Healthcare Fraud

The federal criminal healthcare fraud statute makes it a crime to defraud Medicare or Medicaid. Specifically, the law states that anyone who knowingly and willfully executes or attempts to execute a scheme against a health care benefit program can be imprisoned for a maximum of ten years, unless the violation resulted in a serious bodily injury, in which case the maximum is twenty years.

Healthcare fraud charges are often just the beginning.

The United States Attorney’s Office can also usually add a number of other white color crimes, including violations of the False Statements and False Claims Acts, and mail and wire fraud as previously discussed, which in turn can dramatically increase the maximum prison sentences. As with all white color crimes, these cases are often very complex. The federal government rarely invests the time to prosecute a person who illicitly gained a negligible amount. Far more frequently, the fraud will consist of years of repeated offenses costing the government and taxpayers hundreds of thousands or even millions of dollars.

What does federal law say about healthcare fraud?

18 U.S. Code § 1347 is Health care fraud. It reads:

(a) Whoever knowingly and willfully executes, or attempts to execute, a scheme or artifice—

(1) to defraud any health care benefit program; or

(2) to obtain, by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any health care benefit program, in connection with the delivery of or payment for health care benefits, items, or services, shall be fined under this title or imprisoned not more than 10 years, or both. If the violation results in serious bodily injury (as defined in section 1365 of this title), such person shall be fined under this title or imprisoned not more than 20 years, or both; and if the violation results in death, such person shall be fined under this title, or imprisoned for any term of years or for life, or both.

(b) With respect to violations of this section, a person need not have actual knowledge of this section or specific intent to commit a violation of this section.

We will fight aggressively to defend you.

When that much time and money is involved, you can be sure that the level of complexity for a successful defense will require a skilled and experienced attorney. Tim Bower Rodriguez, PA will fight aggressively to ensure you get the best possible outcome based on the evidence in your case. The government must prove its case beyond a reasonable doubt, and must prove that the defendant, willfully and knowingly, intended to defraud the program. Make sure you retain an attorney that has the skill set required to see you through these charges. Contact us to request your free healthcare fraud defense consultation today.