Operating a business often requires a mindset that numbers are approximate, even when these numbers refer to amounts of money. This is especially noticeable when you are in the healthcare sector, and some of your company’s revenues come from health insurance claims. As everyone who has ever received a shockingly expensive medical bill knows, numbers do not make sense when it comes to health insurance. In writing Alice’s Adventures in Wonderland, Lewis Carroll sought to satirize mathematical theories, which were then new and deviated from the laws of mathematics codified in ancient times. As memorable as his nonsense world is, an account of the United States health insurance industry would have been an even more effective example of a world where logic fears to tread than Carroll’s Wonderland, with its shrinking potions, disembodied smiles, Mad Hatters, and moments.
The difference between a false claim, an inflated price, and a write-off could easily be a matter of semantics, but when you are accused of healthcare fraud, you have an opportunity to persuade the jury that it is plausible to believe that you acted in good faith. If you are being accused of healthcare fraud in your capacity as the owner of a small doctor’s office or pharmacy, contact a Texas white-collar crime lawyer.
Dallas Pharmacy Owner Accused of Healthcare Fraud Over Fraudulent Insurance Claims
The owner of a pharmacy in Dallas was indicted in 2020 on charges of healthcare fraud. Prosecutors alleged that the defendant and a business partner began paying physicians in 2017 to write and stamp prescriptions for common prescription drugs such as headache sprays and pain creams, not the sorts of prescription drugs that would quickly draw the scrutiny of regulators, so not the usual opioids and gabapentin that are typically the subject of fraudulent prescriptions. The conspirators would then bill insurance companies for the prescription drugs, even though patients never received them. At one point, the defendant allegedly illegally possessed doctors’ prescription stamps and bought patients’ information from parties that were willing to sell it.
In this case, the defendant pleaded guilty to the charges, but several defenses are possible in cases like this; you can get acquitted if you can prove that the prosecution’s evidence does not directly link you to all elements of the criminal charge. For example, the defendant might have been able to claim that he did not know that the prescriptions contained false statements or that none of his communications with the doctors prove his complicity in enabling fraudulent prescriptions to go through his pharmacy. Defenses like these often involve claiming that the true guilt belongs to the other conspirators, effectively involving willingness to testify against one’s co-defendants.
Contact the Law Office of Patrick J. McLain, PLLC About Criminal Defense Cases
A Dallas criminal defense lawyer can help you if you are facing criminal charges for writing false information on prescriptions or on health insurance claims or knowingly allowing these practices to occur at a business you control. Contact the Law Office of Patrick J. McLain, PLLC, in Dallas, Texas, to discuss your case.