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Dallas Lawyer for Healthcare Fraud

Healthcare Fraud Attorney in Texas

Healthcare fraud is a serious white collar crime that can result in significant financial losses for individuals, government organizations, and private companies. Healthcare fraud may involve intentionally misrepresenting information, overcharging for medical services, billing for services that were not provided, or other uses of false information to gain money from health insurance companies or government benefits programs. Since this form of fraud is estimated to cost the healthcare industry billions of dollars each year, it is taken very seriously by prosecutors. Those who are accused of healthcare fraud may face federal charges, and if convicted, they could be sentenced to multiple years in prison and be required to pay tens of thousands of dollars in fines.

An attorney who has experience in healthcare fraud cases can provide invaluable legal representation for those who are accused of this offense. At Spencer & Associates, our skilled white collar crime defense lawyers understand the consequences that individuals and businesses may face in these situations, and we work to ensure that they are treated fairly during investigations and criminal cases. We are dedicated to protecting the rights of people who have been charged with crimes and helping them resolve their cases successfully. We provide representation for people throughout the state of Texas who are facing healthcare fraud charges.

Understanding Healthcare Fraud

Healthcare fraud generally involves medical providers deliberately submitting false information or fraudulent claims to health insurance companies or government benefits programs with the intent of obtaining payments. However, it may also involve actions by individuals who seek to receive medical services or make insurance claims. Healthcare fraud may include activities such as:

  • Overbilling - Medical providers may use a number of methods to increase the amounts of the payments they receive for the services provided to patients. They may bill insurance providers for services that were more expensive than the treatment that was actually provided, which is known as "upcoding." They may bill a single procedure as multiple separate procedures, which is known as "unbundling." They may also submit multiple bills for the same procedures.
  • Billing for services that were never provided - In addition to increasing the payments received for services provided, medical professionals may bill insurance companies without actually performing the treatments in question. To support these fraudulent claims, they may falsify medical records and state that certain types of services were provided to patients.
  • Providing unnecessary treatments - Some providers may convince patients to undergo treatments or tests that are not medically necessary in order to bill for these services. This can not only result in financial losses, but it can cause harm to patients.
  • Identity theft - A person may use someone else's information in order to obtain medical services or submit insurance claims. This can result in financial problems for the person whose identity was stolen, and it may also affect their ability to receive medical treatment in the future.
  • Impersonating a medical professional - A person who does not have a valid medical license or does not have the training required to provide certain types of medical services may falsely represent themselves as a doctor or other medical provider. They may do so with the intent of submitting claims to insurance companies or government benefits programs and receiving payments.
  • Prescription fraud - Medical providers may be accused of issuing medically unnecessary prescriptions as part of a drug diversion scheme. Other parties may commit prescription forgery and use falsified prescriptions in an attempt to obtain controlled substances. In addition to charges of fraud, these activities can lead to criminal prosecution for offenses related to drug possession, distribution, and trafficking.

Contact Our Dallas Healthcare Fraud Lawyers

At Spencer & Associates, we have nearly 30 years of legal experience in cases involving fraud and white collar crimes. We can provide effective legal representation for medical providers or others who have been accused of healthcare fraud. We work to ensure that our clients can avoid a conviction whenever possible while also taking appropriate actions to minimize the effects that criminal charges may have on their professional lives. To learn how we can help address issues related to healthcare fraud charges, contact us at 214-385-8500 and set up a free consultation.

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