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Georgia optometrist takes fall for Medicare fraud

Many people agree that doctors charge too much for their services, but one Georgia optometrist was accused of falsely billing over $800,000 in services that he never provided to patients. In a recent health care fraud scheme, the optometrist in question reportedly submitted claims to Medicare for reimbursement from appointments that never occurred.

After some complaints about his billing procedures were made, the FBI discovered that the optometrist claimed to have seen 177 patients on a single day. For the type of examination that the doctor billed for, he would have had to spend 45 minutes examining each of the 177 nursing home residents he claimed to have seen on that one day.

As a national insurance plan, Medicare draws protection from federal agencies. Defrauding a federal institution like Medicare can therefore yield federal charges. Penalties for a federal conviction can include federal jail time, fines, or probation. But someone who has been arrested on suspicion of fraud charges should remember that the circumstances of each criminal case are so unique that there are a variety of options available.

Depending on the facts of a case, an attorney can help an arrestee decide if going to trial or pleading guilty is the best course of action. Sometimes a guilty plea can offer a reduction in charges or sentences in order to ensure a quick case with minimal cost.

Whether the evidence in a case looks impossibly intimidating or not, a skilled attorney will be able to give trusted advice on the best way to proceed. Negotiation is a important part of criminal procedure that an experienced attorney will be able to navigate with ease.

Source: Atlanta Business Chronicle, "Optometrist pleads guilty to Medicare fraud," Carla Caldwell, Feb. 21, 2013

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Nick Lotito & Seth Kirschenbaum

Former Federal Prosecutors

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