Durable Medical Equipment Fraud Defense
Durable Medical Equipment (DME) fraud is a significant legal issue in the complex landscape of healthcare law. This type of fraud typically involves the misuse of billing practices related to DME, which includes medical devices designed for long-term use at home to aid in a better quality of living for patients, such as wheelchairs, oxygen concentrators, and sleep apnea devices. Government investigators have been cracking down hard on suspected cases of Medicare and Medicaid fraud involving DME billing, putting healthcare practices at risk and exposing medical providers to serious civil and criminal liability.
If you are a DME provider or medical practice that prescribes and bills for DME, and you have come under indictment or investigation for alleged DME fraud, your first step should be to contact an experienced healthcare fraud criminal defense attorney for advice and representation. In Los Angeles, The Law Offices of Stanley L. Friedman is led by a former federal prosecutor with over 25 years of experience defending people charged with healthcare fraud and financial white collar crime in L.A. Call now to get out in front of criminal charges and position yourself for the best outcome in your situation.
Key Elements of DME Fraud
DME fraud can manifest in various forms, including:
-
Billing for Non-Delivered Equipment: Charging for DME that was never provided to the patient.
-
Upcoding: Billing for more expensive equipment than what was actually provided.
-
Unnecessary Equipment: Providing patients with equipment they do not need and subsequently billing Medicare or insurance companies.
-
Kickbacks: Receiving illegal payments in exchange for patient referrals for specific DME.
Laws Governing DME Fraud in the United States
DME fraud is predominantly prosecuted under federal law, due to the involvement of federal healthcare programs like Medicare and Medicaid. Key laws include:
-
False Claims Act (FCA): Under this act, knowingly submitting, or causing to submit, false claims for payment of government funds is illegal. It is often used in prosecuting DME fraud cases.
-
Anti-Kickback Statute (AKS): This statute makes it illegal to knowingly and willfully offer, pay, solicit, or receive remuneration to induce or reward referrals for services paid for by federal health care programs.
-
Health Care Fraud Statute: Enacted under the Health Insurance Portability and Accountability Act (HIPAA), this statute specifically targets fraud in healthcare, including DME fraud.
-
Mail and Wire Fraud Statutes: These statutes may be applied in DME fraud cases, especially when fraudulent claims are submitted electronically or via mail.
Legal Strategies for Defending Against DME Fraud Charges
A robust defense against DME fraud charges can include:
-
Lack of Knowledge and Intent: Demonstrating that the accused had no knowledge of the fraud or intent to commit it.
-
Mistakes and Clerical Errors: Arguing that any discrepancies were due to honest errors rather than deliberate fraud.
-
Compliance with Regulations: Providing evidence that all transactions complied with federal healthcare regulations.
In facing DME fraud charges, the expertise of a seasoned criminal defense lawyer, particularly one with a background in federal prosecution like Stanley L. Friedman, is invaluable. As your lawyer, we will:
-
Analyze the Evidence: Thorough examination of all documentation and transactions to build a strong defense.
-
Navigate Complex Laws: With an in-depth understanding of federal laws and healthcare regulations, we can adeptly handle the complexities of the case.
-
Negotiate with Prosecutors: Leveraging his experience and knowledge, Mr. Friedman can negotiate effectively with the prosecution, potentially leading to reduced charges or alternative resolutions.
-
Represent in Court: If the case goes to trial, having a seasoned lawyer with courtroom experience and a deep understanding of DME fraud is crucial for an effective defense.
Get the Help You Need: Contact the Law Offices of Stanley L. Friedman for Effective Defense Against Charges of Durable Medical Equipment Fraud in Los Angeles
DME fraud is a complex area of law, deeply intertwined with healthcare regulations and federal statutes. Facing such charges requires a strategic and knowledgeable defense, which an experienced criminal defense lawyer like Stanley L. Friedman can provide. With a background in both defense and federal prosecution, Mr. Friedman offers a unique perspective and skill set for those accused of DME fraud, ensuring their rights are protected throughout the legal process. In Los Angeles, call The Law Offices of Stanley L. Friedman at 213-629-1500 for the advice and representation you need to deal effectively with charges of DME fraud or other healthcare fraud crimes.