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Healthcare Fraud

Los Angeles Healthcare fraud criminal defense attorney R.J. Manuelian offers his experience to achieve the most positive outcome with regards to the charges and penalties you may potentially face if convicted. Fraud is a serious crime that can result in very negative life-altering consequences. If you or someone you care about live in the Los Angeles area and have been charged or accused of fraud, it is very important that you seek the legal counsel of an experienced Los Angeles health care fraud defense lawyer. Contact the Manuelian Law Firm today to schedule free consultation at (213) 248-6784.

California Healthcare & Medicare Fraud Crimes

Healthcare fraud is also known as medical insurance billing fraud, health insurance fraud, Medicare or Medi-Cal fraud. California prosecutors are vigilant in the prosecution of those who commit or who they think have committed healthcare fraud. Health care fraud or abuse comes in many forms and most often involves unlawful actions performed by a healthcare facility or practitioner in an effort to enhance monetary gain. Health care fraud charges are generally filed against medical professionals, such as doctors, nurse practitioners, or therapists. Often times even medical secretaries, book keepers, or medical billing clerks that work at medical offices or for doctors are also arrested for health care fraud.

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Penal Code 550 (a) Healthcare Fraud

Penal Code 550(a) PC prohibits most forms of healthcare and medical billing fraud in California. Under Crimes Against Insured Property and Insurers Penal Code 550 (a) PC it is unlawful to aid, abet, solicit, or conspire with any person to do any of the following:

(1) Knowingly present or cause to be presented any false or fraudulent claim for the payment of a loss or injury, including payment of a loss or injury under a contract of insurance.

(2) Knowingly present multiple claims for the same loss or injury, including presentation of multiple claims to more than one insurer, with an intent to defraud.

(3) Knowingly cause or participate in a vehicular collision, or any other vehicular accident, for the purpose of presenting any false or fraudulent claim.

(4) Knowingly present a false or fraudulent claim for the payments of a loss for theft, destruction, damage, or conversion of a motor vehicle, a motor vehicle part, or contents of a motor vehicle.

(5) Knowingly prepare, make, or subscribe any writing, with the intent to present or use it, or to allow it to be presented, in support of any false or fraudulent claim.

(6) Knowingly make or cause to be made any false or fraudulent claim for payment of a health care benefit.

(7) Knowingly submit a claim for a health care benefit that was not used by, or on behalf of, the claimant.

(8) Knowingly present multiple claims for payment of the same health care benefit with an intent to defraud.

(9) Knowingly present for payment any undercharges for health care benefits on behalf of a specific claimant unless any known overcharges for health care benefits for that claimant are presented for reconciliation at that same time.

(10) For purposes of paragraphs (6) to (9), inclusive, a claim or a claim for payment of a health care benefit also means a claim or claim for payment submitted by or on the behalf of a provider of any workers’ compensation health benefits under the Labor Code.

 

In California, you can be charged for health care fraud as a misdemeanor if the alleged fraudulent claims are no more than nine hundred fifty dollars ($950).  When the claim or amount at issue is nine hundred fifty dollars ($950) or less, the offense is punishable by imprisonment in a county jail not to exceed six months, or by a fine of not more than one thousand dollars ($1,000), or by both that imprisonment and fine. 

When the claim or amount at issue exceeds nine hundred fifty dollars ($950), the offense is punishable by imprisonment for two, three, or five years, or by a fine not exceeding fifty thousand dollars ($50,000) or double the amount of the fraud, whichever is greater, or by both that imprisonment and fine, or by imprisonment in a county jail not to exceed one year, by a fine of not more than ten thousand dollars ($10,000), or by both that imprisonment and fine.

California Medical Fraud Criminal Defense Attorney

Medical fraud is a serious crime in California that can result in large fines and/or prison time, depending upon the damage caused. If you or a loved one has been investigated or arrested on a charge of medical or healthcare fraud, contact a Los Angeles medical fraud criminal defense attorney from The Manuelian Law Firm today for a free consultation. Whether your case ends up in court before a jury at trial or you wish to negotiate a settlement, R.J. Manuelian offers his experience to achieve the most positive outcome to your fraud case as possible.

Manuelian Law Firm

Address:633 W 5th Street #5710, Los Angeles, CA 90071

Phone: (213) 248-6784

 

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