What are the penalties for healthcare fraud in New Jersey?

healthcare fraud

As healthcare expenses continue to rise in the United States, federal authorities are taking more measures to prevent individuals from committing fraud. When a person intentionally files a deceitful insurance claim to obtain unlawful profits, it is considered healthcare fraud. Healthcare fraud is a serious crime that carries harsh penalties. This white-collar crime is punishable by thousands of dollars in fines and lengthy jail sentences if convicted. Suppose you have been charged with healthcare fraud. In that case, you need a determined Camden County White Collar Crimes Attorney to advocate on your behalf to maximize your chances of achieving a favorable outcome. Keep reading to learn about the potential penalties for healthcare fraud in New Jersey.

What is healthcare fraud?

Health care fraud is a severe crime that can be committed by medical providers, patients, and other people who intentionally misrepresent information to decide the health care system to receive unlawful benefits or payments. Some of the most common examples of fraudulent healthcare claims include the following:

  • Billing services not provided
  • Submitting fake invoices/bills
  • Duplicate billing
  • Changing medical records
  • Intentionally changing a diagnosis to increase the amount to be paid
  • Misrepresenting a medical provider’s credentials
  • Billing for services provided by unlicensed employees as though they were licensed
  • Prescribing unnecessary tests, treatment, or services
  • Forging or altering official forms to distort claims or reimbursements

What are the potential penalties?

Healthcare fraud carries harsher penalties than other white-collar crimes, and the severity of the penalties depends on the individual’s state of mind and whether they are a practitioner. It is a second-degree crime when a healthcare practitioner knowingly commits healthcare fraud. Licensed professionals will not only face hefty fines and jail time, but they will likely face the suspension or revocation of their medical license.

  • Second-degree crime: This type of fraud in the second degree is punishable by up to 10 years of jail time and a fine of up to $150,000.
  • Third-degree crime. This type of fraud in the third degree is punishable by up to 5 years of jail time and a fine of up to $15,000.
  • Fourth-degree crime: This type of fraud in the fourth degree is punishable by up to 18 months of jail time and a maximum fine of $15,000.

However, it is critical to note that non-practitioners can also be charged with healthcare fraud. If you are a non-practitioner who knowingly commits fraud over $1,00 or more, it is considered a second-degree crime.

If you have been accused of committing healthcare fraud, it is imperative to take this accusation seriously. If convicted, you will face harsh penalties that negatively impact your life. To avoid severe penalties, contact a skilled Camden County white-collar crimes attorney from the criminal defense team at Thomas DeMarco & Associates, LLC. Our firm is committed to protecting our client’s rights and interests.

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