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What Is Health Care Fraud in Ohio?

What Is Health Care Fraud in Ohio?

Health care fraud refers to a specific type of fraud in which a person files purposefully inaccurate or dishonest claims for his or her own profit. There are many types of health care fraud, the most common of which include:

  • Billing for health care services that were not performed
  • Billing for health care services not covered under the insurance plan
  • Misrepresenting dates or locations of the service or the provider of the service
  • Allowing or ordering waivers of co-payments or deductibles
  • Incorrectly reporting procedures or diagnoses
  • Overusing services
  • Taking kickbacks or bribes, or committing other forms of corruption

Heath care providers pass the cost of fraudulent claims along to customers. Health care fraud has become so common that some estimates indicate that 10 cents out of every dollar spent on health care goes directly to paying for fraudulent claims.

People convicted of health care fraud charges face significant fines and prison time, the degree of which depends on the level of fraud committed. Health care fraud cases can fall under the jurisdiction of state or federal courts, again depending on the level of fraud in question. Cases involving greater amounts of money and multiple counts of fraud will be more likely to go to federal courts.

There are defenses available to people accused of health care fraud. For example, the prosecution must be able to prove that the defendant was operating out of intent to defraud the health care provider. If there is any reasonable doubt that the defendant intended to commit the crime, the court cannot make a conviction.

For more information on health care fraud and your best legal option when facing these charges, speak with an experienced white collar criminal defense lawyer at the Law Office of Gregory S. Robey in Cleveland.


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