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New Jersey Healthcare Fraud Lawyers

Skilled Defense Lawyer Represents Clients Accused of Committing Healthcare Fraud in Essex County, Union County, Morris County, Middlesex County, Bergen County and Somerset County, NJ

Broadly speaking, healthcare fraud occurs whenever a person attempts to receive some benefit by making false statements, or omitting to state material facts, from a health insurance company.  In today’s increasingly expensive and competitive healthcare market, healthcare fraud is punished severely and on a much more widespread basis—meaning that minor errors that were once overlooked can now lead to criminal conviction and punishment. Regardless of the specific circumstances involved, allegations of healthcare fraud must always be taken seriously because you will face substantial jail time if convicted.

At Zegas Law, we have a proven track record of success in helping clients accused of healthcare fraud navigate the federal and New Jersey criminal justice processes. We take pride in putting all of our substantial resources to work in comprehensively investigating your case to help protect your reputation, career and physical freedom. We also have the experience necessary to defend your rights in a civil lawsuit, which may be brought in addition to criminal charges in healthcare fraud cases. The sooner you retain an experienced lawyer to build an effective defense strategy, the greater are the odds of successfully defeating allegations of healthcare fraud, so call or contact our skilled healthcare fraud defense lawyers for a confidential consultation today.

Variations on Healthcare Fraud in Northern New Jersey

Healthcare fraud can take place under a number of different circumstances in New Jersey and can be perpetuated by the patient or healthcare providers themselves. We have successfully handled cases involving healthcare fraud in cases involving:

  • Providing and billing for unnecessary medical care or procedures
  • Charging for medical care that was never performed
  • Fraudulently filling or refilling prescriptions
  • Double billing
  • Billing for brand name drugs where generic drugs were provided
  • Up-coding, which involves billing for more expensive procedures where less expensive care was actually provided
  • Altering medical records
  • Receiving kickbacks
  • Using false information to obtain services
  • Falsifying termination dates in order to qualify for employer-sponsored health insurance
  • Qui Tam actions

Veteran Criminal Defense Lawyers Advocate for Clients Facing Significant Jail Time for Healthcare Fraud in Union County, NJ

At Zegas Law, LLC, we know that your professional career and your physical freedom are on the line when you have been charged with committing healthcare fraud in North Jersey.  Importantly, depending upon the circumstances and statutory authority used by the prosecution to support the allegations, the relevant criminal charge that will apply in cases involving healthcare fraud may vary depending upon the identity of the defendant, as follows:

  • Licensed healthcare practitioners. Doctors, nurses, dentists, pharmacists, psychologists, physical therapists and others who are licensed to provide some type of medical care can be charged with second-degree healthcare fraud for knowingly committing healthcare fraud, and with a third-degree offense for recklessly committing healthcare fraud.
  • Non-practitioners. Patients and other healthcare employees (those who are not licensed to provide some type of medical care) can be charged with a third-degree offense for knowingly committing healthcare fraud and a fourth-degree offense for recklessly committing healthcare fraud. However, the charges can be elevated to a second-degree crime if the person committed five or more fraudulent acts or if the total benefit to be derived from the fraud was at least $1,000.

Importantly, a conviction for second-degree healthcare fraud can carry between five and ten years in prison, third-degree fraud carries between three and five years in prison and those convicted of fourth-degree healthcare fraud can face up to 18 months in prison. Additionally, these charges may apply for each count of healthcare fraud with which you are charged—and if a patient was seriously injured or died as a result of the healthcare fraud alleged, you can face 20 years to life in prison. In addition to jail time, penalties upon conviction for healthcare fraud may include:

  • Monetary fines
  • Restitution for the victims
  • Ineligibility for government healthcare programs
  • Loss of professional licensing
  • Irreparable reputational damage

Schedule a Confidential Consultation to Discuss Potential Defense Strategies to Healthcare Fraud Charges 

Whether you are a healthcare provider, hospital, pharmacy, healthcare employee or even a patient, allegations of healthcare fraud should be addressed immediately to ensure the best possible outcome. If you are under investigation for committing healthcare fraud or have been arrested, contact our experienced Essex County healthcare fraud defense lawyers as soon as possible to schedule a confidential consultation today.

Frequently Asked Questions About Healthcare Fraud Defense Strategies

FAQ: How do I know whether an investigation for healthcare fraud will result in criminal or civil charges?

Prosecutors have the option of pursuing allegations of healthcare fraud at both the civil and criminal level. In fact, many cases that initially start out as investigations for civil healthcare fraud eventually end up in the criminal justice system.

FAQ: How can a healthcare fraud defense lawyer help in my case?

Our experienced healthcare fraud defense lawyers will conduct a thorough investigation of our own to uncover any available exculpable evidence, as well as analyze all evidence presented by the prosecution, to form a defense strategy unique to your case. Many healthcare fraud cases turn on the defendant’s intent—in other words, whether you intentionally committed healthcare fraud or simply made an error. In many cases, a billing error may be wholly unintentional and even a pattern of billing errors may have resulted from untrained staff members rather than as a result of criminal intent. Regardless of the charges, we will use our well-honed negotiation skills to attempt to obtain reduced charges or even have your case dismissed if possible.

FAQ: What are some of the laws that can be used to charge a defendant with healthcare fraud in New Jersey?

Healthcare fraud charges can be brought under a number of state and federal statutes, including the federal false claims act, the New Jersey False Claims Act, the federal Stark law, the federal anti-kickback law, and the New Jersey Codey Law.

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