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Facing fraud charges? Recent case shows importance of intent

On Behalf of | Apr 8, 2021 | White Collar Crimes |

White collar crimes are those offenses that typically involve some time of fraud in order to acquire financial gain. Embezzlement is a common white collar crime, but prosecutors often bring these types of charges against individuals who work in a professional capacity outside of standard corporate America. For example, doctors and other health care professionals are often accused of health care fraud, which can carry severe penalties upon conviction. If you’re under investigation for health care fraud, then you need to understand the law, how it applies to your case, and what you can do to protect yourself.

How a recent case serves as an example

One recent case appealed at the federal level can highlight one of the most important aspects of health care fraud: intent. There, several individuals where charged and convicted with health care fraud and violating the Anti-Kickback Statute. Amongst them was a young manager whose role included assigning doctors and nurses to patients who received in-home care.

According to prosecutors, this manager’s assignment of medical professionals constituted conspiracy to commit health care fraud and to violate the Anti-Kickback Statute because the other individuals who were ultimately convicted were found to have charged Medicare for improper in-home health care services and even stopping billing altogether for a certain period of time so as not to raise red flags as to billing practices. The manager was convicted, too, getting hit with nearly $13 million in restitution costs and 40 months of imprisonment on each charge on which the manager was convicted, which was several. In other words, the convictions were sure to ruin this individual’s life.

However, a federal Court of Appeals found that the conviction was improper because the government essentially failed to prove that the manager lacked actual knowledge of the illegal business practices in place. Although this employee was essential to carrying out the fraud, there was insufficient evidence to establish that the manager understood that the practices were fraudulent in practice. The Court of Appeals found this fact despite evidence showing that the manager was trained on proper Medicare billing and compliance with federal regulations.

The stakes are high in your fraud case

Fraud allegations can carry significant consequences if you’re convicted. In addition to extensive jail or prison time, you might be subjected to enormous fines that are financially ruinous, as well as suspension or revocation of your professional license. In other words, life as you know it may be on the line. That’s why you need to be diligent and aggressive in building your criminal defense.

Building your criminal defense

While there are a lot of steps you can take to build your defense, including taking depositions, subpoenaing pertinent documents, and knowing the statutory law, you might be able to utilize case law to your advantage. For example, although courts have tended to find that mere proximity to fraudulent activities may be enough for a conviction on certain white color crime charges, the case discussed above shows that some people who are merely pawns and are manipulated into assisting a fraud without actual knowledge of the unlawfulness of those acts may be able to successfully defend themselves against allegations of fraud. Willful blindness won’t be successful defense, but depending on the circumstances at hand you might be able to show that the prosecution’s case lacks the specifics that it needs to be successful.

Choose the defense team that is right for you

Given the complexities in these kinds of cases and the high stakes, you owe it to yourself to develop the best criminal defense possible. This means researching criminal defense firms that you think might be a good fit for your in consideration of their experience, individual attention, and track record of success. Once you’ve done your homework and met with the legal teams that look promising, then you can choose the one that is right for you and work with them to aggressively attack the prosecution to protect your future.

 

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