What are the potential penalties for Medicare fraud?

Physicians or health care entities that are found to have committed Medicare fraud face serious consequences. They will be required to repay the Medicare overpayments which they received and they are likely to face significant financial fines as well. Further, they may face criminal prosecution by the federal government. The United States Attorney’s Office can prosecute health care providers for alleged Medicare fraud under a variety of statutes such as the False Claims Act, False Statements Act and Social Security Act. Penalties for violations of these acts include prison terms and monetary fines. The typical prison term is up to five years for each offense.

The information on this page is meant to provide a general overview of the law. The laws in your state and/or city may deviate significantly from those described here. If you have specific questions related to your situation you should speak with a local attorney.

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