San Pedro Medicare/Medical Fraud Defense Lawyers

If you received a notice that you’re under investigation for Medicare or Medi-Cal fraud in San Pedro, you have a right to be worried and scared. After all, an accusation of healthcare fraud can destroy your reputation, your career, and your freedom. But you don’t have to face this alone. We can help you understand the charges against you and build a strong defense.

For nearly 30 years, The Law Offices of Robin D. Perry & Associates has defended San Pedro healthcare professionals against sophisticated federal fraud allegations. We understand Medicare billing regulations, challenge audit methodologies, and have the experience to lead you through both criminal prosecution and administrative proceedings. Learn more about our firm.

Federal healthcare fraud defense is available at 100 Oceangate #525, Long Beach, CA, 90802, easily accessible to the Federal Courthouse and major medical centers. San Pedro healthcare professionals can reach our office in just 10 minutes via I-710. When you call our law firm, you’ll get access to attorneys experienced in both federal criminal defense and healthcare regulatory compliance. Call 562-216-2944 or complete our confidential contact form immediately.

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“A few years ago, my fiancé was involved in a situation where we needed legal advice and representation. We were referred to Mr. Perry by a close friend. I recall calling Robin Perry on a Saturday morning, I left a voice voicemail, and within minutes he called and talked with us for over an hour. During the conversation he listened to our concerns and addressed each one of them. I’m truly thankful for the personal support Robin Perry gave us, and I’m pretty sure if we didn’t have him we would be singing a different tune. Thank you Mr. Perry your hard work is greatly appreciated!!!”

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What Exactly Is Medicare and Medi-Cal Fraud?

Medicare and Medi-Cal are government programs that help millions of people with healthcare costs. Medicare is a federal program for people aged 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease. Medi-Cal is California’s version of Medicaid, providing healthcare services for low-income individuals and families.

“Fraud” in these programs generally means someone intentionally lied or deceived to get money or benefits they weren’t entitled to. It’s not just an honest mistake; it involves a clear intent to cheat the system.

Common ways people get accused of Medicare or Medi-Cal fraud include:

• Billing for services not provided: This is when a healthcare provider charges for treatments or procedures that the patient never received.
• Upcoding: This happens when a provider bills for a more expensive service than the one actually given. For instance, billing for a complex procedure when only a simpler one was performed.
• Unbundling: This involves breaking down a single, inclusive service into separate charges to increase the total reimbursement.
• Kickbacks: This is when someone offers or receives payment for referring patients or for ordering specific services or equipment. This is illegal and goes against laws like the federal Anti-Kickback Statute (42 U.S.C. § 1320a-7b(b)).
• Falsifying records: This means changing patient medical records to make it look like a service was necessary or provided when it wasn’t, or to justify an inflated bill.
• Misrepresenting patient eligibility: This often applies to patients who might lie about their income or other details to receive benefits they don’t qualify for under programs like Medi-Cal.
• Prescription drug fraud: This can involve forging prescriptions, illegally selling prescribed drugs, or “doctor shopping” to get multiple prescriptions for controlled substances.

These acts are serious, and investigators from both state and federal agencies work hard to find and prosecute them.

Penalties for Healthcare Fraud

Being accused of Medicare or Medi-Cal fraud brings the full force of the law against you. Depending on the details of the alleged fraud, you could face charges under both state and federal laws.

Federal Law (Medicare Fraud)

Most Medicare fraud cases are prosecuted under federal law. For example, 18 U.S. Code Section 1347, the Health Care Fraud statute, makes it a crime to knowingly and willfully execute a scheme to defraud any healthcare benefit program. If convicted, you could face:

• Up to 10 years in federal prison.
• Large fines.
• Up to 20 years in prison if the fraud resulted in serious bodily injury.
• A life sentence if the fraud resulted in a patient’s death.
• Exclusion from participating in federal healthcare programs like Medicare and Medicaid in the future.
• Civil penalties, including triple damages and fines of up to $11,000 per false claim under the False Claims Act (31 U.S.C. §§ 3729-3733).

California Law (Medi-Cal Fraud)

Medi-Cal fraud is often prosecuted under the California Penal Code and Welfare and Institutions Code. Some key statutes include:

• Penal Code Section 550: This makes it illegal to knowingly present a false or fraudulent claim for payment of a loss or injury. This “wobbler” offense can be charged as a misdemeanor or a felony.
  • For losses under $950, it’s typically a misdemeanor, with up to six months in county jail and a $1,000 fine.
  • For losses over $950, it can be a felony, carrying two, three, or five years in state prison, and fines up to $10,000 or double/triple the amount of the fraud.

Beyond prison time and fines, a conviction can also mean losing your professional license (for doctors, nurses, pharmacists, etc.), damaging your reputation, and facing restitution orders to repay the money allegedly defrauded.

How a San Pedro Medicare/Medi-Cal Fraud Defense Attorney Can Help

When you are facing Medicare or Medi-Cal fraud charges, you need a lawyer who knows how to build a strong defense. This isn’t a time for general practice. It’s a time for someone who has experience in this very specific area of law.

At The Law Offices of Robin D. Perry & Associates, we will dig into every detail of the accusation, examining the evidence collected by investigators. This includes reviewing billing records, patient files, and communication. We will look for weaknesses in the government’s arguments, such as issues with how evidence was collected, errors in billing codes, or a lack of proof of intent to defraud. Recall that fraud requires intent; an honest mistake or administrative error is not fraud.

In many cases, our attorneys can negotiate with federal or state prosecutors to reduce charges or explore alternative resolutions that avoid harsh penalties. We will work tirelessly to minimize the impact of the investigation and any potential charges on your professional license and your standing in the community.

Contact Our San Pedro Medicare/ Medi-Cal Fraud Defense Attorneys

An accusation of Medicare or Medi-Cal fraud can feel like an impossible situation, threatening everything you’ve built. But you have options, and you have rights. With the right legal help, you can challenge these allegations and work towards protecting your freedom, your career, and your future.

Call The Law Offices of Robin D. Perry & Associates at 562-216-2944 or fill out a contact form right now for a free consultation.

Don’t let the fear of a healthcare fraud accusation define your life in San Pedro. Take control of your situation.