Medicaid / Medicare Fraud in Pennsylvania

Medicaid / Medicare Fraud in Pennsylvania

Recent reports estimate that Medicaid/Medicare fraud costs the U.S. government about 60 billion dollars annually and so federal prosecutors take Medicaid/Medicare fraud very seriously.  And if you are involved in an improper Medicaid/Medicare claim you could become the target of a government fraud investigation.  Even if you were not actively involved but were aware of improper or irregular billing practices you could face conspiracy charges and will need the help of an experienced Pennsylvania criminal defense attorney.

Common examples of Medicaid/Medicare fraud include:

  • Billing for tests not performed
  • Performing inappropriate or unnecessary procedures
  • Charging for equipment and/or supplies that were never ordered
  • Billing for new equipment when the patient was provided with used equipment
  • Having someone other than a physician fill out a Certificate of Medical Necessity such as a drug/equipment supplier
  • Billing for a defective or incomplete test
  • Inserting false diagnosis codes to get Medicare coverage/reimbursement
  • Using multiple codes when one inclusive code is required by the rules and regulations or submitting multiple bills to obtain a higher reimbursement when one bill should have been submitted.
  • Charging more than once for the same service or procedure
  • Inflating bills by using codes that indicate more complex and expensive procedures and medications were used than actually were
  • Submitting false reports in order to obtain higher reimbursement
  • Waiving patient co-payments

Get serious help for a serious charge

Whether you are a doctor accused of an unnecessary procedure, an administrator accused of falsifying billing or a patient accused of falsely attesting to receiving a procedure, we can help.  If you have been charged with or are under investigation for Medicaid/Medicare fraud, contact The Law Offices of John E. Kusturiss, Jr. online or call (610) 565-0240 to discuss your case.

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