Joseph Potashnik and Associates PC Provides Consultation to Medicare Advantage Insurers

As the Department of Justice consolidates its efforts to fight healthcare fraud, Joseph Potashnik and Associates PC, an NYC-based criminal defense law firm, offers legal representation to MA plans companies investigated or charged with Medicare fraud.


New York, NY -- (ReleaseWire) -- 07/27/2017 --Founded in 2006, Joseph Potashnik and Associates PC has a team of established attorneys who specialize precisely in government-funded healthcare programs fraud cases. The lawyers represent both Medicare and Medicaid program beneficiaries and providers, as well as private insurers who provide Medicare Advantage Plans.

Such private insurers take on the obligation of the Centers for Medicare and Medicare Services (CMS) to set risk scores for specific patients, which will later determine the amount of reimbursement paid to the healthcare provider by the government and the fee paid to the insurer.

As you see, the specifics of MA Plans make it easy for some insurers to commit fraud by setting higher risk scores, either unintentionally or on purpose. Recently, the Department of Justice reached a settlement of $32.65 million with Freedom Health, a Medicare Advantage insurer. Also, there is an ongoing lawsuit against United Healthcare, one of the largest Medicare Advantage insurance companies that allegedly manipulated risk scores to overbill Medicare. In view of these suits, the Justice Department's new Medicare fraud target is for-profit insurers contracted by the government to manage healthcare.

An investigation into the performance of an insurance company can uncover not only deliberate inflation of risk scores but also other activities that may appear fraudulent to the investigators, for example, some inaccuracies in representation of the provider network of a specific insurer. Therefore, it is necessary for a company facing a DOJ investigation to hire an attorney specializing in False Claims Act allegations. Joseph Potashnik and his colleagues have years of experience in dealing with such cases and they are more than capable of providing effective criminal defense services to Medicare Advantage insurance companies. These NYC healthcare fraud defense lawyers will provide guidance to the insurer on any stage of litigation, from initial audit to criminal investigation to court prosecution, if necessary.

About Joseph Potashnik and Associates PC
Joseph Potashnik and Associates, PC is a New York City multi-practice law firm whose attorneys providing legal representation to clients facing criminal investigations and prosecution in state and federal courts. The firm's criminal defense lawyers specialize in cases of immigration fraud, Medicaid and Medicare fraud, financial crimes, cyber crimes, tax fraud and evasion, and a lot more.

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Media Relations Contact

Brad Conelly

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