Healthcare Fraud Accusations in Texas

 Posted on February 27, 2024 in Uncategorized

Healthcare fraud can be a serious federal crime. It can also be something of a catch-all term for any type of fraudulent activity carried out by a healthcare provider or, in rare cases, an individual who is not a licensed medical practitioner. Healthcare fraud can take many forms. For example, anyone other than a licensed healthcare provider who presents themself as one and attempts to bill a “patient’s” insurance company can be charged with this offense. It is also fairly easy for a healthcare provider to commit this crime without intending to defraud anyone or to fall under suspicion while engaging in legitimate practice. Healthcare fraud is usually a federal crime because most health insurance companies operate across multiple states, as do many hospital systems. If you have been accused of healthcare fraud, it is important to reach out to a Dallas, TX, federal health insurance fraud attorney right away.

When Careful Practice Looks Like Healthcare Fraud

It can be difficult for a doctor or nurse practitioner to walk the fine line between avoiding a medical malpractice lawsuit for a missed or delayed diagnosis and being accused of healthcare fraud for ordering tests that later turn out to have been unnecessary. A few types of healthcare fraud legitimate practitioners may find themselves accused of include:

• Ordering unnecessary tests - Often, the only way to eliminate the possibility of a serious medical condition like cancer or a previously undetected congenital heart defect is to run tests in any situation where the patient’s symptoms could possibly indicate a major problem. This can lead to patients undergoing a handful of tests that all come back negative. Someone who is not a specialist in the provider’s field may suspect that these tests were, therefore, ordered unnecessarily for the purpose of fraudulent billing.
• Providing needless treatments - Overtreating a medical issue - or proactively beginning treatment for a condition that may or may not exist - can be an act of caution. If a patient and doctor agree that it is best to begin treatment when it is not perfectly clear whether treatment is absolutely necessary, the provider may find themself wrongfully accused of intentionally ordering unnecessary treatment. 
• Prescription fraud - There may be legitimate and reasonable disagreements among medical professionals about whether a certain drug should be prescribed in a certain situation. A doctor who proactively orders the medication based on their own knowledge and experience with the patient could be accused of prescription fraud. 

It can be very difficult for a cautious and proactive healthcare provider to completely avoid the potential of facing a serious accusation.

Contact a Dallas, TX, Healthcare Fraud Lawyer 

Spencer & Associates is dedicated to defending medical providers accused of healthcare fraud. Our experienced Dallas County, TX, federal healthcare fraud attorneys will work to protect your freedom and medical license. Contact us at 214-385-8500 for a complimentary consultation.