As health care costs increase, the federal government is taking a closer look at the conduct of health care professionals. As a result, health care fraud investigations and prosecutions are on the rise, with many physicians and other medical professionals facing potential criminal accusations. A mere investigation can cause untold damage to one’s reputation, to say nothing of the possible criminal penalties. Any person or organization facing these allegations must be prepared to take immediate action.
Dan C. Guthrie, Jr., is an accomplished white collar criminal defense attorney who has devoted his practice to protecting the rights of individuals facing possible criminal charges. Over his career, he has successfully defended numerous clients at the investigative, indictment and trial stages of a criminal case.
Medicare and health care fraud allegations can involve many different types of conduct, including:
- Upcoding, or using incorrect current procedural technology (CPT) codes to bill for more expensive procedures than those actually rendered
- Unbundling, or charging medical procedures separately when they should be charged together
- Billing for services not rendered
- Performing unnecessary medical procedures to receive insurance payments
- Misrepresenting elective surgeries as medically necessary procedures
- Receiving or paying kickbacks
In most health care fraud investigations, the biggest hurdle for the government is proving intent. That is, the government must prove beyond a reasonable doubt that the defendant intended to commit fraud. The fact is that billing procedures for Medicare and Medicaid are extremely confusing, even for people who work in these agencies. As a result, proving intent in these prosecutions can be difficult.
Taking Proactive Measures to Ensure the Strongest Possible Defense
Dan C. Guthrie, Jr., will leverage his vast experience to seek the best available outcome under the facts of the case. In most cases, he is retained at the investigative stages. While some defense attorneys take a “wait and see” approach, Mr. Guthrie is a staunch believer in the power of proactive representation. He will work to identify all witnesses and look closely at the evidence to find any exculpatory evidence. With years of experience as a prosecutor at the state and federal levels, he understands how the government is likely to proceed and how best to defend against its case.
Contact Dan C. Guthrie, Jr. at 214-953-1000 or contact the firm to schedule a consultation.