The government is trying to review and reform the healthcare system, but there are still some people in Chicago who are committing Medicaid fraud. There are many fraud prevention measures that have been put in place. Yet, there are people who work to see how they can deceive the government.
This is a serious offense that can lead to serious jail time. Recently, Santila Terry, a 45-year-old woman who lives in Chicago, was facing charges for committing both identity and Medicaid fraud. The total estimated loss in the case was almost $1 million. This case is typical in terms of how frauds of that nature are committed.
A service provider bills the government for services that were never delivered right up until they are discovered. According to reports from the Attorney General, Santila was claiming to provide speech therapy to people who did not exist. Another part of the case was identity fraud. Special Therapy Care Chartered used the personal information and Medicaid service provider ID of a previous employee to falsely bill the government.
Frauds That Take Place Over a Long Time
The Medicaid billing scam is done in relatively small individual amounts. Thus, it can take some time for the government to notice that there is something wrong. For example, in the case of Santila, the fraud was taking place for nearly three years. It was only at a very late stage that the Illinois State Police Medicaid Fraud Control Bureau was notified. Others prefer to use kickbacks as a means of getting money to which they are not entitled.
In order to avoid falling into the same trap, Medicaid service providers in Chicago have to take the following steps.
Read the Law. It is so important to read all the rules and regulations on how Medicaid is supposed to be provided. The rules keep changing all the time. That means checking all the notifications and attending conferences where service providers can exchange ideas and information. Ignorance is not a good defense against this law. The court will not accept a plea that the defendant did not know what they were doing.
Only do What You Were Hired to do. The services that are required and eligible for Medicaid payments are specific. There is a list with maximum amounts. It is best to specialize in those services that are registered for the service provider rather than doing a lot of things. This is how accounting mistakes can be made, leading to a full FBI investigation.
Do Regular Checks. Everything must be aboveboard before a claim is made for Medicaid payments. This is because there are audits that can take years before they pick out cases of fraud. The medical fraud case that has been discussed above shows that it can take years before the authorities even come to check up on the accounts.
Steps to Take When Accused
The fact that these are complicated cases with a high chance of being jailed means that you cannot do without lawyers. They should be the first people you call so that they can prepare a defense. If it is a mistake, it may be possible to convince the government not to go ahead with the prosecution. There are serious consequences to these offenses.
If you or someone you know has been accused of Medicaid fraud, please contact David Freidberg Attorney at Law at telephone number 312-567-7100. Your case will be discussed by a qualified attorney who understand the current rules and regulations as well as the law on this type of fraud.
(image courtesy of