Obama Administration Ups Enforcement Against Alleged Health Care Fraud

August 06, 2011 (Press-News.org) A number of large federal health care programs have been vulnerable to fraud for years. Although there is no way to accurately measure the exact financial impact of undetected fraud, officials estimate that abuses of health care initiatives cost billions of dollars every year.

In the current climate of slow economic growth and tight government budgets, officials are making concentrated efforts to trim waste. For the Obama administration, this means taking a hard line on healthcare fraud. New enforcement measures have resulted in a significant number of fines, penalties and individual criminal charges.

Although government efforts have resulted in the recapture of millions of wrongfully expended health care funds, overbroad enforcement has had extreme consequences for doctors, nurses and other health care professionals unfairly swept into the fold.

Dozens of Arrests

In spring 2011, the FBI and the U.S. Department of Justice participated in the largest federal health care fraud bust in American history. All told, 111 health care providers were arrested across the country. Federal officials brought in doctors, nurses, health-care company owners and officers, and others alleged to have been involved in medical care schemes that resulted in over $225 million in wrongful billings to Medicare and Medicaid.

Texas health care providers were a special focus of the investigation. Seven Dallas residents were charged, including the operators of two health care companies. Sylvia Willett, the owner of JS&H Orthopedic, Inc., and her husband, Hugh Willett, were each charged with five counts of health care fraud and one count of conspiracy to commit health care fraud for allegedly billing Medicare over $1.8 million for durable medical equipment that allegedly was never actually provided. If convicted, Ms. And Mr. Willett each could face a maximum sentence of 10 years in prison and a $250,000 fine.

Another alleged Dallas health care scheme involved Ernest Amadi and four co-defendants. The indictment accuses Amadi and his co-conspirators of participating in a Medicare kickback ring that cost taxpayers over $1 million. In this case, each defendant potentially faces at least 10 years in prison and $500,000 in fines.

In Houston, 10 more Texans were indicted in connection to $13.3 million in allegedly illegal Medicare billings.

A Battle for Defendants

Professionals charged with criminal health care fraud face an uphill struggle. Even if they are acquitted, the negative publicity generated by criminal charges can be disastrous to a medical provider's reputation. For those health care professionals ultimately found guilty, jail time and hefty fines can turn their worlds upside down.

However, it is possible to put on a strong defense against federal health care fraud charges. A number of legal strategies can help deflate a trumped-up case. For instance, perhaps federal agents illegally searched for documents or listened in on communications without a proper warrant. Or, even if warrants were issued and properly executed, law enforcement authorities may have acted outside their scope in obtaining evidence. A skilled criminal defense attorney can ensure that no improperly collected evidence will be used against you in a criminal prosecution.

A defense attorney also may be able to attack the essential elements of a health care fraud case. In addition, since a wide and ill-defined range of conduct may constitute health care fraud, charging documents must be particular enough to inform the defendant of the nature of the charges against him or her. An effective criminal defense lawyer will point out these and any other deficiencies in the government's case.

Finally, an experienced criminal defense attorney will always ensure that jury instructions are fair and properly reference the "good faith" defense that negates health care fraud charges for professionals acting without criminal intent.

Seek Legal Assistance

Federal healthcare fraud prosecutions are usually complicated, lengthy cases with high stakes for the people involved. As the Obama administration increases its efforts to crack down on healthcare fraud, especially among doctors and other health care professionals, the right defense is extremely important.

If you are facing healthcare fraud charges or may be under investigation for healthcare fraud, contact an experienced criminal defense attorney today to begin planning the best defense for you and your career. Your future is too valuable to entrust to anyone but a criminal defense attorney with experience in federal court cases.

Article provided by Patrick J. McLain
Visit us at www.dallasdefenselaw.com