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Congress proposing new legislation to battle medicare fraud

Posted on April 13, 2010 12:00 AM EST

Two members of Congress from South Florida are backing new legislation to combat the massive Medicare fraud that costs U.S. taxpayers billions of dollars every year. The politicians believe the legislation along with the increased efforts of the Medicare Strike Forces created by the federal government will put an end to the ongoing problem or at least decrease the amount of healthcare fraud plaguing Miami and the South Florida area. United States Representatives Illeana Ros-Lehtinen and Ron Klein will discuss the new legislation at a senior's center in Miami-Dade Florida. Criminal defense law firmshave kept busy over the past couple of years defending these types of cases in federal court.

Fraud in this county alone purportedly exceeds $3 to $4 billion per annum according to federal law enforcement and healthcare officials. It is estimated that Medicare and healthcare fraud in general, cost the taxpayers in excess of $60 billion a year. The numbers are staggering and with media attention recently garnered by the new healthcare legislation, it is evident that the politicians are getting involved for a multitude of reasons. Although the recent reforms were passed by a democratic Congress, Republicans may step up the plate as mid-term elections are around the corner. The new legislation will unveil stricter penalties for those convicted of healthcare fraud. The proposal suggests that 1 to 2 year prison sentences be enhanced to five to ten years for anyone convicted of filing a false Medicare claim and paying kickbacks in exchange for patient information.

Other than enhanced penalties for Medicare fraud offenders, the legislation also intends to introduce technological advances to pro-actively curb the ongoing problem. The latest technology that will be employed by the federal government is aimed at preventing the fraudulent filing of claims for medical equipment and medical treatment that is not necessary or is never provided. Biometric technology has also been made part of the bill to ensure patients are physically present at clinics and medical offices. While the costs are sure to be high, many believe the benefits will outweigh the costs.

The legislation also contemplates new laws which criminalize acts such as selling a healthcare provider's billing privileges or selling Medicare recipient's identification and information. Despite the fact that the Medicare Fraud Strike Forces have led investigations that have resulted in excess of 500 prosecutions, the federal government believes a more pro-active approach to combating fraud is more effective than the deterrent threat of prison time. The new law will require the Department of Health and Human Services to conduct criminal background checks on all providers and be required to make spot checks of medical offices.

As the federal government moves to imposes harsher sentences and more preventative measures, it is apparent that the war against Medicare fraud has begun and anyone involved in this type of fraudulent practice must take heed that a more thorough program of checks and balances is on the horizon. Anyone being investigated for Medicare or healthcare fraud should contact a Miami criminal defense law firm experienced in defending these types of cases because the consequences of being convicted in federal court on these types of charges are serious. Federal judges have been and will continue to hand down lengthy prison sentences and impose large fines for these types of crimes. Defendants also should be aware that fleeing the jurisdiction can and will result in extradition from a foreign country.

Illeana Ros-Lehtinen, Ron Klein Unite Against Medicare Fraud, The Miami Herald.com, April 13, 2010.
Categories: Fraud