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Attorney General asked to crack down on Medicare overbilling

The federal government is like a giant octopus with its long arms reaching into the pockets of millions of Americans across the nation. It pulls money out of most pockets and puts money into others in its efforts to provide services and care to people on Medicare and Medicaid.

Senate Judiciary Committee Chair Chuck Grassley thinks too much money is being put into the pockets of Medicare Advantage health plans that taxpayer advocates say are overcharging the government. The privately run insurance plans are growing more popular -- and richer at taxpayer expense, critics say, by overcharging the government by billions of dollars.

Grassley has asked Attorney General Loretta Lynch to crack down on systematic abuse by the plans providing care to more than 16 million Americans, according to news reports.

Whatever Lynch, Grassley and other parts of the federal government eventually do to address the problem, it will be at a macro level that will to some degree affect all taxpayers. However, on a micro level -- here in Orlando and surrounding areas -- the problem of overbilling plays out in the offices of doctors and prosecutors alike, involving people known in our communities.

Orlando doctors have been charged with what is known as "upcoding" -- a process of using incorrect codes to have minor procedures billed as more expensive services. In some cases, the upcoding is a repeated clerical error that gives a false impression to prosecutors of ongoing fraud.

In these situations, an experienced attorney can use forensics specialists to identify coding errors and explain to investigators the source of the billing errors. In that way, indictments can often be averted or downsized to more accurately reflect circumstances.

If you believe you're under investigation for Medicare or Medicaid overbilling, it's time to discuss matters with The Law Offices of Mark L. Horwitz. Please see our False Billing page for more information.