As a Florida healthcare professional, it is imperative to document all patient encounters and follow proper billing and coding procedures. The U.S. Department of Justice is actively cracking down on healthcare fraud by going after providers with too many questionable inaccuracies.
Even simple mistakes can lead to federal investigations and accusations of Medicare fraud that can derail your practice as well as your personal life.
Common billing errors
Everyone makes mistakes, and there are numerous codes to choose from when billing the Centers for Medicare and Medicaid Services. Errors that could spark an inquiry include:
- Double billing for services, treatment or equipment
- Inflating telemedicine charges
- Charging for unrendered services
Criminal consequences
Because medical fraud charges deal with stacked crimes such as theft, wire fraud and money laundering, the criminal penalties of a conviction are severe. You could face hundreds of thousands of dollars in fines as well as a lengthy federal prison sentence. To build a defense against a claim, you need to be able to prove the errors were unintentional.
Civil penalties
If convicted of medical fraud in Florida, you may face civil liabilities in addition to criminal penalties. These may include:
- Fines up to $11,000 per claim
- Disciplinary action by the state board
- Loss of professional license
Additionally, federal healthcare programs may bar you from participating in the future.
As a doctor, nurse, pharmacist or chiropractor in Florida, there is constant pressure for you to perform at high levels. Understanding the rules governing Medicare compliance is essential for protecting yourself from fraud accusations.
