In 2013, a doctor practicing in New York plead guilty to a count of fraud in federal court. The verdict came after an investigation determined that he billed insurance companies for procedures that he never performed.
Despite the success of his practice over a number of years, the conviction ended his career as a surgeon. While some people may respond to these circumstances by turning to another field of practice, new allegations against him claim that the doctor transitioned into a very specific field of medical practice under an assumed identity.
According to the allegations, the doctor wasted no time seeking out another creative form of fraud, posing as another doctor to review insurance claims. While the doctor no longer performed surgery, he did allegedly evaluate thousands of medical records for patients facing insurance coverage disputes.
For his services, indictments claim that he received nearly $900,000 over a five-year period. These indictments indicate charges of aggravated identity theft, wire fraud and health care fraud.
Always consider fraud charges seriously
This doctor’s fraudulent activity seems fairly plain to see, but some of these issues are much more complex in practice. This particular doctor appears to blatantly have broken the law by impersonating someone else and performing licensed medical services for pay, but fraud charges can arise in complicated legal grey areas. This is especially true when it comes to dealing with complex insurance company procedures and government subsidy programs.
These systems and processes are rarely plug-and-play or user-friendly, and simple mistakes may catch the eye of an investigator. If you are a medical professional, then you probably know how complicated and unwieldy it is to deal with insurance companies, considering the massive changes in the industry in the last five years alone. It is possible for you to face allegations of fraud due to user error or misunderstandings between your practice and insurance providers or federal programs.
Protecting your rights
While fraud allegations are always something to take seriously, it is never wise to panic. Should you actually face legal action because of fraud charges, it is wise to avoid discussing it with anyone except a legal professional representing your best interests.
An attorney can keep your conversations confidential, but friends, co-workers and family members may all face subpoenas to testify against you. Protecting your rights and future opportunities begins with building a strong legal defense using high-caliber legal resources. Keep your future secure while you resolve accusations of fraudulent behavior.