Medicare is a health insurance program administered by the federal government for people over 65 and people with disabilities. Medicaid, on the other hand, is a state-run system that gets federal assistance for need-based health insurance and healthcare discounts for residents of New Jersey with low incomes. Both of these systems exist to help people, and both systems are vulnerable to fraud and abuse from healthcare providers and regular citizens seeking to save money or make money.
If you or a loved one was accused of Medicare fraud or Medicaid fraud in New Jersey, it is vital to talk to a criminal defense lawyer about your case. The Atlantic City Medicare/Medicaid fraud lawyers at the Law Offices of John J. Zarych offer sophisticated legal representation to help people accused of state and federal crimes for fraud and related offenses. To schedule a free legal consultation on your case, contact our law offices today at (609) 625-3006.
NJ State Charges for Medicare and Medicaid Fraud
Many criminal charges fall under the jurisdiction of both the State of New Jersey and the U.S. Government. In cases of Medicaid/Medicare fraud and fraud related to other federal programs, the state of New Jersey and the federal government may both have the power to charge and prosecute you for a crime. The NJ version of this crime is known as [h]ealth care claims fraud” and is charged under N.J.S.A. § 2C:21-4.3.
This crime is divided into three major subsections which define the potential offenses:
- Subsection a applies only to healthcare providers and makes it a crime to “knowingly” put in a fraudulent claim for services rendered. This is a second degree crime punishable by 5-10 years in prison and fines up to $150,000.
- Alternatively, if a healthcare provider “recklessly” submits fraudulent charges, the crime is a third degree crime punished by 3-5 years in prison and fines up to $15,000.
- Lastly, if you are not a medical practitioner and you “recklessly” commit healthcare fraud, you can be charged with a third degree If you commit this fraud 5 or more times and benefit by at least $1,000, the crime is upgraded to a second degree crime.
If you commit any of the offenses for practitioners or the crime of repeat healthcare fraud, the penalties can be increased based on the benefits you received through fraud. The law authorizes additional fines equal to 5-times the total benefits you received.
Generally, each instance of fraud is a separate offense, and you can be charged separately and face separate fines and jail time for each instance of Medicare/Medicaid fraud.
Federal Criminal Charges for Medicaid and Medicare Fraud
Depending on how exactly the fraud progressed, there are a series of federal statutes you can be charged under. The U.S. government does not have the same power to enforce criminal laws that the state governments do, and it can only prosecute crimes for wrongdoing that affects interstate trade, cross-state communications, fraud against the U.S. Government, fraud that touches federal programs, and other limited issues. Since Medicare and Medicaid are both federally-funded programs and any communications must be wired or mailed across state lines to get you the coverage you need, you could face multiple of these federal criminal charges for defrauding Medicare or Medicaid.
In many cases, the U.S. Government will leave charges to the state government. However, if the FBI or other federal investigators receive information that you are involved in a “ring” or conspiracy to commit Medicare/Medicaid fraud, or if they find a large number of fraudulent healthcare transactions, you may face federal charges instead. When facing federal charges, the penalties can include a federal prison sentence and high fines.
In many cases, the prosecutors handling these cases are very sophisticated United States Attorneys (USAs) and Assistant USAs working directly for the Department of Justice. With help from the FBI and other federal law enforcement agencies, federal criminal cases are often very serious and include strong evidence and arguments against the defendant.
Fighting these kinds of cases requires equally sophisticated criminal defense teams certified to represent you in a federal criminal court.
Call Our Atlantic City Medicare and Medicaid Fraud Defense Lawyers for a Free Legal Consultation
If you are facing criminal charges for defrauding Medicare or Medicaid in New Jersey, contact the Law Offices of John J. Zarych today. Our Atlantic City Medicare/Medicaid fraud defense lawyers represent the accused and fight to get charges dropped and dismissed. If you are convicted of a state or federal crime for Medicare or Medicaid fraud, you could be sent to prison for a very long time and pay severe criminal fines. Contact our law offices today at (609) 625-3006 to set up a free legal consultation and learn more about the charges you are facing.