CALIFORNIA CRIMINAL LAWYERS

Los Angeles Medi-Cal Fraud

The Prevalent Concern of Medi-Cal Fraud and How to Fight Against It

Medi-Cal fraud has become a significant issue in California, and it is causing a lot of troubles for those who really need it. Taking advantage of the state’s funds for those who cannot afford health insurance has led to people making false statements, enabling them to qualify for health insurance paid for by the state. The same problem arises for people who are seeking food stamps.

In California, false reporting of misleading information on the income summary with the intention of demonstrating a lower amount of income than earned is regarded as Medi-Cal fraud. It is a serious offense punishable by imprisonment for up to five years and a fine of up to $50,000. Failure to disclose the truth of the income status before obtaining insurance through Medi-Cal results in fraud since, if people had not misrepresented their income status, they could have used their earnings to purchase insurance and would not have billed the state for their health care expenses.

Individuals charged with Medi-Cal fraud must consult an attorney immediately due to the severity of the punishment involved. There are potential defenses available for which an attorney may argue against Medi-Cal fraud charges. If individuals can show that they did not act knowingly with the intention to commit fraud or prove insufficient evidence to support the Medi-Cal fraud charge, they may reduce the sentence size or fine or even altogether have their charges dropped.

Our firm has handled several Medi-Cal fraud cases and has a track record of success. To explore whether facts in the case give rise to a valid claim against Medi-Cal fraud, it is essential to schedule a consultation meeting with our attorneys to determine whether we can potentially help with the upcoming legal matter. After determining that the case has no conflicts of interest and is not frivolous, you can retain us to represent you in the upcoming legal matter. Once retaining us, we will come up with several theories to argue against the Medi-Cal fraud charge and support provided evidence.

If wrongly accused of Medi-Cal fraud, it is essential to seek legal counsel and fight the charges not to impact your criminal record and overall finances significantly. Our dedicated legal representation team is always ready to assist you in your upcoming legal matter, providing ethical and zealous advocacy for our clients. Contact our law offices today for a consultation.

Defining Medi-Cal Fraud

Medi-Cal is a California health insurance program that provides affordable access to health care for those who cannot afford health care services. One who misrepresents income or family composition to receive Medi-Cal benefits faces criminal charges. This fraudulent act is Medi-Cal fraud, punishable under California law as a felony or a misdemeanor offense.

Medi-Cal fraud can take on various forms: It could be insurance fraud, where a health care provider presents a false bill to Medi-Cal; it could also be patient fraud, where a patient obtains health care services to which they are not entitled. Fraudulent billing practices in Medi-Cal can include upcoding, unbundling, and billing for services not rendered.

Risks Associated with Medi-Cal Fraud

Engaging in Medi-Cal fraud has tremendous risks and consequences for individuals accused. A Medi-Cal fraud conviction results in a criminal record, making it challenging to secure jobs, housing, and future loans. A criminal record quickly exposes an individual to a negative perception, leading to isolation from society.

Besides the impact on an individual’s criminal record, engaging in Medi-Cal fraud also incurs a substantial financial penalty. Under California law, Medi-Cal fraud is punishable by imprisonment for up to five years and a maximum fine of $50,000. Furthermore, the accused must pay restitution and penalties to the state, amounting to three times the value of the fraud committed.

Legal Defense Against Medi-Cal Fraud Charges

If wrongly accused of Medi-Cal fraud, it is critically important to consult an experienced attorney for help. An attorney can mount a legal defense against the Medi-Cal fraud charge, leading to a successful outcome. The effective legal defense strategies in a Medi-Cal fraud charge include:

1. Lack of Knowledge or Intent to Deceive

The prosecution must prove that the accused acted knowingly and intentionally to defraud Medi-Cal. Defense attorneys can argue that the accused had no knowledge or intent of deception when making the determination. Thus, the accused can be innocent of Medi-Cal fraud charges.

2. Insufficient Evidence

Medi-Cal fraud charges require extensive evidence from the prosecution that the defendant committed the fraudulent act or knew about its occurrence. Without substantial evidence, the prosecutor cannot successfully bring charges against the accused. Defense attorneys can question the credibility of the evidence provided, therefore potentially leading to a reduction of sentence or fines or no conviction at all.

Conclusion

Engaging in Medi-Cal fraud is a risky and illegal act that can have severe consequences on the accused’s criminal record, finances, and reputation. If facing a Medi-Cal fraud charge, it is crucial to consult experienced attorneys for legal defense. Our law firm offers ethical and zealous legal representation to fight against wrongful Medi-Cal fraud charges. Our successful outcomes in handling Medi-Cal fraud cases validate our expertise in this practice area. Contact our law offices today for consultation on your Medi-Cal fraud charges.