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Can A Health Care Practitioner Who Submits False Claims Be Liable For Other Crimes As A Result?

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After the defendant/health care practitioner has undergone investigation for submitting false claims by the federal government, other forms of liability may arise as a result of submitting false claims. This is a common tactic prosecutors use: pressing multiple-offense charges that often stem from one charge to safeguard at least one conviction. What are some other crimes a health care practitioner may be charged with after a false claims investigation? When a health care practitioner knowingly presents, or causes to be presented, a false claim to an insurance company and/or the patient for approval or payment, the practitioner may also be liable for false statements, conspiracy and/or false records. If the practitioner knowingly and willfully makes a false statement, or falsely represents a material fact in an application for payment or in a determination of rights to payment, or fails to disclose or conceals facts known that affect the right to payment, then the practitioner may face criminal liability for false statement charges. If the practitioner and another person conspire to submit false claims, then the practitioner and the other person may be liable for conspiracy charges. In order to convict the defendant and the co-defendant of conspiracy charges, the federal government must prove five unique requirements: 1.       The claim was made to the federal government, such as Medicare 2.       The claim was false or fraudulent 3.       The practitioner and the other person agreed to submit the false claim 4.       An act was committed in furtherance of the agreement, such as making a false statement 5.       There was a specific intent to defraud If the practitioner uses falsified records to support their false claims, then the practitioner may be civilly liable and be required to pay a fine. However, the federal government must prove that the false record itself has caused the false claim to be paid. If you are recently being investigated or charged for submitting false claims in New York, then call our office at (212) 577-6677 to get professional legal assistance.