The most important facts at a glance
- Suspected billing fraud not only jeopardizes a doctor's professional reputation, but also their economic existence. There is a risk of criminal consequences, including the withdrawal of a license to practice.
- It is crucial to find a specialized Criminal defense lawyer who will carefully examine the situation and develop an individual defense strategy.
- A customized strategy, including the review of internal accounting documents and strategic negotiations with the investigating authorities, is essential to effectively refute the allegations and achieve an optimal resolution.
What exactly is billing fraud?
Billing fraud occurs when false or inflated invoices are submitted to the health insurance funds or the Association of Statutory Health Insurance Physicians in order to gain an unlawful financial advantage. This can be done, for example, by billing for services not rendered, incorrectly coding treatments or splitting up services.
Whether conduct is criminally relevant is often a question of the individual case. The line between negligence and intentional deception is sometimes blurred. It is therefore all the more important to consult a specialist criminal defence lawyer at an early stage, who will carefully examine the facts of the case and advise you on the prospects of a successful defence.
Your situation - our customized strategy
The accusation of billing fraud plunges most doctors into a deep crisis. Fears about their livelihood, worries about their reputation, overwhelming inquiries from the authorities - in this situation it is difficult to think clearly. This is where you need an experienced lawyer who can keep calm and work with you to develop an optimal defense strategy.
Every case is different - which is why we develop an individual concept for each client to refute the allegations. This includes, among other things:
- Careful examination of internal accounting documents and processing of actual events
- Determination and presentation of exonerating circumstances that also speak for your integrity
- Strategic negotiations with the investigating authorities, possibly with the aim of discontinuing proceedings
A trusting, personal client relationship is particularly important to us. You are the focus - and we take the pressure off you in your difficult situation so that you can concentrate fully on your core task: The care of your patients.
Concentrated expertise for your best possible defense
As specialist lawyers for criminal law, we have a deep understanding of the special features of white-collar criminal proceedings in the healthcare sector. We know what is important in billing fraud proceedings and where the typical pitfalls lie.
With this knowledge and our many years of litigation experience, we have already successfully concluded numerous cases. Be it by obtaining a dismissal in the preliminary proceedings, a plea bargain with a lenient sentence or an acquittal in court - we always give our all for the best possible outcome.
Even in complex, difficult cases, we regularly succeed in achieving a significant improvement in our clients' situation through perseverance and tactical skill. We accompany you through all phases of the proceedings - from the first moment of suspicion to the legally binding conclusion.
What speaks for our law firm?
- Specialization in criminal defense in the healthcare sector with a particular focus on billing fraud
- Years of experience, numerous successes, excellent reputation
- Holistic, individual support with commitment and passion
- Highest level of seriousness, absolute discretion and confidentiality
- Networking with first-class experts and appraisers
- High level of professional expertise coupled with empathy and understanding for your particular situation
With us, you have an experienced and determined lawyer at your side who is fully committed to your interests. We will fight for your reputation, your license to practice medicine and, last but not least, for your personal and professional rehabilitation.
And what happens now?
The first step is very simple: give us a call or send us an e-mail to arrange a non-binding initial consultation. During this appointment, you can describe your situation to us in detail and clarify any unanswered questions. We will then analyze the situation from a legal perspective and show you specific options for action.
When you mandate us, we take care of all the necessary steps directly - from the official inspection of files and communication with the authorities and public prosecutor's office to dedicated representation in court. You will always be closely involved and retain full control at all times.
It is important that you take action as early as possible. The sooner we can intervene, the better the chances of turning the tide and influencing the proceedings in your favor. So don't be afraid to contact us - even if the accusations seem unfounded. We are here for you.
Frequently asked questions
Billing fraud occurs when doctors deliberately submit false or inflated invoices to health insurance companies in order to gain an unlawful financial advantage. Examples include billing for services not rendered or the deliberate miscoding of treatments.
Billing fraud is a criminal offense that can be punished with at least a fine or imprisonment of up to 5 years. As it is usually a case of commercial fraud, each offense is generally punishable by a prison sentence of between 6 months and 10 years. There is also the threat of professional sanctions, including the withdrawal of a license to practice. Disciplinary measures and civil reclaims are also possible.
Yes, legally speaking, that makes a big difference. Only intentional billing fraud is punishable. However, negligent billing errors can have consequences under professional and contractual law.
As soon as you receive notification from the public prosecutor's office, the health insurance company or the health insurer about an investigation or an examination, it is strongly advisable to seek legal advice. The sooner you consult a specialist criminal defence lawyer, the better.
If there is an urgent suspicion of a crime, the public prosecutor's office can order a search of the practice premises. Relevant documents and data will be confiscated. Keep calm, ask to see the search warrant and contact your lawyer immediately.
Following a report or initial suspicion, the public prosecutor's office initiates the investigation. Interrogations take place, sometimes even house searches. At the end, a decision is made as to whether charges will be brought. If so, the case goes to trial in court.
The strategy depends on the individual case. It is important to carefully analyze the facts of the case and the evidence. It is often possible to achieve a dismissal or a lighter sentence by working through exonerating circumstances, presenting counter-expert opinions or skillful negotiations.
The costs vary greatly depending on the scope and complexity of the case. As a rule, defense lawyers in cases of billing fraud will bill on the basis of a fee agreement. In addition, there may be expenses for expert opinions and the like. It is therefore difficult to make a general prediction.
This cannot be said uniformly either. White-collar criminal proceedings in the medical field often take several months, sometimes even years, due to the large number of documents that need to be evaluated. However, good legal representation can often shorten the duration.
Look specifically for a specialist criminal lawyer, ideally with experience in white-collar criminal cases in the healthcare sector. Look for relevant litigation experience and references. Specialization in medical billing issues is an advantage. We at SITTIG LAW fulfill these requirements.
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