Medicare & Medicaid Fraud Attorney in Houston, Texas
Has the AG or OIG Contacted Your Health Care Organization?
Large and small health-care providers across the country and particularly in Texas-are under increasing levels of scrutiny in every area of their businesses. Nowhere is this truer than in regard to billing practices. Your organization could easily be the target of a government investigation, even if you had no intent to commit fraud.
If the Office of Inspector General (OIG) or State Attorney General (AG) has contacted you about a healthcare fraud investigation, speak with an experienced health and medical law attorney at Hendershot, Cannon & Hisey, P.C. before you respond. Even if investigators say you are not the target of the investigation, you may inadvertently make an admission that jeopardizes your practice or organization. Our job is to protect your interests from the time you suspect a problem through the conclusion of your case.
Have you been contacted by the Attorney General or Office of Inspector General? Contact us right away at (713) 909-7323. We serve clients throughout Texas.
Common violations include:
- 60-Day rule
- Billing for services that a health-care professional did not provide
- Double-billing Medicare or Medicaid and a private company for the same treatment
- Upcoding, or exaggerating the service performed
- Certifying patients for unneeded services
- Accepting or providing anything of value for referrals for Medicare or Medicaid services
- Inducing referrals by making payments
- Business relationships where compensation is not set at a fair market value
The result of a Medicare and Medicaid fraud investigation can have serious consequences and/or penalties. The earlier you contact us, the sooner we will begin investigating and preparing your case.
Complex Health Care Regulations
We advise clients throughout Texas on the most complex health care regulations, including:
- Fraud & Abuse Violations: The federal government has enacted an anti-kickback law called the Fraud and Abuse Statute, and Texas has the Patient Solicitation Act. These laws make it illegal to knowingly and willfully receive or offer payment to influence referrals of state or federal healthcare program business.
- Stark Violations: The Stark Law, known as the self-referral law, governs medical professionals' conduct regarding the referral of Medicare or Medicaid patients to an entity in which the provider or an immediate family member has a financial interest for the provision of Designated Health Services.
- False Claims Act Violations: The OIG and Texas AG are conducting an increasing number of investigations into possible violations of the federal False Claims Act by healthcare professionals and facilities. If the OIG or AG has requested information or an interview or has served a notice or subpoena, contact our legal team today.
- Recovery Audit Contractor (RAC) Program: The RAC program detects and recovers improper payments to medical care providers. Private contractors assess health-care records for signs of wrongdoing. Investigators may look for things like improperly coded or duplicate services, billing for services uncovered, and incorrect payments.
- ZPIC Audits: Zone Program Integrity Contractors oversee the Medicare Benefit Integrity program, including Parts A and B, home health care services, hospice care and durable medical equipment (DME). ZPIC audits are typically initiated based on rate analysis or information provided by a whistleblower.
- Novitas Audits: Novitas Solutions Inc. is an administrative services processing company which serves as the Medicare Administrative Contractor (MAC) for Jurisdiction H. If it finds patterns of coding errors or overbilling, it can initiate an audit. If audit findings warrant it, Novitas can recommend additional pre/post-payment reviews.
- TDI Audits: The Texas Department of Insurance oversees the insurance industry in order to protect patients from unethical or unfair behavior. The TDI has a law enforcement arm (the Fraud Unit) with full police powers to conduct criminal investigations and make arrests. Contact us, so we can help you prepare for an audit and affirm your rights while remaining compliant throughout the process.
Strategic Representation to Prevent or Resolve any Healthcare Fraud Matter
Contact us so we can advise you on the creation, implementation, and maintenance of compliance plans designed to prevent and resolve problems before they become investigations.
Our Houston Medicare & Medicaid Fraud attorneys advise healthcare clients on matters such as:
- Civil Investigative demands
- False and fraudulent claims investigation
- Qui-Tam Defense
- Prescription drug fraud
- physician self-referrals
- Kickbacks, brides and rebates
- billing and coding errors
Contact Our Houston Medicare & Medicaid Fraud Attorneys Today.
Accused of Medicare or Medicaid fraud? Contact Hendershot, Cannon & Hisey, P.C. to discuss your case with a dedicated Houston health law attorney. Fill out a simple online consultation form or call (713) 909-7323 to get started with us today.