Lawyers for Medicare Fraud Charges in Perth and WAChambers Legal
As a false claim to or improper use of government healthcare benefits, Medicare fraud is viewed as a serious offence under Australian law.
If you have been charged or suspect you are under investigation, it is important you get informed legal advice as soon as possible. Chambers Legal staffs a team of experienced fraud lawyers who can explain the complex principles and consequences that apply to your case.
To discuss your situation, book a free consultation.
What Is Medicare Fraud?
Medicare fraud is the act of a person or business knowingly providing false or misleading information to obtain a benefit through the Medicare system. Individuals (patients) and healthcare providers (doctors, dentists etc.) can both be charged.
It is important to recognise that even an honest mistake can be investigated as a fraud matter. If you feel you could be subject to investigation, contact a criminal lawyer as soon as possible to understand your rights if you are questioned by police.
Examples of Medicare Fraud
Medicare fraud takes many forms but the most common offences are:
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Billing for services not provided
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Double billing or unbundling services
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Misusing Medicare numbers
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Falsely claiming eligibility for rebates
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Submitting claims using another person’s details
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Providing false information in relation to bulk billing
Some fraud stems from an isolated incident, whilst other fraudulent activity is a part of a wider pattern of behaviour. In both cases the legal consequences are significant.
Penalties for Medicare Fraud
Sentences for Medicare fraud vary depending on the nature and value of the conduct. For example:
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Obtaining a financial advantage by deception carries a maximum of 10 years’ imprisonment
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Conspiracy to defraud the Commonwealth also carries up to 10 years
But not every instance of Medicare fraud results in imprisonment, courts will also consider sentences such as:
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Fines
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Repayments
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Deregistration and industry sanctions (for providers)
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Good behaviour bonds
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Community based orders
Whether these lesser penalties apply will depend on the amount of money involved, the level of planning, whether the accused cooperated/repaid and their prospects of rehabilitation
How Chambers Legal Can Help
With significant legal consequences looming, being investigated for or charged with Medicare fraud offences can be incredibly stressful. Chambers Legal staffs a team of experienced criminal lawyers who can:
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Review the evidence and advise you of your options
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Respond to investigating agencies on your behalf
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Negotiate more favourable outcomes
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Defend you in court if charges proceed
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Working to reduce penalties
Recognising the incredible hardship you and those around you are facing, we are committed to transparency and integrity. Our team will always work to support you, providing all advice in writing and pairing it with proper cost notice
Four Possible Defences
Should a Medicare fraud charge proceed to court, several legal defences may be available:
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Lack of Intent – The act was a mistake or misunderstanding and the accused did not intent to deceive the Medicare system
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Mistaken Identity – The accused person was not the one who submitted or authorised the claims
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Misleading Evidence – The prosecution’s investigation was based on a flawed assumption
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Duress or Coercion – The accused was pressured or threatened into submitting false claims
Every fraud case is different and finding the best strategy to avoid a prison sentence will depend on the facts and evidence. Securing experienced legal advice from Chambers Legal is the surest way to protect your position and have your voice heard.
Speak with a Criminal Defence Lawyer at Chambers Legal
If you’re facing a Medicare fraud investigation or charge, it’s important to get legal advice as early as possible. We can help you understand your rights, assess the case against you, and defend your position.
Frequently Asked Questions
Yes.
Unintentional billing errors can still raise a red flag for Medicare and other investigatory bodies. Whilst they are not intentional fraud, it is still important to seek early legal advice and protect your position.
There are several departments and agencies that investigate Medicare fraud. Smaller to mid-range offences will be assessed by the Department of Health and the Professional Services Review.
In more serious cases, the Australian Federal Police and Commonwealth Director of Public Prosecutions will also be involved.
Yes.
For health practitioners, fraud allegations can result in penalties from industry bodies, including the suspension or cancellation of registration.
Legal advice can assist you in navigating professional consequences as well as legal, so contacting Chambers Legal as soon as possible will put you in the best position to protect your future.
Potentially.
If the patient in question received a service, the filings may still be considered fraudulent if the provider intentionally billed using incorrect item numbers, overcharged or claimed for services not covered.
The key element of a fraud charge isn’t whether a service was provided, but rather the intend and accuracy behind how that service was billed.
Don’t ignore it, but don’t respond without legal advice.
A review notice is often indicative of a broader investigation, so it is important to engage a fraud lawyer at Chambers Legal to protect your rights and reduce the risk of further action.
Most matters are prosecuted under Commonwealth legislation, including the:
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Criminal Code Act 1995 (Cth)
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Health Insurance Act 1973 (Cth)
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Taxation Administration Act 1953 (Cth)
As mentioned above, Medicare fraud laws apply to individuals and corporations and carry criminal, financial and professional punishments.