False Billing

Nevada Healthcare Fraud Attorney Helps Understand False Billing Charges

Charging too much for medical services by using false or increased billing codes is a growing problem that the government is trying hard to end. False billing is a type of insurance fraud in Nevada that carries serious penalties. In addition to stiff penalties, a medical professional may lose his or her license to practice medicine.

False billing is one way to defraud an insurance company, and is closely related to the Nevada crime of healthcare fraud.

What activities constitute false healthcare billing in Nevada?

False billing to defraud an insurer is an intentional and willful act involving deception. It includes providing false information or failing to include important information when presenting documents or claims to an insurance company.

Examples of false billing activity include:

• Using false information to get a health insurance policy;
• Double billing for the same procedure;
• Falsifying medical records of a patient to justify more and more expensive treatments and testing; an
• Charging for office visits, tests, surgeries, or other medical services that we’re not actually provided.

Conspiring to commit an act of false billing and aiding and abetting another person in false billing activity are also punishable offenses under Nevada’s healthcare fraud laws.

Who can be responsible for healthcare fraud in Las Vegas, Nevada?

Anyone who deliberately tries to get or actually does get money from a health insurance company for services that were not performed can be liable for healthcare and billing fraud. This means that anyone working in a doctor’s office can be liable- not just the doctor or owner of the practice.

Sentencing for healthcare and billing fraud in Nevada

Health care fraud in Nevada is a Category D felony which carries 1 to 4 years in a Nevada prison and fines up to $5,000.

As with all crimes involving theft of money or property, a person convicted of false billing and healthcare fraud will be required to pay restitution to the victim, who is usually a health insurance carrier.

Federal laws for healthcare fraud and false claims (18 USC 1347)

The Nevada crime of false billing is also punishable by federal law.

A person who defrauds a Medicare or other governmental healthcare insurer or provider can be charged with a federal crime. Federal healthcare fraud has longer prison sentences and fines than charges under Nevada law.

Sentences for federal healthcare fraud depend on whether the result of the fraud is bodily harm:

• If the fraud does not result in serious bodily harm, the penalty can include up to 10 years in a federal prison, which is located outside the state of Nevada;
• If any serious bodily injury results from the fraud, the prison time increases to a period up to 20 years long.
• If a person dies from healthcare fraud activities, the penalty includes life in prison.

In each of these cases, the person convicted of healthcare and billing fraud may also have to pay fines.

False billing as a federal crime has a strict liability standard of proof. This means that the government does not need to prove that you intended to defraud anyone with your billing practices. Instead, there is an assumption that false billing was intended to defraud the insurer.