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What is considered Medicare fraud?

The consequences of Medicare fraud are serious which is why anyone facing Medicare fraud charges should be familiar with what is considered Medicare fraud. Medicare fraud, as the name suggests, refers to a type of fraud and fraud crimes generally involve allegations of some use of deception for material gain. Accused individuals can face the weight of the criminal justice system and should understand the legal resources available to them.

Medicare fraud involves identity theft and can be alleged when an individual is accused of unlawfully gaining access to a Medicare number or other personal identifying information such as a Social Security number of birth date to gain access to Medicare benefits without the true beneficiary's knowledge or permission to do so. It can occur when a Medicare card is taken and fraudulently used.

Medicare fraud can also be understood as involving a claim for reimbursement for health care services through Medicare that the claimant is not entitled to. Other specific examples of Medicare fraud include phantom billing, upcoding and unbundling and fraudulent patient billing. Any type of alleged Medicare fraud can result in serious charges and potential penalties and consequences for the accused individual.

Defending against Medicare fraud charges is an important as defending against any other type of criminal charges. Accused individuals need to know how to protect themselves and how their criminal justice rights can protect them. Understanding these rights can help accused individuals know what to do as they develop a criminal defense strategy to respond to the charges they are facing.

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