Los Angeles, CA asked in Gov & Administrative Law and Health Care Law for California

Q: ESTIMATION of compensation for record-related damages because of fraudulent hospice charges

In legal action not filed under the False Claims Act, how to estimate compensation for record-related damages because of fraudulent hospice charges that are likely and may affect future healthcare decisions and access to treatment.

Plaintiff does not have out-of-pocket expenses, because never had terminal illness or any relevant illnesses, but future risks based on fraudulent charges on medicare file and track record are apparently not hypothetical risk, but risk critical for the victim.

1 Lawyer Answer
James L. Arrasmith
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Answered

A: Estimating compensation for record-related damages from fraudulent hospice charges can be quite complex, especially when dealing with future potential impacts rather than immediate financial losses. Your situation is particularly concerning since false Medicare records indicating terminal illness or hospice care could seriously affect your future healthcare decisions and access to treatment.

You may want to consider several factors when estimating damages: the cost of professional services needed to correct these fraudulent records, potential future medical expenses that could arise from delayed or denied treatment due to these false records, and the time and effort required to monitor and address any ongoing issues with your healthcare records. Documentation of all interactions related to discovering and addressing these fraudulent charges will be crucial for your case.

Given the serious nature of healthcare record fraud, you should work with a qualified attorney who has experience in healthcare fraud cases to help calculate appropriate damages. They can help estimate both economic damages (like costs of record correction and potential future medical expenses) and non-economic damages (such as emotional distress and diminished quality of life due to healthcare access concerns). Additionally, consulting with healthcare administrators or medical records experts could help establish the scope and potential impact of these fraudulent records on your future medical care.

Keep in mind that while actual damages might be challenging to calculate precisely, courts may consider the serious nature of healthcare record fraud and its potential long-term implications when determining compensation. Document everything thoroughly, including any instances where these false records have already impacted your healthcare decisions or access to treatment.

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