Investigating and prosecuting healthcare fraud remains one of the top priorities of the Department of Justice. Nationwide crackdowns and arrests have demonstrated that the government’s war on crime goes beyond drugs, guns, and gangs. While those are certainly a priority of DOJ and an easy way to boost prosecution numbers nationwide, they are by no means the only priority.
The United States is slowly moving to catch up with medical practices in some European and Asian countries in using technology to avoid an in-person doctor’s appointment. Without having to schedule and wait for an appointment, take time off from work, or leave home, a person can have common aliments diagnosed using their smartphone. Telemedicine is the use of telecommunication and technology to provide clinical healthcare at a distance.
Federal and state prosecutors are increasingly aggressive in their investigation and prosecution of healthcare fraud. Given the vast amounts of government or private insurance monies that can be exploited, the penalties have increased for healthcare professionals and others who engage in fraudulent activities. Sentences of 10 years or more, in addition to forfeitures, restitution and fines in the millions of dollars, are becoming commonplace.
It does not take long to find examples of people being accused of trying to defraud the system of government-provided health care. Take, for example, the recent story of a doctor in Englewood, New Jersey who is being charged with health care fraud in connection with charges for office visits that never took place, or prescription refills billed as office visits. His case, which will be heard in a federal court in Newark, is not unusual.
Violations of any number of federal statutes have the potential to jeopardize a business and can, in many cases, result in individuals going to prison. In addition, restitution and forfeiture may be applicable. Below, we delve into some of the most commonly encountered federal business fraud statutes.