New Jersey residents who are accused of healthcare fraud potentially face serious consequences, including up to five years in prison and more than $150,000 in fines, depending on the charge. There are two main types of healthcare fraud in the state of New Jersey: Medicaid fraud and healthcare claims fraud.
A person may be accused of Medicaid fraud for several reasons. For example, if it is believed that the person is somehow receiving more benefits than they are eligible to receive, they may be charged with fraud. On the other side, healthcare professionals and doctors can also be accused of Medicaid fraud if they overcharge for the services they provided or if they offered or received kickbacks for providing services that were paid for by Medicaid.
Both doctors and those who are not in the healthcare industry may be accused of healthcare claims fraud if they submit a claim to an insurance company for services that were not rendered. For example, a person may be accused of fraud if they file an insurance claim form for certain a medication but the medication was never received. Likewise, a doctor may be accused of a violation if they seek payment for a service, such as an exam or biopsy, that they did not provide.
When a person is accused of fraud, they potentially risk facing jail time and an expensive fine. A criminal law attorney may defend their client by providing evidence suggesting that the accused person did not file a false claim or was not attempting to receive more benefits those for which they were eligible. If the evidence against the accused person is strong, the attorney may negotiate with the prosecution to reduce the potential punishments or charges.