Areas of Expertise

Medicare and Medicaid Fraud

Medicare is an entitlement program – an individual is entitled to it because it was paid for through Social Security taxes. Medicaid, on the other hand, is a federal program for low-income, financially needy people, set up by the federal government and administered differently in each state. People may qualify and receive coverage from both Medicare and Medicaid, but there are separate eligibility requirements for each program. The Bennett Law Firm has represented health care providers, hospitals, nursing homes, group practices, individual doctors, ambulance companies, durable medical equipment suppliers and clinical laboratories that have been charged Medicare or Medicaid Fraud.

Medicaid Anti-Kickback Statute

The Anti-kickback statute prohibits knowingly and willfully paying or receiving any remuneration directly or indirectly, overtly or covertly, in cash or kind, in exchange for prescribing, purchasing or recommending any service, treatment or item for which payment will be made by Medicare, Medicaid or any other federally funded healthcare program. To convict a healthcare provider under the Anti-Kickback Statute, the government must prove:

The provider solicited or received remuneration, and
The remuneration induced the provider’s referral of program-related business, and
The provider entered into the remuneration and inducement agreement knowingly and willfully.
This broad statute prohibits not only patently illegal actions, such as overt kickbacks and bribes, but also an array of complex economic relationships which could result in conflicting interests, including discount arrangements, incentives given to pharmacists, payments for services and the practices of manufacturers giving gifts and business courtesies. Violations of the anti-kickback statute are punishable by fines up to $ 25,000 and/or imprisonment for up to five years. Civil remedies may also be available.

The Bennett Law Firm is currently representing healthcare organizations and providers under investigation by the U.S. Department of Health and Human Services in connection with the activities associated with the TAP Pharmaceutical investigation and settlement.