South Florida Man Charged For Health Care Fraud: 3 Things To Know
Fraud schemes can take many shapes and forms, and misconduct in the context of health care recently led to federal criminal charges for a South Florida man. The US Attorney’s Office for the Southern District of Florida announced the arrest, stating that the defendant had submitted around $38 million in fraudulent claims to Blue Cross Blue Shield and United Healthcare. To further the scheme, the man would illegally bill the insurance companies for administration of the medication Infliximab; the drug is used to treat various digestive disorders. However, investigators determined that patients did not require the medication and did not receive it – even though the insurers were billed for it.
The defendant in the case was charged with 10 counts of health care fraud, a federal offense. The criminal process may take some time, but there are some aspects of the case that may be useful to know if you are facing similar charges. Though your Florida criminal defense attorney will address details, there are three things to know:
- What an “Indictment” Means
Though many criminal cases start with an arrest, many others are preceded by an intense investigation by officials. Authorities may conduct a probe before filing charges because they need sufficient evidence to show probable cause. Then, a prosecutor presents this information to a grand jury that determines whether the suspect should face charges. If so, the grand jury issues an indictment outlining the allegations. When the defendant is subsequently apprehended or turns themselves in, the case moves forward in a similar fashion as if it began through an arrest.
- How Federal Sentencing Guidelines Work
US statutes provide judges with a structure for imposing punishment after a conviction, to ensure consistency and fairness in sentencing. Each crime defined by federal law carries an offense level from 1 to 43; more serious crimes are assigned higher numbers. At the same time, the sentencing guidelines also put the defendant into a criminal history category. These two factors are positioned on an X-Y axis, and the sentencing guideline is where they intersect. The judge reviews the range and can issue penalties within these parameters. The federal sentencing guidelines are not mandatory, but the judge must provide an explanation for any deviation.
- Asset Seizures in Criminal Cases
The South Florida man accused of health care fraud faces potential seizure of assets as a criminal penalty, which is separate from and in addition to the punishment in the federal sentencing guidelines. Officials claim the defendant used the proceeds from the fraud to purchase real estate and luxury vehicles, so they may be subject to seizure to pay for losses to the insurers.
Discuss Details with a South Florida Criminal Defense Lawyer
This information is useful for explaining indictments, federal sentencing, and seizures, but you need more than a legal summary to fight fraud charges. To learn how our team can help, please contact Linkhorst & Hockin, P.A. to set up a consultation. Our firm serves clients throughout Palm Beach County in a wide range of criminal matters, and we are happy to assist with your case.
Resource:
justice.gov/usao-sdfl/pr/miami-resident-charged-committing-38-million-health-care-fraud-scheme-spending-proceeds
