As a practicing medical professional, you may understand all too well just how expensive healthcare is in this country. You may have sympathy for your patients and the medical bills you are forced to impose on them; especially those who require extensive treatment or who have limited disposable income as it is. Even though this is a tough situation, you must make accurate billing records for all your patients. Otherwise, you may be accused of and subsequently charged with medical billing fraud. So, with that being said, please follow along to find out what constitutes medical billing fraud in New York State and how a proficient New York billing fraud attorney at Walker Medical Law can help defend you against such accusations.
What constitutes medical billing fraud in New York State?
As per the New York State Department of Health’s website, fraud is defined as conduct intended to deceive. Further, it gives the following examples of what might constitute medical billing fraud by a practicing medical professional:
- A practicing medical professional may provide misleading billing statements to patients.
- A practicing medical professional may submit false bills for service to healthcare insurance providers.
- A practicing medical professional may prescribe unnecessary treatment or drugs to patients for additional bills.
It is worth mentioning that it does not matter whether a practicing medical professional performs any of the above acts intentionally or accidentally; it may constitute medical billing fraud all the same.
How do I defend myself if I am accused of medical billing fraud?
You must be made well aware that the Health Maintenance Organization (HMO) and the government are routinely auditing your medical billing to monitor for any potential fraudulent activities. What’s more, your patients may begin to pick up on discrepancies with bills they receive from you day in and day out. This is all to say that the HMO, a government agency, or a patient may report you for medical billing fraud to the Office of Professional Medical Conduct (OPMC) or Office of Professional Discipline (OPD).
With this, the OPMC or OPD may be prompted to run an investigation against you. You must prepare for this investigation with any conceivable defense you may have for this incident. Most commonly, practicing medical professionals argue that a patient is simply upset by the high cost of their medical care and they are simply trying to dispute their obligation to pay for it. Or, that a patient has requested a practicing medical professional to bill dishonestly but that they never followed through with it.
If you think now is the time to get started on your medical misconduct defense, then please reach out to one of the talented OPMC/OPD misconduct defense attorneys. Our team at Walker Medical Law is well-equipped to take on your case.
