Theft

April 19, 2024

When Medical Professionals are Accused of Healthcare Fraud

This country faces a serious problem in terms of healthcare fraud, and authorities have not hesitated to impose serious consequences. As the most expensive white-collar crime in the country—racking up nearly $100 billion in lost funds — the state of California is more than willing to prosecute fraudsters. Both state and federal prosecutors, in fact, are going after individuals and organized groups who engage in this type of fraud on a daily basis.

Examples of Fraud

Fraud might occur involving individuals who work in hospitals, nursing homes, dentist offices, and more. Professionals and staff who try to cheat health insurance companies are a serious concern because there are multiple ways to engage in a swindle, and a successful fraudster can essentially steal big dollars and impact patient outcomes. Deliberately providing incorrect or false information to an insurance company is the bottom line of many fraud cases.

Double billing insurance companies for a single procedure;
Coding procedures in a way that makes billing more expensive;
Charging for procedures and/or care to increase profits;
Prescribing unnecessary medications and/or procedures in order to get kickbacks from pharmaceutical companies.

Legal Penalties

When the fraud involves under $950, offenders in California may face misdemeanor charges with up to six months in jail and fines of $1,000. Felony health care fraud, however, could mean up to five years behind bars and as much as $50,000 in penalties, or double the amount of the fraud. In the case of medical professionals being convicted, they could lose their professional license. Federal penalties are dependent on the degree of injury that occurs to a patient. Even with no injuries, perpetrators could wind up serving 10 years behind bars. That doubles when serious injury results from the fraud and becomes a life sentence if the fraud results in a fatality.

Federal False Claims Act

Any person or entity who knowingly submits a sham claim for Medicare, Medicaid, or other federally funded programs or who intentionally retains an overpayment for 60+ days is in violation of the federal False Claims Act. In addition to having to pay triple the damages suffered by the Government, perpetrators may have to pay nearly $22,000 per falsified claim.

Defending Fraud Claims

One of the strongest defenses against claims of healthcare fraud is to demonstrate that any perceived billing irregularities were the result of misunderstandings and/or unintentional mistakes. Demonstrating that patients received legitimate care consistent with billing will be important, as will establishing a pattern of providing high-quality care aimed at patient well-being. Continue reading

November 25, 2022

Criminal Charges for Retail Theft

by David M. Boertje

Traditionally the holidays are a time when retailers experience an escalation in retail theft. Whether it is a case of beer or a pearl necklace, the law sees it all the same. Shoplifting costs retailers, insurance companies, and consumers every single day. And if you are caught in California, you will be the one to pay the price. That is why finding an experienced local criminal defense attorney would be a good move right about now.

Prevention

Retailers take the theft of their merchandise seriously and are doing whatever they can to put a dent in retail theft. In addition to providing employees with better training so they can spot shoplifters, many retailers are hiring undercover personnel who pretend to be shopping while keeping an eye out for would-be thieves. Technology is helping, too. As everyone knows, cameras are everywhere these days, tracking the movements of customers and of thieves. Pricier items may be under lock and key and often contain tags that set off alarms in the event of a theft.

If You Have Been Stopped for Shoplifting

Let’s say that you have been stopped by a store employee who thinks you have been trying to lift something without paying. What should you do? For starters, let’s talk about what you should not do:

Never try to talk your way out of it.
Do not attempt to explain, argue, or physically resist a store employee, security staffer, or police officer.
Do not give your personal information to store employees.
Never sign anything.

Instead, here is what you should do:

If a bonafide police officer questions you, tell them your name.
Ask to speak to your attorney straight away.
Say nothing to managers, loss prevention individuals, or anyone else.

After an Arrest

The number one rule following an arrest is this: Keep your mouth shut. You should have been advised of your Miranda rights. Say nothing beyond expressing your desire to speak to your attorney.

California Penalties for Shoplifting

Shoplifting, which is defined as going into a business that is open intending to steal merchandise worth $950 or less, is taken seriously in California. Offenders could wind up in jail for as long as six months, on top of having to pay fines up to $1,000 and pay restitution to the store owner. And that is for simply attempting to steal something—whether or not you are successful. If the theft involves merchandise valued at more than $950, charges of grand theft can result, which could mean up to three years behind bars and $10,000 in fines. Naturally, repeat offenders could see the penalties increase. Continue reading

April 30, 2021

How Petty Theft in San Diego Can be Charged as a Felony

by David M. Boertje

Taking the neighbor’s bike, lifting a shirt from a friend’s house because you love it, maybe even grabbing a couple of candy bars and a drink from the corner store without paying for them seems fairly innocent. There are many people who think that these actions are not that big of a deal. Taking something here and there without permission or without paying, in reality, is not the most heinous of crimes. Despite this, it still is illegal. In the state of California, if you are arrested for stealing property that is valued at $950 and less, you have committed petty theft. Petty theft is a misdemeanor offense and the maximum jail time you will serve is six months if convicted.

The penalties will increase considerably for some people who are charged with petty theft. Anyone who has been convicted of certain crimes will face a sentence enhancement for their unlawful actions. A person who has a criminal record with qualifying crimes should not take petty theft charges lightly. If you were arrested and charged with petty larceny with a prior in San Diego, you are not out of options when it comes to defending yourself, however. David M. Boertje is a San Diego criminal defense attorney who can discuss your case with you and determine what defense strategy is best suited to protect your interests.

What Happens When You are Charged With Petty Theft With a Prior in California?