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While many people in Fairfax and across the country might not realize it, Medicare fraud can come in different forms and is treated very seriously by law enforcement. For those who are either being charged or are concerned about the potential of committing fraud in this way, it's important to know the details of Medicare fraud. Gathering the proper information can be the difference between facing charges, being acquitted or avoiding prosecution altogether.

Medicare fraud is a prominent issue today. It can be committed by patients and medical professionals alike. Sometimes, they work together to commit the act. In some instances, there are groups of people conspiring to commit Medicare fraud. Costing billions of dollars annually, those who are abusing and cheating the system can raise costs and diminish the effectiveness of the program for everyone. Medicare fraud generally falls into the categories of: statements or misrepresentations that are known to be false being submitted to receive healthcare payments; accepting, requesting or paying to receive reward referrals; making referrals that are prohibited for certain health services.

These types of acts can be committed by anyone. Examples of schemes that have been discovered in the past include bills being presented for services that were not provided and billing for more treatments and procedures than were conducted or needed. Those who are caught up in these types of acts willingly or not need to understand the potential legal consequences. There can be jail time, fines and other punishments administered. Medical professionals who partake in this level of fraud can lose their rights to work in the medical industry.

There are many aspects of fraud that must be understood when facing the charges. Because the charges can be complex and these acts are so popular in the media, overzealous prosecutors might try to use individuals as an example of what happens when Medicare fraud is believed to have been committed. Acquiring experienced legal advice is the first and most important step for a person facing these allegations. It can be the difference between harsh penalties after a conviction and being absolved and acquitted of all charges.

Source: CMS.gov, "Medicare Fraud & Abuse," accessed on Nov. 10, 2014

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