Lafayette Healthcare Fraud Lawyer

Lafayette Healthcare Fraud Attorney

Healthcare fraud investigations move fast. Threats of prison time and other penalties can be frightening. If someone doesn’t fight back right away, they risk losing everything. Federal investigations can threaten careers and families. Working with a Lafayette healthcare fraud lawyer can help you create a measured response.

Service to Clients and Our Country

The Lafayette-based firm of The Law Office of Joshua S. Guillory is dedicated to protecting individuals and families. We are known for defending the Constitution and guiding people through some of the hardest moments in their lives. As a veteran, our lead attorney brings military discipline to every case.

What Counts as Healthcare Fraud?

Healthcare fraud covers many actions that usually involve billing. In Lafayette, most claims involve healthcare providers or billing professionals. The charges often accuse people of filing claims for services they didn’t perform.

In some cases, the accusations involve performing unnecessary procedures or manipulating patient records. A provider might face allegations based on how they coded a service. Another person may be charged for having a financial relationship with another party.

These cases often turn on the details. A mistake can sometimes be framed as fraud when it isn’t. Whether the case starts in state or federal court, the law looks at intent. The government must prove that someone acted intentionally to commit fraud. That can make room for strong defenses when the conduct doesn’t meet the standard.

Common Defenses in Healthcare Fraud Cases

Most cases of healthcare fraud look at the facts behind the situation. Some of the most common defenses include:

• Lack of intent: Prosecutors have to show that the person acted knowingly. Honest mistakes can be enough to cause trouble. The law draws a clear line between an error and a crime. According to the United States Sentencing Commission, 89.5% of those convicted had little or no criminal history before receiving charges, so proof of wrongdoing is important.
• Insufficient evidence: In some cases, the government fails to collect strong evidence. If the evidence is weak or does not match the claims, the defense can move to dismiss or limit charges. In some cases, 5.8% of sentences were reduced due to the accused’s minimal involvement in the fraud act.
• Valid medical judgment: Medical decisions can be complicated. A treatment plan that one doctor questions may still fall within accepted care. Disputes over billing or procedures don’t always prove fraud.
• Delegation and oversight: Staff members often handle day-to-day billing. If a person charged was not directly involved or was a trusted staff member who made errors, that can support a defense. However, 22.1% of sentences were increased due to the accused’s role as a leader or supervisor.
• Entrapment or overreach: It’s possible for an investigator or whistleblower to push someone to take actions that they wouldn’t have done on their own. This can be considered entrapment.

These defenses depend on the records and how the government framed the case. Each one needs a careful review by a legal professional.

Who Investigates Health Care Fraud Cases?

Healthcare fraud cases often begin with audits or whistleblower reports. The investigation may involve federal and state agencies. These investigators work closely with prosecutors from the U.S. Attorney’s Office or Louisiana’s Attorney General’s office.

Agents can review records and speak with staff. They often rely on data mining to spot trends they think are suspicious. The process could go on for months before someone knows they are being targeted. By then, investigators may have gathered records without the person’s knowledge.

The process can feel one-sided because of these agencies’ access to data and resources. That’s why early legal help makes a difference. A Lafayette Healthcare Fraud Lawyer can help protect rights and speak with investigators on their client’s behalf.

What Penalties Come With a Conviction?

The penalties in a healthcare fraud case can be life-changing. If charged under federal law, a person may face years in prison. The length of the sentence often depends on the amount of money involved or whether patients were harmed.

In addition to jail time, people may owe large fines. These cases are separate from any civil claims that are filed. Civil claims can lead to even more damages owed. Some cases bring professional consequences, like a loss of licensure.

Businesses can also be excluded from federal programs. This lack of revenue can be enough to end an operation entirely. Even if someone avoids jail time, the long-term cost of a conviction can be steep.

FAQs About Lafayette, LA Healthcare Fraud Laws

Q: What Are the Common Types of Healthcare Fraud in Lafayette?

A: There are numerous types of healthcare fraud that takes place in Lafayette. It can take many forms. Some cases involve billing for procedures that never took place. Others stem from performing unnecessary services to increase reimbursement. Some providers may use a false diagnosis to justify tests or surgeries. Even small errors repeated over time can lead to criminal charges.

Q: Who Governs Healthcare Fraud?

A: Healthcare fraud is governed by both state and federal agencies. At the federal level, agencies including the Department of Justice (DOJ), the Department of Health and Human Services (HHS), and the Office of Inspector General (OIG) review these cases. Locally, the Louisiana Attorney General’s Medicaid Program Integrity Unit may get involved.

Q: Can a Healthcare Fraud Case Be Dismissed Before Trial?

A: A healthcare fraud case can be dismissed before trial under certain circumstances pertaining to the case. A defense lawyer may challenge how the charges were brought or the evidence itself. Courts sometimes dismiss charges that are vague or based on flawed investigations. Early dismissal depends on the facts, and every situation is different.

Q: What Are the Consequences of Healthcare Fraud?

A: The consequences of healthcare fraud can be harsh. A person may face prison time and the loss of a professional license. Civil penalties can follow. These are common in cases tied to government programs like Medicare or Medicaid. It’s possible to lose your reputation or the ability to practice medicine.

Fight Back Against Healthcare Fraud Charges

No one plans to face a federal fraud charge. These cases can start with confusion and turn into fear. But a charge is not the same as a conviction. Federal prosecutors expect targets to fold under pressure. Schedule a consultation with The Law Office of Joshua S. Guillory for a close analysis of your case.