Legal Defenses in Healthcare Fraud Cases
Healthcare fraud is a serious offense under both federal and California law, often involving allegations of fraudulent billing, kickbacks, or false claims to Medicare or Medicaid. If convicted, healthcare providers could face heavy fines, imprisonment, and the loss of their professional licenses. However, just because you are accused of healthcare fraud doesn’t mean you are guilty. Several legal defenses can often be raised to challenge the charges.
At The Law Offices of Stanley L. Friedman, we focus on defending clients accused of healthcare fraud in Los Angeles and across California. Read on as we explore some common legal defenses, including lack of intent, entrapment, and more, that can be used to protect your rights and potentially get your charges reduced or dismissed. For personalized advice tailored to your situation from a California criminal law specialist, contact The Law Offices of Stanley L. Friedman for representation from an experienced and successful Los Angeles healthcare fraud defense lawyer.
1. Lack of Intent
One of the most effective defenses in a healthcare fraud case is the argument that the defendant did not intend to commit fraud. Healthcare fraud charges often require proof that the defendant acted knowingly and willfully. If the prosecution cannot prove that you had the intent to deceive or defraud, you cannot be found guilty.
In complex healthcare billing practices, mistakes can happen. Errors in coding, documentation, or billing are common, but not all errors are fraudulent. For example, if a healthcare provider inadvertently submitted incorrect billing information or misunderstood Medicare or Medicaid rules, this lack of intent could be a viable defense. Demonstrating that these errors were unintentional or due to negligence rather than willful fraud can be key to a successful defense.
2. Insufficient Evidence
Another defense in healthcare fraud cases is that the prosecution has insufficient evidence to prove fraud. Healthcare fraud investigations are often based on large volumes of medical records, billing statements, and testimony from witnesses such as former employees or business partners. However, this evidence can be circumstantial or unreliable.
For instance, billing irregularities may result from human error or systemic issues within a medical practice rather than fraud. In such cases, the defense can challenge the credibility of witnesses or the interpretation of evidence, arguing that the government has not met the burden of proof to establish guilt beyond a reasonable doubt.
3. Good Faith Belief
The “good faith” defense asserts that the defendant acted with honest intentions and without any intent to defraud. A healthcare provider may have believed that their actions were compliant with the law, even if they were later found to be improper. The defense might argue that the healthcare provider sought legal advice or followed industry standards but was unaware that their actions were in violation of healthcare regulations.
For example, if a physician received legal advice on a referral arrangement that later turned out to be deemed illegal under the Anti-Kickback Statute, the physician may argue that they acted in good faith, believing the arrangement was lawful at the time.
4. Statute of Limitations
Healthcare fraud cases are governed by a statute of limitations, which sets a time limit on when charges can be filed. Under federal law, the statute of limitations for most healthcare fraud offenses is six years. However, some exceptions exist that may extend this period, such as when the alleged fraud involves a government healthcare program.
If the alleged fraudulent activity occurred outside this time frame, the defense may move to have the case dismissed on the grounds that it is time-barred. This is an effective defense strategy when the prosecution has delayed filing charges, allowing too much time to pass between the alleged offense and the initiation of legal proceedings.
5. Entrapment
Entrapment occurs when law enforcement officials induce an individual to commit a crime they would not otherwise have committed. In healthcare fraud cases, this might happen during undercover investigations or sting operations.
If the defense can prove that the government coerced or improperly persuaded the defendant into engaging in fraudulent activity, entrapment may be a valid defense. This strategy can be difficult to prove, as the defendant must show that they had no predisposition to commit fraud before the government’s intervention. However, when successful, it can result in the dismissal of the charges or acquittal.
6. Duress or Coercion
Another defense that may apply in healthcare fraud cases is duress or coercion. This defense involves showing that the defendant was forced to engage in fraudulent activity under threat of harm. In healthcare practices, lower-level employees may be pressured by superiors to engage in fraudulent billing or other illegal activities to keep their jobs. If the defense can demonstrate that the defendant acted under duress or coercion, this may mitigate or even eliminate criminal liability.
Contact The Law Offices of Stanley L. Friedman for Strategic, Effective Defense Against Healthcare Fraud Charges in Los Angeles
Facing healthcare fraud charges can be overwhelming, but several powerful legal defenses may be available to you. At The Law Offices of Stanley L. Friedman, we understand the complexities of healthcare fraud cases and are prepared to build a strong defense to protect your rights and your future.
If you have been charged with healthcare fraud in Los Angeles, it’s essential to consult with an experienced criminal defense attorney who specializes in white-collar crime. Contact our office today at 310-598-2000 to schedule a consultation and discuss your case in detail. We will work tirelessly to defend you and ensure the best possible outcome.
