Healthcare Fraud Involving Mobile Clinics Defense
Experienced Defense Team
If you need advice regarding charges of healthcare fraud involving mobile clinics, do not hesitate to contact one of our healthcare defense attorneys as soon as possible.
As the coronavirus pandemic continues to take its toll on society, healthcare fraud has grown increasingly rampant. The DOJ is ramping up its investigative tactics to prosecute instances of healthcare fraud involving medical clinics, healthcare centers, and also mobile clinics.
It can also be hard to maintain compliance with the constantly evolving federal laws. This puts healthcare centers, medical clinics, and mobile clinics at risk of a federal investigation, which exposes these companies to significant monetary penalties, injunctions, loss of license, and even imprisonment.
Do not wait to get in touch with a qualified attorney today. Put Oberheiden, P.C. on your side to protect your reputation and business.
What Is A Mobile Clinic?
A mobile clinic refers broadly to a movable vehicle that provides certain healthcare services to individuals. These mobile clinics travel to both urban and rural communities and provide healthcare services typically outside community centers, schools, parks, or apartments.
They are unique in that they can provide health services to vulnerable individuals in communities where access to healthcare is limited, thus erasing issues of travel and money for many individuals.
In addition to providing general healthcare services to individuals, some mobile clinics also offer certain emergency services, dental services, specific screenings, or even home visits. Overall, they are regarded as having a positive impact on society by making individuals more aware of their health and better able to receive access to healthcare services.
Mobile Clinics and the Coronavirus
Mobile clinics have been especially popular and useful during the coronavirus pandemic. The vehicles drive into certain towns where access to healthcare and hospitals for COVID-19 testing is scare and provide certain services such as outdoor testing, blood tests, and other health exams.
It has been particularly useful in areas experiencing extreme economic troubles or for individuals with chronic or long-term conditions who are especially scared of traveling long distances.
Mobile clinics are also being used beyond COVID-19 testing-related issues. For instance, some mobile clinics are offering vaccinations or other immunizations for many health conditions.
The use of mobile clinics has been lauded as a beneficial and convenient for all individuals to access meaningful healthcare while reducing various risks.
Healthcare Fraud and Mobile Clinics
Healthcare fraud can be perpetrated in various ways. It is punishable at both the state and federal levels and can lead to substantial monetary penalties, fines, and even imprisonment.
As the coronavirus pandemic continues to plague America, fraudsters are capitalizing on societal fear to perpetrate a healthcare fraud scheme that benefits them financially. Examples of healthcare fraud by mobile clinics can include the following:
- Billing for medical services that were not provided;
- Performing medical services on a patient that are not medically needed;
- Coding the medical procedures incorrectly in order to increase reimbursement (e.g., upcoding);
- Billing under a physician who is not physically present;
- Billing twice for the same medical service;
- Forging a prescription for a patient;
- Falsifying a patient’s records or diagnosis;
- Billing one procedure in separate billing codes to increase reimbursement (e.g., unbundling)
- Issuing prescriptions or other drugs that have no medical purpose;
- Accepting kickbacks, referrals, or other bribes in connection with medical services.
Improper billing is the most common instance of healthcare fraud and the one most aggressively investigated and prosecuted by federal agencies and prosecutors.
Potential Liability for Healthcare Fraud
Healthcare entities such as mobile clinics face liability under a vast array of federal statutes for healthcare frauds such as improper billing. Under the False Claims Act (31 U.S.C. §§ 3729 – 3733), individuals can face a civil penalty of not less than $5,000 and not more than $10,000 plus three times the amount of damages for submitting a false statement to the government. Each fraudulent billing is treated as a separate offense, which means individuals can easily face hundreds of thousands of dollars for a multi-billing fraud scheme.
Healthcare fraud under U.S. Code § 1347 is also a powerful tool used by the government in investigating and prosecuting mobile clinics for healthcare frauds. To prove healthcare fraud under § 1347, the government must prove beyond a reasonable doubt that the individual or company knowingly and willingly executed a plan to defraud a healthcare benefit program or obtained by fraud any money under control or custody of a healthcare benefit program in connection with the delivery or payment of healthcare services.
Other federal statutes that mobile clinics may be charged or prosecuted under include the Anti-Kickback Law (42 U.S.C. 1320a-7b); Aggravated Identity Theft; and Federal Conspiracy (18 U.S.C. 1349). Penalties can reach as high as $250,000 with a maximum of 20 years in prison, depending on the statute.
DOJ Prosecutions for healthcare Fraud
The DOJ has been aggressively prosecuting instances of healthcare fraud, especially in an era where the nation is being tormented by the coronavirus pandemic. On July 31, 2020, the DOJ indicted an Alabama doctor for an elaborate drug-billing scheme involving a pharmacy that was doing business as Global Compounding Pharmacy. The 11-count indictment charges Dr. Michelle Martine Jackson with conspiracy to receive kickbacks, conspiracy to commit healthcare fraud and mail fraud, healthcare fraud, and aggravated identity theft.
Specifically, Dr. Jackson issued unnecessary prescriptions to an employee of Global and her family and friends; to individuals with whom the doctor did not have a doctor-patient relationship; and to individuals with whom she did have the doctor-patient relationship but who did not medically need the drugs.
This indictment brings the total number of individuals charged in this investigation to 30. Already, the DOJ has entered guilty pleas with 24 of these individuals. The DOJ plans to continue its aggressive effort at investigating and prosecuting individuals for healthcare fraud.
Need Advice Regarding healthcare Fraud?
Do you want to make sure your business is compliant with federal law? Are you worried about an impending federal investigation into your clinic? If so, then do not wait to get in touch with an experienced healthcare defense attorney immediately.
The federal government will continue to utilize an aggressive strategy to uncover egregious instances of healthcare fraud. It is critical to defend yourself against an indictment or a federal investigation. Proper defense requires a prompt response.
At Oberheiden, P.C., our healthcare fraud defense attorneys can review your business to ensure compliance with federal law and defend you against allegations of healthcare fraud such as improper billing.
We have the experience, knowledge, and dedication needed to advise you on compliance or rigorously defend you against federal accusations.
Call or contact our office for a free consultation to protect your career, business, and reputation.
Dr. Nick Oberheiden, founder of Oberheiden P.C., focuses his litigation practice on white-collar criminal defense, government investigations, SEC & FCPA enforcement, and commercial litigation.