NEW JERSEY CRIMINAL LAWYERS

NJ Healthcare Fraud Lawyers

Healthcare Fraud in New Jersey: What You Need to Know

Healthcare providers in New Jersey must exercise extreme caution while dealing with insurance claims and billing for Medicare or Medicaid. State and federal laws allow governmental agencies and investigators to demand health care records of healthcare providers associated with Medicaid or Medicare claims at any time.

Apart from healthcare professionals such as doctors, nurses, hospitals, and healthcare staff, other diverse entities can also face accusations of healthcare fraud by investigating bodies such as major pharmaceutical companies, suppliers of durable medical equipment, rehab facilities, labs, home healthcare providers, nursing homes, and medical transportation providers.

It is crucial for any individual/entity accused of medical fraud or abuse to engage an experienced healthcare fraud attorney when facing payor queries and government inquiries. In New Jersey alone, charges of healthcare abuse and fraud can entangle any person or entity regardless of whether they are guilty or not.

Areas Where Fraud Allegations May Appear
Accusations and investigations can arise from a wide range of billing errors as well as potential fraud allegations including:

– Overbilling for insurance claims by Medicaid/Medicare/third-party paying companies
– Department of Justice investigations into violations in Medicare billing regulations
– Civil monetary fines charged by State agencies

Procedures Followed When State Healthcare Fraud Is Suspected/Uncovered
Unfortunately for even honest health-care providers in New Jersey, cases related to fraudulent behavior constitute a common occurrence. Doctors/hospitals may be investigated for conspiracies involving millions of dollars while patients may stand accused too stealing only a few extra dollars from insurance carriers. The point is that these investigations are serious affairs that sometimes begin with an insurance company investigation instead of being initiated by the government.

Insurance companies are quite adept at uncovering fraud practices thanks to their dedicated squadrons of investigators who work tirelessly looking into instances of healthcare fraud. However, Medical providers or those under investigation should be wary about sharing information with these insurance investigators because anything they say may often be used against them in the future.

Attorneys who specialize in healthcare fraud can usually negotiate with investigators from insurance companies for a civil resolution to accusations, which and help sidestep criminal prosecution. If the case does make its way to government regulators, a healthcare fraud lawyer has sufficient time to begin preparations in defense even before law enforcement gets involved.

New Jersey’s Response to Health and Government Fraud
Our state is aggressive when it comes to prosecuting false claims of abusive or fraudulent behavior in governmental-funded healthcare services. The New Jersey False Claims Act guides the Office of Government and Healthcare Fraud’s investigations on cases relating to requests for state funds using fraudulent means.

The Division acts as representatives of both the State and Division across all subsequent litigation relating to consumer protection and investment issues and fraud allegations.

Results of Healthcare Fraud Charges
Given the regulatory environment that continues evolving into literal minefields for health care consumers or providers, cases related to health care or insurance fraud have resulted in severe penalties such as public censureship, fines, imprisonment or incarcerations, license revoking as well as restitution orders.

These punishments underline how crucial it is for providers and users of healthcare products/services must exercise extreme caution when conducting business transactions because reckless healthcare claims are now subject to new criminal investigation guidelines.

Protecting Your Interests with New Jersey Healthcare Fraud Attorney Services

If you are a doctor/nurse/hospitals/nursing homes/rehab facilities/medical transportation providers/home care services staff/-facing these charges threatens your livelihood’s entirety- nevertheless; charges leveled against you may ruin all your hard work over these many years. This is why it is essential at once at the first sign of trouble from an insurance company fraud investigator/ or contact by Federal/State regulators that you engage legal counsel known widely as providing some of the guidance on responding effectively.

Our lawyers can assist with:

– Defending against Qui Tam actions/cases .
– Analyzing and reviewing potential problems arising from Medicare exclusions or providers for your good.
– Investigations and defense for insurance fraud and abuse allegations.
– Defense of Medicare/Medicaid abuse/fraud accusations.
– Disciplinary hearings or judgments involving administrative actions brought against healthcare professionals regarding healthcare-related licenses.

Conclusion
The years you have invested in becoming a professional serving in the health-care sector must not go to waste by false claims of fraudulent behavior. Our experience preparing complex, time-consuming defenses on behalf of our clients speaks for itself, so don’t hesitate to get in touch with us.