McAllen Healthcare Fraud Attorney

Trusted Defense for Serious Charges

Healthcare fraud is a serious offense that can carry severe penalties. Much like other types of fraud, including credit card fraud and mortgage fraud, prosecutors tend to pursue these cases relentlessly. And, as with most white collar crimes, the legal process can be complex and difficult to navigate.

If you have been charged with healthcare fraud, be sure to have the experienced legal team at The Law Office of Carlos A. García, PLLC by your side. We have the resources and experience necessary to provide you with the aggressive defense you need.

Provider Healthcare Fraud

Fraud can either be committed by the consumer or the provider. The three most common types of provider healthcare fraud are unbundling, upcoding, and kickbacks. Unbundling refers to the practice of billing a single procedure separately in order to make more money. Upcoding refers to the practice of billing consumers for more expensive services than what they had initially been billed for. And, lastly, a kickback is a money payment made in exchange for patient referrals.

Other types of provider healthcare fraud include:

• Billing for unrendered services
• Providing unnecessary services
• Falsifying medical information in order to justify procedures
• Identity theft

Medicare / Medicaid Fraud

When it comes to allegations of fraud related to the Medicare or Medicaid programs, the federal government will conduct an investigation through the Attorney General’s Medicaid Fraud Control Unit. Oftentimes the charges will constitute as "conspiracy," which means that two or more people worked together to commit fraud against the government.

Penalties for Medicare fraud include:

• Up to 10 years in prison per each count of Medicare fraud
• Maximum 20 years in prison if fraudulent action resulted in serious physical injury to a patient
• Life sentence in prison if fraudulent activity resulted in a patient's death

What Is Consumer Healthcare Fraud?

Consumer healthcare fraud can be committed either by an individual or a group. In this type of fraud, an individual might forge medical bills, file claims for medical services that were never rendered, falsify information to gain access to another person's insurance benefits, or seek prescription medicine with the intent to sell to another party. The penalties for healthcare fraud are serious, including up to $10,000 in fines and possible prison sentences.

If you have been charged with healthcare fraud, allow our legal team to provide you with the defense you need. Our McAllen healthcare fraud attorney is Board-Certified in Criminal Law by the Texas Board of Legal Specialization.