What are the penalties for healthcare fraud in New York?



    healthcare fraud medical practitioner

    In the United States, the cost of health care services has increased drastically in recent years. Due to this escalation, practitioners and their patients have been driven to commit healthcare fraud. Healthcare fraud is a serious white-collar crime with significant penalties, including hefty fines and a lengthy jail sentence. If you work in the medical field and have been charged with fraud, contact our proficient Nassau County Criminal Defense Attorneys, who can help defend your rights. Continue reading to learn about the potential penalties for healthcare fraud in New York. 

    What is healthcare fraud in New York?

    Healthcare fraud is committed when a medical provider or patient knowingly deceives the healthcare system for unlawful benefits or payments. Although this crime typically occurs when a healthcare professional exploits a healthcare program for illegal profits, non-practitioners can also be charged with this type of fraud as they can file fraudulent claims. Healthcare fraud can take a variety of forms, including but not limited to the following:

    • Duplicate billing
    • Submitting fake invoices/bills
    • Billing for services not provided
    • Prescribing unnecessary tests, treatment, or services
    • Misrepresenting or committing material information when applying for programs or services
    • Altering medical records
    • Billing non-covered services as covered services
    • Failing to disclose a bill
    • Forging claims for reimbursement

    As a practitioner, you will not only face penalties such as fines and jail time, but you also could have your medical license suspended or revoked. With your career at stake, taking any accusation of this type of fraud seriously is imperative. It is also critical to note that you may find your financial accounts have been frozen as the funds are believed to have been illegally obtained.

    What are the potential penalties?

    Compared to other white-collar crimes, healthcare fraud typically carries harsher penalties. On the federal level, the severity of an individual’s penalties is based on a sliding scale. This means the criminal fines are based on the practioner’s income. Therefore, a practitioner who knowingly commits this fraud is subject to a $15,000 fine, up to 10 years of jail time, and must pay full restitution. However, suppose the practitioner knowingly commits reckless fraud, meaning severe injury resulted from the violation. In that case, a judge can impose a stricter sentence including up to 20 years of jail time. It is critical to note that if death results from a practitioner’s actions, this type of fraud is punishable by life in prison.

    Contact a determined Nassau County criminal defense attorney today if you have been charged with healthcare fraud. At Grunwald & Seman, P.C., our criminal defense team is prepared to vigorously defend your rights and interests to maximize your chances of reaching a favorable outcome. Allow our firm to fight on your behalf today.


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