Criminal Defense Lawyers

Conspiracy to Commit Medicare Fraud (18 U.S.C. 1347; 18 U.S.C. 371)

Last Updated on: 11th March 2025, 10:25 pm

CONSPIRACY TO COMMIT MEDICARE FRAUD

Let’s be brutally honest for a second. If you’re on this page, it’s probably because you or someone close to you is worried about a serious criminal situation. Conspiracy to commit Medicare fraud is a huge deal, and it can open the door to massive amounts of legal trouble. When you’re up against federal authorities who have the power to investigate you day and night, you need a top rated federal defense law firm on your side, capable of winning your case. That’s exactly where Spodek Law Group comes in. We are a nationwide federal defense law firm created by Todd Spodek, and we focus on giving you the best possible representation at all times. We won’t tolerate excuses, and we won’t back down from a fight.

Today, we’re going to pull back the curtain on how conspiracy to commit Medicare fraud works. We’ll discuss how it’s charged, where you can find official definitions, how prosecutors approach these cases, and what punishments you might face. Then, we’ll explain specific defense strategies that may help you. We’ll be candid: this is not a place for you to hide from the facts. If you want to beat serious charges, you’ll need a plan, an attorney who cares about your future, and a willingness to face reality head-on.

WHAT EXACTLY IS CONSPIRACY TO COMMIT MEDICARE FRAUD?

A conspiracy is an agreement between two or more people who were planning or intending to break the law. Medicare fraud is a crime that involves illegal activity against the Medicare program, which is a federal program under the oversight of the Medicare.gov system. Conspiracy to commit Medicare fraud means you and others plotted to cheat Medicare out of money or benefits. This is important because federal prosecutors will often charge everyone involved if they see any sign of collusion.

Conspiracy that was formed to commit fraud may include schemes like billing Medicare for services that were never provided, or misrepresenting a procedure in order to get higher reimbursements. The minute the government spots unusual billing patterns, it launches an investigation. Once they discover any communication or agreement that points to a plan to cheat the system, they may charge you. The consequence of being charged is terrifying: it can mean criminal penalties, including years in federal prison, massive financial fines, and a lifetime burden of having a federal conviction.

WHERE TO FIND OFFICIAL DEFINITIONS

The Justice.gov website has detailed information about conspiracy laws and how the federal government prosecutes them. The Office of Inspector General (OIG) at the U.S. Department of Health and Human Services also has guidelines on healthcare fraud and the laws that were created to punish fraud against Medicare. If you dig through these official websites, you’ll find that they emphasize the government’s commitment to stopping fraud by any means necessary. Reading the official policy helps you see just how seriously they take these cases.

Evidence that was collected from medical providers, billing companies, or patient files may all be used as proof that a conspiracy existed. Once that evidence is linked to you, the government will examine every step you took to see whether you participated in the scheme. This is why it’s crucial to have an experienced federal defense law firm who knows how these investigations work.

PENALTIES AND PUNISHMENT

Let’s talk about the consequences: If you’re found guilty, the penalties for conspiracy to commit Medicare fraud can be harsh. Prison time is a real possibility, and the federal sentencing guidelines often include years in prison for large-scale fraud. The federal court might also impose massive fines that could bankrupt you, or order restitution that forces you to pay back every dollar Medicare lost. In some cases, the sentence may include probation, community service, or strict monitoring of your finances. This is not a slap on the wrist; the government wants to make an example of anyone who tries to cheat Medicare.

Getting convicted also means your life changes forever. You might lose professional licenses that were crucial to your work, and your reputation in your community might suffer. If you are a doctor who was working for a major hospital, you could lose your job. If you own a clinic, your entire business may collapse. The government will also freeze assets they believe are linked to the fraud, which means your bank accounts, property, or other valuables can be seized. Once that happens, it can be very difficult to maintain financial stability.

WHY PROSECUTORS PURSUE THESE CASES AGGRESSIVELY

The government treats any attempt to defraud Medicare as a threat to public funds. Federal authorities know that the entire Medicare system depends on honest providers and accurate billing. When they suspect wrongdoing, they may assign special task forces to investigate. This is especially true if your alleged conspiracy involved large amounts of money, multiple people, or many patients. The bigger the potential fraud, the more likely the prosecution will demand serious punishment.

Here’s a harsh reality: If you think you can hide behind complicated medical codes or claim ignorance about billing, the Department of Justice may disagree. They have resources that can dig into emails, billing records, call logs, or even text messages. Investigators who were working to trace transactions can build a paper trail that proves who was involved. That kind of evidence can crush your defense if you aren’t prepared.

HOW WE AT SPODEK LAW GROUP DEFEND YOU

We are Spodek Law Group, and we have over 50 years of combined experience dealing with legal challenges nationwide, including federal cases involving healthcare fraud. Our criminal defense attorneys know exactly how prosecutors build conspiracy cases, and we develop defense strategies that chip away at their claims. Our approach is straightforward: we look for holes in the government’s evidence, we examine the motives of witnesses who were talking to prosecutors, and we pressure the prosecution to prove every piece of their case beyond a reasonable doubt.

Let’s say there is evidence that was illegally obtained, for instance, through an improper search. That evidence can be challenged in court. If it’s thrown out, the government’s argument might collapse. The consequence is huge: without key proof, they may have to drop or reduce charges. Another angle is to show you lacked the intent to join any conspiracy. Maybe you were simply following the rules that were provided to you by a superior, without understanding the bigger picture. In that situation, we focus on separating you from the real ringleaders who orchestrated the fraud.

Sometimes, we can negotiate a favorable plea agreement if going to trial is too risky. That negotiation can reduce your charges or your sentence, so you avoid the longest prison terms or largest fines. Our goal is to protect your livelihood, preserve your reputation, and safeguard your freedom. We’ll be brutally honest with you about what to expect, and we’ll outline the best possible plan for minimizing damage.

STRATEGY, LEVERAGE, AND YOUR ROLE

You want a lawyer who focuses on leverage points that create maximum impact. That means we look at every angle of your case—financial records, medical records, electronic communications—to find the one piece of evidence that can shift the entire narrative. If we find that the prosecution’s star witness has major credibility problems, we highlight those problems in court. If we discover that investigators broke certain rules, we bring that up before the judge. Our job is to break down the government’s case at its roots, so the entire structure topples.

We also expect you to work with us. Don’t withhold information that could help us. If you’ve made mistakes, own them, because trying to bury the truth almost always backfires. When we push you beyond your comfort zone, it’s for a reason: half-hearted defenses rarely lead to victory. At Spodek Law Group, we hold you to a high standard, because your future is on the line.

MULTIPLE POINTS OF VIEW

Government agents who were assigned to a Medicare fraud unit typically see this crime as a direct threat to taxpayers, and they aim to punish it severely. Meanwhile, healthcare providers who were charged with conspiracy might believe they merely followed normal billing practices that were standard in their clinic. The tension is clear: one side claims you scammed a national program, the other side says you complied with complicated regulations. The truth may be somewhere in between. Our job is to show your perspective, highlight the facts, and dismantle any false assumptions the government is making. That kind of nuanced argument can persuade the judge or the jury that you do not deserve the harshest penalties.

QUICK-REFERENCE FAQ TABLE

TAKE ACTION NOW: DEFEND YOURSELF BEFORE IT’S TOO LATE

Prosecutors are thorough, but you still have rights. We are Spodek Law Group, and we’re available 24/7 to provide a risk free consultation. Once we understand your situation, we’ll start developing a defense that fights for your freedom. If you wait too long, you could lose the chance to challenge crucial evidence or secure favorable testimony. The consequence of waiting is devastating—your case grows cold, and the government gains more time to strengthen its arguments.

We push you to think bigger about your defense. We don’t tolerate half-measures or cheap excuses. If you want to protect yourself, you must go all in. That might mean gathering every record you have, listing every conversation you recall, and being completely transparent about what really happened. It’s not comfortable, but it’s necessary. Without that, we can’t design the best possible defense.

When you choose Spodek Law Group, you hire a rock star team of attorneys who have over five decades of combined experience. We know how to handle tough conversations with federal prosecutors, we understand how evidence that was illegally obtained can be excluded, and we fight to ensure your voice is heard. Our brand is built on delivering successful outcomes, especially in complex federal cases. Conspiracy to commit Medicare fraud is serious, but it’s not unbeatable. There is hope when you have a strategic plan and a law firm willing to put in the work.

CONTACT US FOR A RISK FREE CONSULTATION

Ready to talk? If you’re facing allegations, or even if you suspect you might be under investigation, call us. There’s no need to wait until you’re indicted. Early intervention can mean the difference between an easy dismissal and a lengthy federal trial. Even if your case is already in motion, we can still step in, examine the prosecutor’s evidence, and find ways to minimize the charges.

We’re not going to sugarcoat anything. We’ll tell you precisely where you stand, what your biggest vulnerabilities are, and how we’d defend you. That honesty can be uncomfortable, but it’s the only way we know how to operate. When you call Spodek Law Group, you get attorneys who think in systems and root causes, not surface-level quick fixes. We design specific action plans to address every gap in your defense, and we won’t let you hide from the responsibilities that come with protecting your freedom.

Don’t gamble with your future. Reach out to us now, and let’s figure out the path forward. We’re here, day or night, because your life doesn’t pause just because the government decided to take action against you. With the right legal strategies, your story doesn’t have to end with a conviction.

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