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Christopher B, Esq.
Christopher B, Esq., Lawyer
Category: Criminal Law
Satisfied Customers: 2983
Experience:  associate attorney
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Thank you response. If I am the owner of the facility was

Customer Question

hello Christopher and thank you for your response. If I am the owner of the facility was unaware during this period what is my exposure?
Submitted: 1 year ago.
Category: Criminal Law
Expert:  Christopher B, Esq. replied 1 year ago.

You have exposure as I outlined in my previous answer. Each instance can be an additional count and if Medicare is involved then it can only get more serious. If you knowing cover up this behavior then you can be charged with intentional fraud instead of a simple mistake. Clearing up the mistake and repayment of the charges should take care of the problem unless it is more widespread. Noone wants to punish someone that made an honest mistake and if you self report, it is more likely that nothing will come from it. It is very difficult to give you advice on your exposure as I am simply seeing a couple of paragraphs on a message board. I would contact a local attorney and get out in front of this to limit any exposure.

Expert:  Christopher B, Esq. replied 1 year ago.

From Title 18 4117 from the Pennsylvania code:

(g) Civil action.--An insurer damaged as a result of a violation of this section may sue therefor in any court of competent jurisdiction to recover compensatory damages, which may include reasonable investigation expenses, costs of suit and attorney fees. An insurer may recover treble damages if the court determines that the defendant has engaged in a pattern of violating this section. (h) Criminal action.-- (1) The district attorneys of the several counties shall have authority to investigate and to institute criminal proceedings for any violation of this section. (2) In addition to the authority conferred upon the Attorney General by the act of October 15, 1980 (P.L.950, No.164), known as the Commonwealth Attorneys Act, the Attorney General shall have the authority to investigate and to institute criminal proceedings for any violation of this section or any series of such violations involving more than one county of the Commonwealth or involving any county of the Commonwealth and another state. No person charged with a violation of this section by the Attorney General shall have standing to challenge the authority of the Attorney General to investigate or prosecute the case, and, if any such challenge is made, the challenge shall be dismissed and no relief shall be available in the courts of the Commonwealth to the person making the challenge. (i) Regulatory and investigative powers additional to those now existing.--Nothing contained in this section shall be construed to limit the regulatory or investigative authority of any department or agency of the Commonwealth whose functions might relate to persons, enterprises or matters falling within the scope of this section. (j) Violations, penalties, etc.-- (1) If a person is found by court of competent jurisdiction, pursuant to a claim initiated by a prosecuting authority, to have violated any provision of this section, the person shall be subject to civil penalties of not more than $5,000 for the first violation, $10,000 for the second violation and $15,000 for each subsequent violation. The penalty shall be paid to the prosecuting authority to be used to defray the operating expenses of investigating and prosecuting insurance fraud. The court may also award court costs and reasonable attorney fees to the prosecuting authority. (2) Nothing in this subsection shall be construed to prohibit a prosecuting authority and the person accused of violating this section from entering into a written agreement in which that person does not admit or deny the charges but consents to payment of the civil penalty. A consent agreement may not be used in a subsequent civil or criminal proceeding, but notification thereof shall be made to the licensing authority if the person is licensed by a licensing authority of the Commonwealth so that the licensing authority may take appropriate administrative action. Penalties paid under this section shall be deposited into the Insurance Fraud Prevention Trust Fund created under the act of December 28, 1994 (P.L.1414, No.166), known as the Insurance Fraud Prevention Act. (3) The imposition of any fine or other remedy under this section shall not preclude prosecution for a violation of the criminal laws of this Commonwealth.

Please let me know if you have any further questions and please positively rate my answer if satisfied.

Expert:  Christopher B, Esq. replied 1 year ago.

I see you have reviewed my answer, do you have any further questions? If not, please positively rate my answer (there should be smiley faces or numbers from 1-5 next to my answer, a good or excellent rating would be fantastic) as that is the only way I will be compensated by the site for my work. This will not cost you anything extra and this extra step would be appreciated.

Expert:  Christopher B, Esq. replied 1 year ago.

Any chance for a positive rating? Feel free to ask any related followup questions as I want you to be a satisfied customer.

Expert:  Christopher B, Esq. replied 1 year ago.

You requested me specifically for this question and I am wondering if you have any further questions regarding this matter. I thought I answered your question fully and I would hope you could positively rate my answer so the site will reimburse me for my work. Again, this will not cost you any additional money and I would appreciate your help on this extra step.