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Be Very, Very Aggressive Or Lose Everything

MEDICARE FRAUD

The FBI is the primary agency for exposing and investigating medicare fraud, with jurisdiction over both federal and private insurance programs. Being charged with medicare fraud means that the FBI is accusing you of conducting a fraudulent act or false claim for payment from a federal program company.

Don't Retain A Junior Medicare Attorney

MEDICARE FRAUD

Medicare fraud investigations are considered a high priority within the FBI's Complex Financial Crime Program, and each of the FBI’s 56 field offices has personnel assigned specifically to investigate medicare and medical fraud matters. The FBI seeks to identify and pursue investigations against the most egregious offenders involved in medicare fraud through investigative partnerships with other federal agencies,

We Have Medicare Defenses

YOU'RE FACING PRISON AND FINANCIAL RUIN

You are not only facing a lenghty prison term, but also the government wants everything that you have accumalated in your lifetime including your property, your license, your practice, all of your money. You and your family will be left for broke.

This is an important step in which 99% of those later accused wish that they could redo. Instead of fighting at this stage many enter into an agreement to offset future billing and regret it forever.

This is a major stage when the government issues subpoenas, requests documents. interviews witnesses and procures testimony. An agreement should be in place regarding the parameters of the investigation.

If the corporation wishes to resolve the criminal and civil investigation, to avoid the government using a criminal investigation to leverage a civil settlement, counsel must send a letter to prosecutors.

About Us

Michael Devereux is one of the more highly respected Medicare attorneys in Los Angeles. His vast experience, zealous advocacy for his clients and extensive knowledge of many areas of medicare law make Mr. Devereux the premiere Los Angeles attorney located in prestigious Century City. Mr. Devereux started his own firm in 2004 after working for the Cochran Firm, and assisting with the Robert Blake and Michael Jackson defense teams. As the sole proprietor of Wexford Law, Mr. Devereux has been successfully representing clients for close to 20 years. Former clients, their family and friends repeatedly return to Wexford Law for help in matters involving appeals, medicare audits, medicare litigation, CMS audits, and medicare fraud defense. Mr. Devereux loves taking on the federal government in Medicare matters.

Wexford Law and Michael Devereux, Top Rated Attorney for Medicare Fraud Defense

Medicare fraud is a serious charge that can have devastating consequences, including everything one ever acquired and more. It can leave families devastated with their loved one and primary bread winner serving a long prison term. The client is likely to lose their license, their practice, their home, their cars, any investments and any cash that they have, along with other assets.

What is Medicare Fraud?

The majority of Medicare fraud is committed by organized crime groups and a very small minority of dishonest health care employees. The most common types of health care fraud according to CMS include: 1) Knowingly submitting, or causing to be submitted, false claims or submitting misrepresentations to acquire claims reimbursement from payers for which no entitlement exists; 2) intentionally soliciting, receiving, offering, and/or paying remuneration to encourage or reward referrals for items or services reimbursed by payers; and 3) providing prohibited referrals for specific designated health services.

How Can Providers Detect Medicare Fraud?

As value-based purchasing takes hold of the Medicare industry, providers are also seeing claims reimbursement rates drop in favor of incentive payments. Efforts to maximize revenue may push some providers and/or employees to engage in Medicare fraud and abuse activities without intending to, such failing to correct a billing clerk who assumes a provider performed specific services, billing for medications that patient never picked up, and coordinating with other provider organizations under value-based agreements. While providers may or may not intend to commit Medicare fraud and abuse crimes, the federal government is as strict as ever with cracking down on Medicare fraud schemes.

Federal False Claims Act

Imposes civil liability on any individual who knowingly submits, or causes the submission of, false or fraudulent claims to the federal government, law officials do not need proof of specific intent to defraud to charge individuals.

Anti-Kickback Statute

Targets individuals who knowingly and willfully pay, solicit, offer, or receive remuneration directly or indirectly to induce or reward referrals of services and items reimbursed by federal healthcare programs.

Physician Self-Referral Law

Prohibits providers from making referrals for services reimbursable by federal healthcare programs to an entity in which the provider (or family member) has an ownership or investment interest or a compensation agreement.

IMPLEMENTING A COMPLIANCE PROGRAM TO IDENTIFY AND PREVENT MEDICARE FRAUD

Developing a strong compliance program is key to preventing healthcare fraud and abuse activities.

ADDRESSING DOCUMENTATION, CODING, AND BILLING PROCESSES TO AVOID MISCONDUCT

While a compliance program is the foundation for Medicare fraud and abuse prevention, providers should also consider improving their medical billing and coding processes.

HEALTHCARE FRAUD LAWS COMPLICATE VALUE-BASED PURCHASING IMPLEMENTATION

Under value-based purchasing models, providers may seek business relationships with other organizations to fill care gaps. Controlling care across the continuum also allows providers to monitor patient outcomes and costs to maximize value-based reimbursement.

PENALTIES MAY INCLUDE PRISON & RESTITUTION

The penalty at conviction for Medicare fraud can be steep, including years in prison, along with loss of home, cars, investment properties, airplanes, bank accounts, license, your practice, etc. At the end of the day, your loved ones can be displaced while you are serving time in prison.

Our Medicare Experience

Our experience includes representing phsycians, surgeons, dentists, pharmacies, and other providers. We discovered that early intervention of a skilled lawyer knowledgeable, not only in criminal healthcare defense, but Medicare law as well is key. Medicare fraud prosecutions are highly specific prosecutions lead by the U.S. Attorney’s Health Care Fraud Division. Thus, the defense of such allegations requires highly specialized Medicare fraud defense attorneys capable of analyzing a voluminous amount of health data with knowledge of billing practices, compliance issues and medical necessity.

Medicare Fraud Defense

Criminal Medicare fraud convictions require proof beyond a reasonable doubt that an individual knowingly and/or willfully submitted a false claim or engaged in kickbacks or other Medicare fraud. However, proof of actual knowledge or specific intent is not required for a conviction. A person can be convicted if their employee is found to have acted with deliberate ignorance or reckless disregard of the truth or falsity of the claim. In some Medicare fraud cases, the ultimate issue is simply whether the individual acted knowingly and/or willfully. In other cases, the issues are much more complex. For example, Medicare fraud allegations involving worthless services, medical necessity or overutilization present an additional question regarding the standard of care. The federal government's trend is to criminally charge physicians who allegedly prescribe/perform Medicare services that are not medically necessary. Our Medicare fraud defense lawyers are uniquely suited to defend these claims. Our knowledge of conditions of payment, conditions of participation, with years of defending physicians provides us with the necessary knowledge to understand and apply the standard of care, DRG’s, CPT’s, clinical practice guidelines and conditions of payment in the defense of our clients.

Results Oriented - Wexford Law is Michael Devereux, Not A Law Firm By Committee

Results matter at Wexford Law. Our approach is client-oriented, and we are committed to providing the best results possible. Some law firms measure success by their growth in size. Yet, other law firms measure their success by profit. Our priority is to measure our success based upon results. You will not be shuffled off to a junior attorney. Your attorney will have close to 20 years of attorney experience from beginning to end. Our endeavour is to establish long-lasting relationships with our clients so that they can refer us to their friends and family.

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If you or your business is facing a legal challenge, contact us today to arrange a free initial consultation with an attorney.

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FAQ

Lawyers, by virtue of a state's bar admission, are expected to both uphold the law and protect the rights of their clients. In addition to actually knowing the law, particularly within his or her practice area, an attorney must be able to communicate clearly with their clients, work competently to resolve their client's needs and be ethical in the performance of their overall handling of a case.

Unfortunately no since Wexford Law is not a non-profit entity. However, you may qualify for free legal help if you meet certain income requirements, especially if you are charged with a crime for which the sentence would deprive you of liberty (such as jail or prison time). For non-criminal matters, community legal clinics and lawyers working \"pro bono\" offer free legal services for those who qualify.

It depends on the situation and the breadth of service since only lawyers may practice law. Paralegals, for example, may represent you in certain situations involving complaints against a government agency (such as a dispute over Social Security benefits). You may also represent yourself in court, hire a notary public, or work with law students (under the supervision of a lawyer) under certain circumstances.

To become a lawyer, one must first complete special training and meet other professional requirements. Although each state has its own standards for licensing attorneys, most states require hopeful lawyers to obtain an undergraduate degree and then graduate from an accredited law school. Once the formal education is complete, they must also take and pass the state's Bar Examination (a rigid test of knowledge in all fields of law), submit to the investigation into their moral character and fitness to practice law, and be sworn in by the state or federal Supreme Court.

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