How to Survive a Medicaid Fraud Investigation

The healthcare in the US is excellent but you do need to have insurance to benefit from it fully. Unfortunately there are an estimated 27 million people in the US without health insurance. This means there are plenty of people looking or a way round the system.

Even those who are insured can make false claims in order to get the treatment they need. Having insurance doesn’t mean there will get the medical attention they need.

This is demonstrated by the fact that there were 4 billion health insurance claims in 2011, this figure continues to increase.

What Is Health Care Fraud?

In a nutshell any act to deliberately mislead the health insurance company is fraud. This can range from lying about existing conditions or your age to companies billing for services not performed or creating diagnosis to justify tests.

You can even use someone else’s health care to get the treatment you need.

In many cases this goes on and is never traced, but there are investigators looking for anything suspicious that they can pounce on. You might not even know your company is completing Medicaid fraud but they will!

The Process

The Medicaid fraud investigator will search through all the documents that your company has provided to find what they believe constitutes fraud.

When they feel they have enough evidence they will send you a letter to ask you to attend an interview. If you go without a lawyer then you are likely to find yourself the subject of an arrest warrant shortly afterwards.

At this point you’ll need the services of Los Angeles bail bonds just to get you out of jail and start your defense.

The investigators will assume you are guilty; your cooperation in the interview will simply strengthen their case!

How To Survive The Investigation

The first thing you must do is contact a lawyer which specializes in Medicaid fraud.

They will contact the investigators to find out what the allegations are and what proof they have managed to collect. They will then be able to talk to you about the issues and look for a solution.

This might be locating other documents which show you didn’t know the fraud was happening. The lawyer must accompany you into the interview. They are responsible for making sure you do not say anything that can later be used against you. Listen to them; they know what they are doing!

You will need to provide the requested information but you can prepare your defense and your lawyer will ensure they are aware of all the facts.

With any luck the case will not proceed to court.

If court is inevitable then your lawyer may be able to negotiate for a low penalty. They will also keep you informed regarding every step of the procedure and how to best negotiate each obstacle.

Having a lawyer is not a guarantee that the investigators will go away but they will ensure you have a fair hearing and the best possible outcome.