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TAMPA HEALTHCARE FRAUD ATTORNEY
Experienced Healthcare Fraud Defense Lawyer in the Tampa Bay Area
Healthcare fraud is a serious white-collar crime that can result in severe penalties, including steep fines, loss of licensure, and even imprisonment. This type of fraud often involves allegations such as submitting false claims, misusing funds from a healthcare benefit program, or committing Medicare fraud.
Here at Buda Law, our Tampa healthcare fraud attorneys understand the intricacies of healthcare fraud investigations and prosecutions. We are dedicated to protecting the rights and reputations of individuals accused of health care fraud in Tampa, Florida and the surrounding areas.
Our law firm has the knowledge and skills needed to defend against charges involving fraud and deception, ensuring that clients facing scrutiny from either the local or federal government, or both, receive the strong legal representation they deserve.
If you’re facing healthcare fraud allegations, contact Buda Law at (813) 322-2832 or reach out online for a free consultation right away.
What is Healthcare Fraud?
Healthcare fraud occurs when someone knowingly submits false or misleading information to obtain unauthorized benefits or payments from a health care program. Under both federal law and Florida law, a key element of healthcare fraud is fraudulent intent, meaning the person acted deliberately to deceive or mislead for financial gain. This type of fraud can be committed by individuals, patients, or healthcare providers, and often includes practices like billing for services not provided, overcharging for services, or misrepresenting treatments.
Common examples include Medicare fraud, filing claims under false pretenses, and forging patient records to justify unnecessary medical procedures. Because health care programs are often funded by the federal government, fraudulent actions can lead to serious penalties at both the state and federal levels, including hefty fines, restitution, and imprisonment.
Examples of Healthcare Fraud
Here are some of the most common examples our healthcare fraud defense attorneys see at Buda Law:
- Billing for services not rendered (charging for procedures, tests, or appointments that never actually happened)
- Upcoding (billing for more expensive services or procedures than were actually provided)
- Unbundling (separately billing for procedures that should be billed together at a reduced rate)
- Performing unnecessary services (ordering tests, procedures, or treatments that are medically unnecessary just to bill more)
- Falsifying patient diagnoses (changing or exaggerating a diagnosis to justify more costly treatments)
- Kickbacks and referral schemes (receiving or giving money or other benefits in exchange for patient referrals)
- Medicare fraud or Medicaid fraud (submitting false claims to government health programs for payment)
- Prescription fraud (issuing unnecessary prescriptions or falsifying prescriptions to distribute medications illegally)
- Phantom billing (charging for equipment, medications, or services that a patient never received)
- Misrepresenting provider credentials (falsely claiming to be a licensed healthcare provider to bill insurance companies)
- Duplicate billing (submitting multiple claims for the same service)
- Identity theft to obtain medical services or submit false claims (when someone uses another person’s personal information to access health care services or bill insurance fraudulently)
Laws Governing Health Care Fraud
Health care fraud is a serious criminal offense governed by both state and federal statutes, with harsh penalties for those convicted. Some of the most common federal statutes include the False Claims Act (31 U.S.C. §§ 3729–3733), the Health Care Fraud Statute (18 U.S.C. § 1347), and the Anti-Kickback Statute (42 U.S.C. § 1320a–7b). These laws broadly criminalize any scheme to defraud a health care program funded by the federal government, such as Medicare or Medicaid fraud.
At the state level, Florida has its own powerful set of laws targeting health care fraud. Florida Statutes § 817.234 specifically makes it a felony to knowingly submit false or misleading claims to insurance companies for payment. There are also strict penalties for related offenses such as identity theft charges in Florida (F.S. § 817.568), particularly when a person’s private information is used to bill health care services fraudulently.
State prosecutors often work in tandem with federal agencies to ensure that those who engage in health care fraud are prosecuted to the fullest extent of the law.
Who Investigates Health Care Fraud?
At the federal level, a variety of agencies and laws work together to investigate and prosecute fraud involving government-funded health programs. For example, the Federal Bureau of Investigation (FBI), the U.S. Department of Health and Human Services (HHS), the Drug Enforcement Administration (DEA), Department of Justice (DOJ), and the Office of Inspector General (OIG) all play major roles in detecting, investigating, and referring cases of health care fraud for prosecution.
Most Medicare fraud cases arise from activities like billing for services not rendered, upcoding procedures to more expensive ones, and falsifying patient information. Medicare audits are often triggered by suspicious billing patterns, and providers who fail audits may become targets of a broader federal investigation. Agencies such as the Centers for Medicare & Medicaid Services (CMS) regularly conduct audits to protect the integrity of services offered to Medicare beneficiaries. If irregularities are found, the case may be referred to the United States Attorney’s Office for possible criminal prosecution. In more serious instances involving the illegal distribution of prescription drugs, the Drug Enforcement Administration (DEA) also becomes involved.
Who Can Be Charged With Healthcare Fraud?
- Medical Professionals
- Doctors, nurses, and pharmacists accused of fraudulent billing or performing unnecessary procedures.
- Any medical provider involved in actions violating healthcare fraud and abuse laws.
- Healthcare Facilities
- Hospitals, clinics, nursing homes, laboratories, and home healthcare services engaged in systemic fraud schemes.
- Administrative Staff and Billing Professionals
- Employees responsible for falsifying records, manipulating billing systems, or improperly handling claims.
- Staff implicated in healthcare fraud investigations due to discrepancies in health care billing.
- Patients
- Individuals accused of fraudulently obtaining healthcare services, prescriptions, or Medicare benefits.
- Cases involving false claims or abuse of healthcare programs.
If you or someone you know is facing allegations of healthcare fraud or medicare fraud, consulting with an experienced Tampa fraud defense attorney like those at Buda Law is critical to protecting your rights.
Penalties for Healthcare Fraud in Florida
Healthcare fraud prosecution in Florida can lead to extremely severe penalties. Depending on the nature and amount of the fraud, individuals may face charges ranging from third-degree felonies to first-degree felonies. Penalties can include lengthy prison sentences, often up to 30 years for major offenses, along with substantial fines that may reach hundreds of thousands of dollars.
Penalties can also extend to the loss of professional licenses, effectively ending a medical career or business operation. With so much at stake, it is essential to explore your legal options. Working with an experienced fraud lawyer at Buda Law in the Tampa Bay area, can make a significant difference in building a strong defense and minimizing potential penalties.
Federal Penalties for Healthcare Fraud
Because healthcare fraud can also trigger federal charges, defendants often face simultaneous prosecution under both state and federal law, significantly raising the stakes. At the federal level, penalties for healthcare fraud are extremely serious and are largely determined by the Federal Sentencing Guidelines, which take into account the amount of loss, the number of victims, and whether the fraud involved vulnerable individuals such as elderly patients. Convictions can result in lengthy sentences in federal prison, often ranging from several years to decades, especially in large-scale fraud cases. In addition to imprisonment, defendants may face substantial fines, mandatory restitution to victims, forfeiture of assets, and exclusion from participating in federal healthcare programs like Medicare and Medicaid.
Given the harsh consequences, it is critical for anyone facing healthcare fraud charges to work with an experienced federal criminal defense attorney as soon as possible.
What to Do If You’re Accused of Healthcare Fraud in Tampa
Taking immediate steps to protect yourself is critical if you are accused of healthcare fraud. First and foremost, avoid discussing the case with investigators without a fraud defense attorney present. Anything you say could be used against you by federal prosecutors building their case.
Contacting an experienced attorney like Andrew Buda of Buda Law as soon as possible is essential to safeguard your career and reputation. The experienced fraud defense attorneys at our law firm can provide a free consultation to assess the allegations and develop a strong defense strategy to challenge the charges, protecting your rights every step of the way.
Why You Need an Experienced Tampa Healthcare Fraud Attorney Like Andrew Buda
When facing health care fraud charges, it is essential to work with an experienced and knowledgeable advocate like Andrew Buda, a Tampa criminal defense attorney at Buda Law. As one of the area’s former prosecutors, Andrew Buda brings valuable industry knowledge to every case, allowing him to anticipate the government’s strategies and fight aggressively for your rights.
Charges involving alleged fraud often lead to highly complex cases, and the burden is on the prosecution to prove guilt beyond a reasonable doubt. Having an extremely professional and highly skilled defense lawyer who understands both state and federal court procedures can make all the difference in seeking justice and protecting your future.
Buda Law proudly serves clients throughout Hillsborough and Pinellas County, including Tampa, St. Petersburg, Clearwater, Dade City, Palm Harbor, Pinellas Park, New Port Richey, Spring Hill, and beyond, offering personalized and aggressive defense strategies tailored to each client’s needs.
Call the Tampa, Florida Criminal Defense Attorneys at Buda Law For a Free Consultation Today
Healthcare fraud charges are serious and carry severe consequences, including fines, prison time, and damage to your career and reputation. That’s why, when faced with these allegations, it is essential to have skilled legal help on your side.
At Buda Law, our Tampa healthcare fraud attorneys provide aggressive representation for clients accused of health care fraud, Medicare fraud, and various other related offenses. With our experience and dedication, we fight to protect your rights and achieve the best possible outcome for your case.
Contact Buda Law today online or by phone at (813) 322-2832 for a confidential consultation and experienced legal representation in healthcare fraud cases.
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