Healthcare Fraud Lawyer, Columbia: Strong Defense Against Healthcare Fraud Charges
The legal team at Parham Law Firm, LLC, provides strong legal defense against state and federal healthcare fraud charges for healthcare providers and facilities that include:
- Doctors
- Nurses
- Chiropractors
- Hospitals
- Nursing homes
- Assisted living facilities
- Hospice care organizations
Florence healthcare fraud lawyer Rose Mary Parham has 22 years of experience as a trial lawyer, including more than a decade as a former United States Assistant District Attorney. The firm uses this experience to provide strong defense against healthcare fraud charges.
Healthcare Fraud ∙ Fraudulent Healthcare Claims
Healthcare fraud is a serious crime. Seeing the impact of fraud on the multibillion-dollar healthcare industry, the federal government added resources for healthcare fraud prosecution in 1996. These cases are being charged more frequently and prosecuted more aggressively than ever.
Attorney Rose Mary Parham can help defend you against healthcare fraud charges involving:
- Medicare and Medicaid fraud
- Insurance fraud
- Improper coding/up-coding
- Kickbacks
- Overbilling/improper billing
- Falsifying medical claims
- Claims adjusting
State And Federal Charges ∙ Qui Tam
Parham Law defends medical professionals and facilities against state and federal charges and qui tam claims involving healthcare fraud. In most cases, the investigation begins long before charges are issued.
If you have reason to believe you are under investigation for healthcare fraud, do not talk to anyone about your case. This includes friends, colleagues and especially the investigating officers. The things you say can be used against you down the road. Contact a lawyer before talking to anyone.
The sooner you contact Parham Law Firm, LLC, the more the firm can do to protect your interests in the investigation and help you in your case.
Understanding Common Types Of Healthcare Fraud Charges
Healthcare fraud charges cover a wide range of conduct, and federal prosecutors pursue these cases aggressively. Rose Mary Parham brings 26 years of trial experience to white collar defense, including cases built around the specific billing codes and federal statutes that govern healthcare fraud prosecutions in South Carolina. That experience shapes how Parham Law Firm, LLC, builds a defense for each type of charge.
Medicare, Medicaid and private insurance fraud
Because Medicare and Medicaid are federally funded programs, allegations of fraudulent billing can draw in the Department of Justice, the HHS Office of Inspector General and other federal agencies. The False Claims Act also allows private individuals to file qui tam lawsuits on the government’s behalf, which means an investigation can be well underway before formal charges are filed. Private insurance fraud is serious but is generally prosecuted at the state level and does not carry the same federal penalty exposure.
Upcoding and unbundling
Upcoding means billing for a more expensive or complex service than the one actually provided. A provider who bills for an extended office visit when only a routine appointment took place is upcoding. Unbundling means separating procedures that are required to be billed under a single code and submitting them as multiple charges instead. Both are treated as False Claims Act violations and are among the most common triggers for federal billing audits and qui tam complaints.
Anti-Kickback Statute and Stark Law violations
Under the Anti-Kickback Statute, it is a federal crime to knowingly give, accept or solicit anything of value to generate referrals paid for by a federal healthcare program. Fines can reach three times the kickback amount, and prison time is also on the table. Stark Law operates differently: it applies only to physicians and prohibits self-referrals for Medicare-covered designated health services when the referring physician has a financial or family tie to the receiving entity. Intent is not an element of a Stark Law violation, which sets it apart from the Anti-Kickback Statute. Prosecutors frequently bring both charges in the same case, and an effective defense turns on understanding exactly how the referral and payment arrangement was structured.
Contact Parham Law Firm, LLC
To schedule a consultation with an experienced attorney, call Parham Law at 888-341-3469 or contact the firm online.