Medical Billing and Reimbursements Legal Services
- the U.S. Department of Health and Human Services (HHS); and
- the Centers for Medicare & Medicaid Services (CMS).
CMS regulates federal intermediaries and develops fee schedules for physicians, ambulance services, clinical laboratory services and durable medical equipment, prosthetics, orthotics, and supplies. Irregular billing practices or filing improper reimbursement requests with commercial payers or federal intermediaries for procedures and services performed may lead to both criminal and civil investigations against you or your practice.
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Illegal Billing Practices
The Department of Justice (DOJ), as well as other federal and state authorities across the country, investigate illegal billing practices. These investigative and enforcement agencies take improper medical billing and reimbursements very seriously and often attach excessive fines and punishments to convictions for things like:
- Insurance Over-Billing
- Billing for Services Not Rendered
- Billing for Services Not Covered
- Co-Payment Fraud
- Cost Reporting Fraud
- Durable Medical Equipment Fraud
- False or Altered Data Code Sets
- False Reporting of Diagnoses’
- Misrepresenting Services
- Phantom Patients
- Providing Unnecessary Procedures
- Providing Unnecessary Treatments
- Retention of Overpayments
- Unbundling Services
Contact Us Today For Help
If you have been charged with a crime in connection with your billing practices or reimbursements or are currently under investigation by a government agency, the Health Law Group can connect you with an experienced attorney now.