Home » Posts taggedhealth insurance

Is A Health Care Fraud Attorney Really Necessary When You’ve Been Mistreated?

 

Most people never dream of finding a health care lawyer when they have been mistreated by their doctor or health care professional. It does seem a little odd because most of us trust our doctors and the people who look after us in our time of need. Unfortunately there are a few professionals who are only in this profession for money. Many doctors who aren’t honest try to defraud you out of money and it’s serious to say the least which is why an attorney is needed.

Mistreatment or Fraud On The Part Of the Insurer Is Serious

What happens when you’ve been mistreated by a doctor? What if they charge you or your insurance company for something that hasn’t been performed? That is fraud and while it might seem as though it’s just a few hundred dollars, it can all add up. You really cannot afford to be the victim of mistreatment or even a fraud by the doctor. For this reason, you are going to require the services of a health care professional. A health care fraud attorney will fight for your corner and will absolutely ensure you are treated fairly. This is so important and finding a great lawyer to help shouldn’t be too troublesome.

You Don’t Have To Be Left Out-Of-Pocket

If you have been a victim of a fraud by your doctor or the doctor or indeed the insurance company has mistreated you in some way, it’s necessary to ensure you get fair compensation. However it isn’t just about money but rather getting fair justice as well. This is so important and too many frauds go unpunished by medical professionals. With a good health care lawyer you know your case is going to be taken with utmost care and attention. This is certainly something that is important to thousands and it’ll make all the difference to families as well. Know why !

Finding the Best Health Care Lawyer Is Necessary

When it comes to finding a good lawyer, you have to approach this smartly. You not only have to look at the reputation of the lawyer but how long they have been practicing in this area. If the attorney or lawyer has many years of experience, that is a real advantage as it means they are well adverse in this area of law. Also, you know they are going to be honest with your chances of winning the case. If there isn’t a high probability you’ll win, you will be told about that. In truth is your case may depend on the lawyer you choose. If you don’t find an honest or trustworthy professional then you may be stuck with someone who isn’t experienced enough to take your case. A health care fraud attorney must always have excellent experience to deal with your case.

Get Someone on Your Side

You never know what could happen when facing a lawsuit, whether you are bringing on a health care professional or you are the one being sued. That is why you absolutely must find a professional who can help you. Choosing a health care attorney is really quite necessary in today’s world and they know how to handle these cases extremely well. They know the law and will be able to do the things you can’t. A health care lawyer is a useful professional and they can help you too, check here: http://federal-lawyer.com/healthcare-defense/

Continue reading

Five Physicians Plead Guilty to Health-Care Fraud – An Important Lesson For Physicians

Physicians

The United States Attorney in Boston recently announced the settlement of a health care fraud case involving five urologists and TAP Pharmaceutical Products, Inc., a major American pharmaceutical manufacturer. The government alleged that the urologists received illegal inducements from TAP to prescribe the drug Lupron in the 1990s. The physicians pleaded guilty to health care fraud, and TAP agreed to pay $875 million to settle allegations of fraudulent drug pricing and marketing of Lupron.Visit my latest blog posted at http://www.seventhcircuitcases.com/dont-fall-victim-to-health-insurance-fraud-3-ways-to-protect-yourself/

TAP markets Lupron for the treatment of advanced prostate cancer. The U.S. Attorney initiated an investigation into TAP’s pricing and marketing of Lupron in 1997, after a urologist employed by an HMO reported to law-enforcement authorities that he was offered an educational grant to reverse a decision he had made on behalf of the HMO to exclude coverage for Lupron.

To induce physicians to prescribe Lupron instead of a cheaper alternative, TAP gave physicians free samples of the drug, worth as much as $40,000, as a form of volume discount. The average cost of a monthly dose of Lupron was $400 to $600. Because Lupron must be injected under the supervision of a physician, Medicare, which normally does not reimburse for medication, reimbursed physicians 80% of their administration cost. The remaining 20% was reimbursed by the patient as co-pay. TAP fully intended and expected the physicians to prescribe the free Lupron to their patients and then bill the patients and their insurers the average wholesale price of the drug. That is precisely what the physicians did.

As a further incentive to encourage physicians to prescribe Lupron, TAP offered them free consulting services, free trips to golf and ski resorts, and money disguised as “educational grants,” that the physicians used to pay for cocktail parties, office Christmas parties, medical equipment, and travel expenses. The Government described these items as kickbacks and bribes used to influence the physicians to prescribe Lupron.

The TAP case is likely to have a significant impact on the marketing practices of not only pharmaceutical companies, but on all health care vendors. For physicians, the message should be loud and clear.

First, physicians need to carefully examine some of the perks they are used to receiving from health care product and service vendors.

The Federal government cited as illegal inducements many of the marketing practices typically utilized by pharmaceutical companies and other health care vendors, including: free products, free consulting services, trips to golf and ski resorts and money purportedly for “educational grants” but used for other purposes. Thus, physicians who accept free services, free products, or money from vendors risk criminal charges and civil liability.

Physicians

It is known as health care fraud and therefore a felony under the Medicare-Medicaid Anti-kickback statute (42 U.S.C. 1320a-7b) to receive or solicit payment in exchange for ordering an item, such as a prescription drug, reimbursable by Medicare or Medicaid. This statute was expanded to apply to all federal health care programs under the Health Care Portability and Accountability Act (HIPAA).

In terms of civil liability, physicians who knowingly submit false claims for reimbursement by the federal government can incur civil penalties of up to $10,000 per claim, plus treble damages, under the Federal False Claims Act (31 U.S.C. 3729-3732). At $10,000 per claim, civil monetary penalties often reach millions of dollars. For example, TAP’s $875 million penalty included over $559 million to settle its federal civil False Claims Act liability in the Lupron case.

Second, physicians need to realize that the Government is paying close attention to their interactions with manufacturers and vendors of health care products and services. The TAP case highlights the government’s increased vigilance in investigating and prosecuting violations of the fraud and abuse statutes. In a six-month period (April through September 2001), the Government recouped more than $1.22 billion through both Civil Monetary Penalty Law and False Claims Act civil settlements. Physicians should stay tuned to further developments in this area. If you are in any doubts, contact a health care lawyer today.…

Continue reading

Don’t Fall Victim to Health Insurance Fraud! 3 Ways to Protect Yourself

Cheap health insurance

Cheap health insurance plans have been developed so that a person who has no coverage by their employer can find insurance coverage on their own. These low cost health insurance policies can also be very beneficial to someone who has left a 9-to-5 job to go into business on their own. Often the low cost of these policies allow for savings to put toward other forms of expense.

Sometimes, an inexpensive health care plan is designed to target retirees and elderly people who can’t negotiate the rate a large business could. Whatever your situation is, whenever you are considering a new health insurance policy you should do your homework ahead of time, so that you don’t regret it later.

What are the three ways you can be caught in the scam of health care fraud?

1. Be wary of insurance agents who try to sign you up quickly because they offer you a “special deal.” Typically these are the insurance providers who will pay for a small premium amount and lesser medical claims. However, they could vanish overnight if a more expensive claim has been filed or if regulators begin to scrutinize their behavior.

How would you know if health care fraud is a risk with your insurance company? If it is a smaller and lesser known insurance company and if you have been getting your claim delayed and they have been making excuses and not making payments. In this case it is in your best interest to go to the Better Business Bureau or the Attorney General’s office. If you are a small business owner you should be very careful about choosing an insurance company that is not familiar to you as you could wind up being liable for the unpaid medical bills your employees generate.

2. Secondly, be careful to make sure the health insurance plan you’ve signed up for is licensed by the state insurance commissioner. Your state insurance commission regulates legitimate insurance companies operating within your state. If a health plan isn’t listed with them then a company is more than likely fake and could lead to health care fraud.For more information, visit their official website.

Cheap health insurance

3. Insurance scams operate by offering policies that appear very attractive and hard to resist when first presented. If you find yourself being tempted by an unusual amount of coverage that doesn’t seem to be in line with the other plans you consider, it’s time to do your homework and dig deeper before signing anything or committing yourself. Illegitimate insurance providers try to make an offer irresistible; once they have sold a large number of policies they disappear, taking your money with them.

If you wonder if it’s possible in this day and age for companies like this to exist, watch the John Grisham legal thriller “The Rainmaker.” Keep in mind, where there is a dollar to be made people are going to try to make it, even if it means taking advantage of somebody in a deceitful and sleazy way.

Click here to find out more information about health care fraud and don’t be a victim on it or contact a health care lawyer today.…

Continue reading