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Baton Rouge agency owner charged with Medicaid fraud

A conviction on some criminal charges couples prison time with other severe consequences. Penalties for violations of federal health care programs are detailed and lengthy in U.S. Code 1320-a: 7-b. In short, a Medicare or Medicaid fraud charge has the potential to ruin a defendant's professional standing and finances.

The head of a Baton Rouge personal care agency was recently charged with health care fraud. The 36-year-old owner of Distinctive Healthcare Services LLC is accused of billing the state Medicaid Program for thousands of dollars in services clients never received. Money laundering activities apparently funneled over $100,000 from corporate to other bank accounts.

Federal and state authorities claim to have evidence the defendant billed Medicaid for services she could not have rendered because, in some instances, the Zachary defendant was out of state or the recipient was in prison. Investigators also said the woman paid kickbacks to Medicaid-qualified individuals to pretend they were the agency's clients.

The defendant reportedly also employed 10 convicted felons, who were forbidden by state law to work as personal care employees. Bills sent from Distinctive Healthcare Services to the state's Medicaid office last year totaled $885,000. Reports did not say how much of that total included fraudulent bills.

Medical fraud can include a series of charges, which may be prosecuted in state or federal courts. With government money at stake, fraud investigators are often zealous. Agents, who may or may not have medical or accounting knowledge, can incorrectly decipher a medical provider's patient files and coding or billing systems.

Some individuals feel any defense against federal prosecutors is hopeless, but that's far from true. Prosecutors who claim defendants have broken federal laws must back the charge with solid evidence before a guilty verdict is possible. Defense attorneys experienced with fraud cases and federal courts can tell clients what to expect and guide them along the most advantageous legal course.

Source: The Advocate, "Zachary woman accused of Medicaid fraud" Baker-Zachary Bureau, Mar. 06, 2014

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