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Buellton Health Care Insurance Fraud Defense

Buellton Health Care Insurance Fraud Defense 

Health care and insurance fraud can take many forms, but one of the most common involves people receiving benefits they shouldn’t or charging services that weren’t provided. Whether you are being accused of making false statements to receive medical benefits and kickbacks through health care claims – or even have been charged with the illegal possession and use of medications or medical equipment, you need legal advice from an experienced Buellton health care insurance fraud attorney.

Read more below to learn:

  • Buellton health care and insurance fraud law
  • What the prosecution has to prove in order to get a conviction
  • Ways to defend against health care and insurance fraud charges
  • Health care andiInsurance fraud penalties and types of fraud
  • Real-Life example for health care and insurance fraud charges
  • Contacting a health care and insurance fraud lawyer for immediate help

Buellton Health Care and Insurance Fraud Law

Healthcare fraud can take many forms and can affect us, in one way or another. Charges under Insurance Code Section 1871.4 and Penal Code Section 550 focus on the person submitting the insurance claim making false statements to either obtain or deny the insurance benefits. Since these alleged false statements are then being used to get health insurance benefits, the person accused could possibly face what is called perjury, under Penal Code Section 118. Essentially, perjury is the intentional act of swearing in a false oath or even falsifying an affirmation to tell the truth. 

Importance of a Buellton Health Care and Insurance Fraud Attorney.

These claims call for immediate action in contacting an experienced Buellton Health Care and Insurance Fraud Attorney.

What the Prosecution Has to Prove in Order to Get a Conviction

The law says that in order to get a conviction for health care insurance fraud, criminal court must be able to prove beyond a reasonable doubt that you were involved in two (2) things: First, someone must have committed fraud by lying about certain aspects of the healthcare, and second, you or the person in question knew about it. Prosecutors need to convince a jury that both these elements are true.

Let’s look at each one separately.

This is what the PROSECUTION has to prove in order to get a conviction:

First, the prosecution has to show that someone lied about certain aspects of your healthcare—like saying they did or didn’t perform a medical procedure when they really did or didn’t. This may seem straightforward, but there are several different ways you can commit fraud related to your own healthcare. For example, an overbilling scheme involves billing patients for services not rendered or at rates higher than what was agreed upon with Medicare or private insurers. Meanwhile, upcoding means doctors bill insurers for more serious diagnoses than what’s been confirmed through diagnostic tests like MRIs and X-rays—which can result in greater reimbursement from Medicare or private insurers.

You may be tangled in this either through the medical center you work for or through being a patient. Either way, obtaining an experienced Health Care Fraud and Insurance Lawyers in Buellton would be your first step in ensuring you are on the correct path to defending yourself.

Contacting a Health Care and Insurance Fraud Lawyer for Immediate Help

If you’ve been a direct victim of health care fraud in Buellton, California, or even through allegations of health care fraud (on either side) consider contacting Sanford Horowitz Criminal Defense, P.C. for representation. We have experience dealing with health care fraud cases related to prescription drugs and medical devices, hospital finances, insurance claims, and many other areas.

 If you or your company is involved in such activity or suspects it might be, get in touch with us today at (805) 749-5670! Our team will be happy to discuss how we can help ensure that you receive restitution or compensation for any losses you may have incurred.

Ways to Defend Against Health Care and Insurance Fraud Charges

If you’re facing allegations of health care fraud, then there are several ways to defend yourself against them.

A Buellton health care insurance fraud attorney can help protect your rights by investigating whether or not your actions were truly fraudulent, while also consulting with you on how to handle any charges levied against you.

It’s important to remember that being accused of committing health care insurance fraud is not proof that you did so.

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