Heiferman & Associates, PLLC discusses state and federal authorities' current efforts to shut down healthcare fraud.

State and Federal Authorities’ Efforts to Shut down Healthcare Fraud

Healthcare fraud costs the state and federal governments billions of dollars in taxpayer money. This means that there is obviously a big incentive for the government to crack down on this type of crime. There has been a significant increase in concerted efforts of the government to target and prevent potential healthcare frauds. Investigations and criminal charges have been aggressively brought and the government is looking to make an example out of those suspected of healthcare fraud violations.

Healthcare fraud may involve defrauding private or public health insurers. The two public healthcare insurers are Medicaid and Medicare. Both patients and healthcare providers may be the perpetrators of healthcare fraud. Doctors, Pharmacists, and other medical professionals are often the targets of criminal investigations. A doctor may be suspected of billing for unneeded procedures or overcharging patients. They may also be suspected of filing duplicate claims for services that were already rendered or billing for non-covered services as if they were covered services. Any of these actions means that the medical professional may be held responsible for or perpetrating the crime of healthcare fraud.

Federal Authorities Efforts to Shut down Healthcare Fraud Results in Arrest of Five New York Medical Providers

With increased efforts by federal authorities to shut down the perpetration of healthcare fraud, five suspects were taken into custody at the end of September. Among those suspects was a city neurologist. The licensed neurologist, Dr. Denny Martin, was arrested on September 26th on allegations that he participated in a scheme to bill Medicaid for over 3,000 fraudulent claims filed between the years of 2015 and 2019. The majority of the fraudulent claims filed come from alleged home health and podiatry visits. Numerous federal law enforcement agencies participated in the investigation, including, but not limited to the United States Attorney’s Office for the Eastern District of New York (EDNY); Attorney General of the Justice Department’s Criminal Division;  Federal Bureau of Investigation (FBI); Drug Enforcement Administration(DEA); and U.S. Department of Health and Human Services, Office of Inspector General, Office of Investigations, (HHS-OIG).

Additionally, anesthesiologist Dr. Anna Steiner has been accused of playing a role in an alleged $17.4 million scheme involving kickbacks paid in return for prescribing prescription medication and medical equipment and ordering diagnostic tests, all seemingly unnecessary or ordered without a doctor’s consultation. Dr. Steiner has been charged with healthcare fraud and conspiracy to commit healthcare fraud.

Additionally, a registered nurse at the Nassau University Medical Center pleaded guilty to possession of a synthetic opioid after stealing drugs from his workplace. Pharmacist Andrew Barrett, previously convicted of healthcare fraud back in 2016, and pharmacy owner Phyllis Pincus were both indicted for allegedly filing false claims with Medicare and Medicaid for medicines that were never dispensed to patients.

Healthcare Fraud Defense Counsel

Those convicted of healthcare fraud face severe potential penalties. A person found guilty of this crime stands to serve jail or prison time and pay fines of up to $250,000 per offense. A court may also order payment of restitution for any amount that the defendant profited from the crime. Additionally, the defendant may likely face loss of professional licensure. Not only are the penalties for healthcare fraud severe, but the effects of having this on your criminal record are also likely to follow you indefinitely. The experienced criminal defense attorneys at Heiferman & Associates PLLC know the severity of what their clients are up against when facing criminal charges in state and federal courts. We take our duty to you seriously and fight for you every step of the way. Contact us today.