audit results are shared with the provider, as well as any corrective action the CMS determines needs to be taken. Depending on the circumstance, the CMS may refer the case to the Division of Compliance Enforcement (DCE) to determine if any further action, including fines, sanctions, termination, or other legal steps need to be taken against the provider.
Medicare Fraud Conviction
If you are dependent on the Medicare program and suspect that you may be dealing with fraud, you are urged to contact a reputable lawyer who is familiar with the Medicare program and laws that regulate it. Healthcare providers and medical professionals such as physicians are expected to abide by fair and legal practices. If you believe that a medical professional conducted an illegal referral or has engaged in any other form of Medicare fraud, contact a respected and skilled lawyer right away.
As a Medicare fraud lawyer in San Francisco, CA can explain, conviction for Medicare fraud could result in harsh penalties. A person who is convicted faces up to five years in prison and fines up to $25,000. There can also be civil penalties, including up to $50,000 for each violation and $11,000 for each false claim. In addition, a person could face a fine triple what the government suffered because of the false claims issued by the Office of Inspector General.
Call Our Office for Legal Assistance
Medicare fraud lawyers can provide legal assistance to both healthcare providers and individuals who have information regarding a suspected case of Medicare fraud. Navigating the complex laws overseeing healthcare operations can be difficult, so hiring a lawyer who specializes in the Medicare program can be greatly beneficial. There are many nuances within the laws, and dealing with the issues involving government systems can pose many challenges. Doing this on your own is not recommended. Instead, leave the work to a legal professional who has the experience and knowledge to help you obtain quality legal representation and positive results.
If you are being investigated or charged with Medicare fraud, contact the Morales Law Firm right away to meet with a San Francisco, CA Medicare fraud lawyer to find out how we can help. Your medical license and your freedom could be at stake.
Reasons To Hire a Medicare Fraud Lawyer
If you or a loved one were injured at the hands of a Medicare professional, it’s possible you’re entitled to compensation. Medicare errors account for many deaths and injuries in the United States, so Medicare fraud lawsuits are not uncommon. If you feel you could gain compensation through a lawsuit, you might want to speak with a lawyer. The following are some reasons to hire a Medicare fraud lawyer.
- To Help You Determine Damages To Seek
Knowing what damages you can claim is one of the first things you can ask a Medicare fraud lawyer about. There are several different types of damages you may be able to seek in your Medicare fraud claim. You likely have high Medicare costs you’ll need compensation for, and that could include future Medicare costs. If you missed work while recovering, you could seek lost wages and even loss of future earning capacity. If you have mentally, emotionally and physically suffered, you may be able to seek pain and suffering. Whatever losses you have faced because of injury, a lawyer will work on your case and fight to recover your deserved compensation, pursuing the person responsible. Your lawyer can walk you through all the specific damages to help you make a determination.
2. To Work With the Insurance Company
Insurance companies can be difficult to deal with, but you don’t have to do it yourself. Working with a lawyer allows you to work with someone who can fight for your rights. Attempting to communicate with an insurance company may just leave you feeling more frustrated and helpless. A lawyer who understands their tactics and knows what strategies to counter them with is more likely to have a productive conversation with them. They are also equipped to evaluate any settlement offer given to you by the insurance company. Some insurance companies try to lowball their offers in an attempt to save money for themselves, and that’s not fair to you and others in your situation. A lawyer can work through negotiations to ensure the fairest outcome possible.
3. To Accelerate the Process
Whether you’re dealing with the insurance company or the other party in a lawsuit, the process can sometimes take a while. With the help of a Medicare fraud lawyer, the process can be accelerated so you can gain compensation sooner rather than later.
4. To Negotiate a Fair Settlement
Negotiations can get tricky if you don’t know what you’re doing. A Medicare fraud lawyer likely has plenty of experience in these types of negotiations. If the settlement being offered is low, your lawyer can point out the reasons you deserve more. Appealing to the emotional side of the case can be difficult, but your lawyer can show why compensation is essential for those emotional scars caused by your injury.
Contact a Lawyer Today
Taking legal action may be something that you are not comfortable doing. However, it is best that you are able to fully understand the legal resources at your disposal. It may not be too late to file a claim. If you are a victim of Medicare fraud or are a healthcare provider facing an audit, a skilled lawyer can help you.
Medicare fraud can be frustrating for several reasons, but especially because you’ve put your trust in a Medicare professional who failed you. Waiting too long to learn about your legal options regarding a Medicare fraud case can cost you the ability to submit a valid claim. You don’t want to miss out on monetary compensation that you may be eligible for. To learn about the legal services that you can receive, arrange a consultation with a lawyer as soon as you can. If you or a loved one were injured at the hands of a Medicare professional, contact our Medicare fraud lawyer today to discuss the options you have moving forward.