Criminal Defense Lawyers

How Lawyers Defend Clients Against Medical Identity Theft Charges

How Lawyers Defend Clients Against Medical Identity Theft Charges

Medical identity theft is a growing problem in the United States. This type of fraud occurs when someone uses another person’s personal information, such as their name, health insurance details, or medical records, to obtain medical services or goods. Victims of medical identity theft can face financial losses, damage to their credit, and errors in their medical records that could impact their healthcare.If you’ve been accused of medical identity theft, having an experienced defense lawyer on your side is crucial. Here’s an overview of how criminal defense attorneys help clients fight medical identity theft allegations.

Understanding the Charges

Medical identity theft can lead to both civil and criminal charges. On the criminal side, defendants may face charges like:

• Identity theft or fraud – Using someone else’s personal information to obtain medical care, services, insurance reimbursements, prescription drugs or medical equipment.
• Insurance fraud – Submitting false claims to private insurance companies or government health programs like Medicare.
• Forgery – Creating fake prescriptions or medical documents.
• Larceny – Stealing medical supplies or equipment.
• Conspiracy – Working with others to commit identity theft or fraud.

The exact charges depend on the details of each case and the applicable state laws. Defense lawyers start by thoroughly examining the charges and the prosecution’s evidence. This helps them identify weaknesses in the state’s case and begin planning the defense strategy.

Investigating the Facts

In building a defense, lawyers dig deep into the specifics of the allegations. They’ll look for evidence that the defendant:

• Had permission to use the alleged victim’s medical information. Some identity theft charges arise from misunderstandings about whether a patient authorized someone else to seek care in their name.
• Lacked criminal intent. Mistakenly using someone else’s health insurance card at the doctor’s office is different from deliberately stealing identities to defraud healthcare providers.
• Didn’t actually gain any medical services or goods illegally. Prosecutors must prove the defendant used stolen information successfully, not just attempted to do so.

Thorough investigation and analysis of the prosecution’s timeline of events can uncover factual errors, inconsistencies and other opportunities to undermine their case.

Challenging the Evidence

In many medical identity theft prosecutions, the evidence mainly consists of documents – medical records, insurance claims, prescriptions, invoices from healthcare providers, etc. Defense lawyers scrutinize this paper trail for any irregularities that suggest fabrication, tampering or fraud.They also look for chain of custody gaps and other evidentiary weaknesses that could get key prosecution documents excluded from trial. Medical records in particular must meet special requirements to be admissible in court.Beyond documents, attorneys also assess any physical evidence like prescription drugs or medical equipment allegedly obtained illegally. They determine whether proper procedures were followed in collecting, storing and testing those items. Sloppy forensic handling gives the defense grounds to question the reliability of the physical evidence.

Interviewing Witnesses

Witness interviews and depositions are another critical step. The defense attorney’s goal is to identify witnesses who can contradict the charges or provide testimony favorable to the defendant.Potential witnesses include:

• The defendant – The lawyer will prepare their client to tell their side of the story clearly and believably at trial. They’ll also advise the defendant about whether or not to testify.
• Healthcare providers – Doctors, nurses, pharmacists and others involved in the defendant’s medical treatment may help establish timelines and facts that undermine the prosecution.
• Character witnesses – Friends, employers, clergy and family members who can vouch for the defendant’s honesty and integrity.
• Expert witnesses – Accountants, investigators and other specialists who can analyze the financial records and other data to point out inconsistencies.

Raising Affirmative Defenses

Beyond contesting the prosecution’s charges and evidence directly, defense lawyers also research possible affirmative defenses to assert. These include:

• Mistake – The defendant believed they had legitimate access to use the medical information or made an honest error in doing so.
• Consent – The alleged victim gave the defendant permission to use their personal information to get medical treatment.
• Duress – An abuser or other third party coerced the defendant into medical identity theft.
• Insanity – Due to mental illness, the defendant did not understand their actions were wrong or illegal.

Other potential defenses depend on the specific charges and circumstances of the case.

Negotiating Plea Agreements

If the prosecution’s case looks strong, the attorney may advise their client to negotiate a plea bargain rather than go to trial. They’ll work to get charges reduced or dropped in exchange for the defendant’s guilty plea. This avoids the risk of conviction on more serious charges at trial.Even when pleading guilty, the lawyer’s advocacy can significantly reduce sentencing. They’ll present mitigating factors to the court like mental health issues, substance abuse treatment needs, a defendant’s minor role in the overall fraud scheme and other information that may warrant leniency.

Going to Trial

If no acceptable plea deal can be reached, the attorney will aggressively defend their client at trial. This involves presenting opening and closing arguments highlighting reasonable doubt about the charges, cross-examining witnesses, authenticating evidence favorable to the defense, and objecting to the prosecutor’s improper questions and evidence.The lawyer will also seek to exclude prejudicial evidence and testimony before trial through motions. Skilled trial attorneys know how to present the defendant’s case in the best light possible and capitalize on any weaknesses in the prosecution’s arguments.

Appealing a Conviction

If convicted at trial, the defense lawyer may advise their client to appeal. Appeals focus on legal and procedural errors that occurred during the trial, like improperly admitted evidence, lack of proof beyond a reasonable doubt, and incorrect jury instructions.While appeals rarely lead to an acquittal, they may result in a conviction being overturned. This gives the defense another chance to win an acquittal or better plea bargain in a new trial.Fighting medical identity theft charges takes knowledge, preparation and persistence. An accomplished defense lawyer thoroughly investigates the facts, aggressively challenges the prosecution’s evidence and arguments, and presses every possible advantage for their client. Their advocacy can help achieve the best possible outcome.

How to Avoid Being Falsely Accused

While the best defense against false medical identity theft allegations is hiring a top lawyer, you can also reduce the risk by:

• Closely guarding your health insurance details, medical paperwork and prescription information.
• Reviewing medical bills and statements routinely for any suspicious claims.
• Securing documents you discard that contain personal information.
• Using online patient portals to monitor your medical records.
• Being cautious when giving personal information to new healthcare providers.
• Reporting stolen insurance cards, prescriptions or other medical paperwork to the police and your healthcare providers immediately.
• Placing a fraud alert or credit freeze on your accounts if you suspect any medical identity theft.

Finding the Right Lawyer for Your Case

If you are under investigation or have been arrested for medical identity theft, time is of the essence. Consult with a criminal defense attorney as soon as possible about building your defense. Look for a lawyer with extensive experience fighting healthcare fraud cases and a proven ability to get charges reduced or dismissed pre-trial. With an experienced legal advocate on your side, you can avoid being wrongly convicted.

References:

 https://www.consumer.ftc.gov/articles/what-know-about-medical-identity-theft

 https://www.equifax.com/personal/education/identity-theft/articles/-/learn/medical-identity-theft/

 https://ncdoj.gov/protecting-consumers/protecting-your-identity/medical-identity-theft/

 https://oig.hhs.gov/fraud/consumer-alerts/medical-identity-theft/

 https://www.cms.gov/files/document/wsafeguardingbooklet042516fpdf