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Medicare fraud charges can lead to criminal charges

The addiction crisis continues to ravage Kentucky and other states across the country. There are medical means to help those affected and a local doctor was accused of Medicare fraud after allegedly writing more prescriptions for an addiction treatment medication than she was authorized to write. The drug, buprenorphine, more commonly known as Suboxone, is prescribed in the treatment for opioid addiction.

Current law limits the number of patients who can be treated to 100 per month. This is done predominantly because buprenorphine can be diverted for illegal use. The civil complaint against the doctor alleged that she treated as many as 294 people a month during the time period in question. The doctor agreed to a settlement where she will pay a fine of $1.4 million. The settlement did not include an acknowledgement of wrongdoing.

According to the civil complaint filed by the government, the clinic billed Medicare for services not provided. This included physical examinations, recording patient histories and making medical decisions. In addition, nurses were alleged to have handed out doses of other drugs used in combating addiction to as many as 250 to 300 patients per day. While the allegations in this case are civil and not criminal, a person in such a situation could also face criminal and even professional misconduct charges.

A physician who finds him or herself in such a position in Kentucky will likely benefit by consulting with a criminal defense attorney to get an understanding of the legal options available.  A person accused in criminal court of Medicare fraud is presumed innocent unless and until proven guilty in a court of law. It falls to prosecutors to prove their case and that proof must be supported by the competent and relevant evidence.

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