Charging too much for medical services by using false or increased billing codes is a growing problem that the government is trying hard to end. False billing is a type of insurance fraud in Nevada that carries serious penalties. In addition to stiff penalties, a medical professional may lose his or her license to practice medicine.
False billing is one way to defraud an insurance company, and is closely related to the Nevada crime of healthcare fraud.
False billing to defraud an insurer is an intentional and willful act involving deception. It includes providing false information or failing to include important information when presenting documents or claims to an insurance company.
Examples of false billing activity include:
Conspiring to commit an act of false billing and aiding and abetting another person in false billing activity are also punishable offenses under Nevada’s healthcare fraud laws.
Nick Wooldridge has a long track record of representing clients accused of serious federal and state crimes in Nevada.
Anyone who deliberately tries to get or actually does get money from a health insurance company for services that were not performed can be liable for healthcare and billing fraud. This means that anyone working in a doctor’s office can be liable- not just the doctor or owner of the practice.
Health care fraud in Nevada is a Category D felony which carries 1 to 4 years in a Nevada prison and fines up to $5,000.
As with all crimes involving theft of money or property, a person convicted of false billing and healthcare fraud will be required to pay restitution to the victim, who is usually a health insurance carrier.
The Nevada crime of false billing is also punishable by federal law.
A person who defrauds a Medicare or other governmental healthcare insurer or provider can be charged with a federal crime. Federal healthcare fraud has longer prison sentences and fines than charges under Nevada law.
Sentences for federal healthcare fraud depend on whether the result of the fraud is bodily harm:
In each of these cases, the person convicted of healthcare and billing fraud may also have to pay fines.
False billing as a federal crime has a strict liability standard of proof. This means that the government does not need to prove that you intended to defraud anyone with your billing practices. Instead, there is an assumption that false billing was intended to defraud the insurer.
If you have been arrested for false billing and healthcare fraud in Nevada, hire an experienced Las Vegas federal criminal lawyer as soon as possible to build your defense. Your professional license and freedom are at stake and you deserve the best defense possible