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.
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 completed.
- 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 completed.
- 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
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
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.