Penalties and Charges for Health Insurance Fraud for Doctors

 Posted on December 06, 2023 in Uncategorized

Allegations of healthcare fraud in Texas can lead to severe criminal penalties for physicians. If you are facing charges, you should be aware of the potential consequences for medical professionals. A Texas lawyer can help you determine your specific charges' best course of action.

Civil False Claims Act Violations

When healthcare providers knowingly submit inaccurate Medicare or Medicaid billings, they face fines under the federal and Texas False Claims Acts. These civil statutes assign a various range per false claim. The government also recoups legal fees spent proving the case. With multiple patients and claims spanning months or years, penalties easily reach hundreds of thousands of dollars.

Criminal Insurance Fraud Convictions

Beyond civil damages, healthcare fraud constitutes a felony offense under the Texas Penal Code's theft liability provisions. Criminal prosecutors often aggressively pursue these cases, seeking lengthy incarcerations and substantial sanctions.

Depending on the scope of payments involved, physicians may face 2nd or 1st-degree felony charges carrying years of potential prison time. Fines can also reach up to five digits in severe cases. Exact sentences vary case-by-case based on evidence and aggravating factors. However, any criminal conviction severely threatens one's medical license and career.

Administrative Sanctions Against Licenses

Beyond court-ordered consequences, the Texas Medical Board initiates disciplinary actions that threaten practicing privileges. Typical sanctions for billing fraud include license suspension, revocation, heavy fines, practice restrictions, rehabilitation programs, ethics courses, or permanent revocation after repeat offenses. These outcomes restrict a physician's ability to treat patients and earn income, inflicting lasting career damage.

Seeking Experienced Legal Representation

Facing accusations of healthcare claims deception, immediately obtaining legal representation can make an immense difference. Relying on lawyers who are familiar with Texas insurance laws and medical regulations allows for effective responses to allegations. On your behalf, a lawyer can challenge unethical investigatory tactics, attack weak evidence or inconsistencies, and present facts demonstrating your compliant medical billing and coding policies. This protects your practice, assets, and freedom from unfair damage.

Contact a Dallas, TX Insurance Fraud Lawyer

Facing allegations puts your career and livelihood at risk. Working with a Dallas, TX insurance fraud attorney can help you with your case to determine the best steps. Call Spencer & Associates at 214-385-8500 for a free consultation to see how we can help you with your specific situation. Regardless of the severity of these charges, we are prepared to provide you with a robust defense. We look forward to your call.