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Photo of attorney William Marcus Wilkerson
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Medicare fraud: what to know

On Behalf of | Sep 30, 2022 | Criminal Defense |

Medicare is one of the largest federal entitlement programs operating in Texas. The program pays out hundreds of billions of dollars every year. As a result, it is an incredibly attractive target for scammers and identity thieves. These men and women see the program not as a force to aid seniors but as a way to line their own pockets.

What is Medicare fraud?

The crime of fraud involves the acquisition of property under false pretenses. Medicare fraud is fraud directly connected to the massive spending program that comprises Medicare. This crime can be committed in a variety of different ways. One common approach is to work through doctors. A doctor may submit a false claim to Medicare for work that they did not perform honestly.

They may then split the incoming funds with their supposed patient. Hospitals and medical offices may bill Medicare for services not performed and take the money for themselves. Another common form of Medicare fraud is stealing a person’s identity and claiming Medicare benefits using that identity. In this way, they are directly siphoning funds that do not belong to them from the federal government.

Possible penalties

Medicare fraud is a severe act that can lead to a significant prison sentence. Some individuals charged with Medicare fraud may face charges similar to grand larceny. The charges may also be federal felonies and carry with them the possibility of lengthy jail time.

In situations where a person plans a fraud with other perpetrators, it is possible for them to face conspiracy charges as well as fraud charges. Victims also need to make sure to take action if they suspect fraud. They need to make it clear that they report the fraud and aid the law enforcement process in order to help diminish the losses of the Medicare program.