Federal and state agencies continue to coordinate efforts to identify and prosecute various types of health care fraud. These efforts typically involve extensive investigations that can go on for a long time before the official filing of charges.
Health care providers can face many serious repercussions from a finding of fraud, which extend far beyond the already significant criminal penalties.
An investigation is a serious matter
Many providers make the mistake of waiting until they face charges to seek assistance. They assume the matter is not that serious so long as there are no charges yet, or that they can make everything go away just by explaining themselves.
The truth, however, is that anything they say is far more likely to hurt their case rather than help it. While investigators can seem friendly and sound as if they do not think this is a serious matter, providers need to understand that their foremost goal is to get more evidence, not to help.
Common signs of scrutiny
A provider should never ignore signs of a potential investigation. Some indicators include learning that government agents contacted a patient or employee, receiving a subpoena or request for information or finding out authorities are auditing or arresting other professionals in the same circle.
Avoiding common mistakes
Many providers either panic or fail to take this matter seriously enough. Panic often leads providers into hasty actions that can land them in even more serious trouble. A top example is altering or disposing of potentially incriminating documents or providing investigators with false information.
Conversely, simply ignoring requests for information can also harm a case. A lawyer can review the request and discuss whether it is legitimate, how best to comply or whether it would be in the person’s best interests to respond with an objection.