Criminal Defense Lawyers

Healthcare Fraud Defense Attorneys

Last Updated on: 24th February 2025, 01:09 am

When you’re dealing with allegations of healthcare fraud, it’s no small matter. Our Healthcare fraud defense attorneys understand the importance of dealing with stressful allegations of healthcare fraud – in all shapes, forms, and states nationwide.

It’s serious. It’s stressful. It can change your life forever. You might even go to jail.

AT SPODEK LAW GROUP – WE GET IT

We understand how frightening it can be when the federal government or state authorities accuse you of violating the law. If you’re looking for a dedicated criminal defense attorney who can handle federal charges pertaining to healthcare fraud, you’ve come to the right place. We have over 50 years of combined experience handling challenging legal issues nationwide, coast to coast.

Facing Allegations of Healthcare Fraud?

Healthcare fraud is a type of crime which involves misleading or deceiving a healthcare program (such as Medicare or Medicaid) or private insurer to obtain financial gain. Under 18 U.S.C. § 1347, anyone convicted of healthcare fraud can face severe penalties, including prison time, financial fines, restitution, and more. Many times, the U.S. Department of Justice (DOJ) (https://www.justice.gov/criminal-fraud) prosecutes these crimes in federal court.

COMMON TYPES OF HEALTHCARE FRAUD

• Billing for Services Not Provided: Submitting claims for procedures, tests, or services that never happened is something the government is cracking down on, especially with the creation of DOGE.
• Upcoding or Unbundling: Reporting a more expensive procedure code than was performed, or separately billing procedures that are typically bundled together is another type of fraud and deception.
• Kickbacks: Under 42 U.S.C. § 1320a–7b(b), offering or receiving illegal remuneration in exchange for patient referrals is strictly prohibited. The Office of Inspector General (OIG) (https://oig.hhs.gov/) closely monitors these cases.
• Violations of Stark Law: 42 U.S.C. § 1395nn prohibits physician self-referrals for certain designated health services. The Stark Law is state and federal agencies take seriously.

PENALTIES AND CONSEQUENCES

If you’re found guilty of healthcare fraud:

• You could face MANY years in federal prison.
• You might pay monetary fines that can reach hundreds of thousands—or even millions—of dollars for all types of healthcare fraud.
• You risk restitution orders which might force you to repay all fraudulent gains.
• You could lose professional licenses (medical, nursing, pharmacy) if convicted, permanently.
• You might also face a permanent criminal record, damaging your future job prospects and your personal reputation.

The stakes could not be higher. You could lose it all, if you’re convicted of healthcare fraud.

Regardless of the situation you find yourself in, know that our criminal defense attorneys can help you. We have handled healthcare fraud cases nationwide,

STRATEGIES WE USE TO DEFEND YOU

Our healthcare fraud defense attorneys begin by examining every piece of evidence. We challenge the prosecution’s case at every stage. Below are common defenses we explore:

1. Lack of Intent

   • We argue you did not knowingly or willfully commit fraud. Healthcare regulations can be extraordinarily complex. Honest mistakes do happen.

2. Insufficient Evidence

   • Prosecutors must prove guilt beyond a reasonable doubt. We look for every hole in their claims, every weak link in their chain of evidence.

3. Illegal Search and Seizure

   • If federal agents collected evidence in violation of your Fourth Amendment rights, that evidence may be suppressed. All evidence must be gathered lawfully.

4. Entrapment or Government Misconduct

   • If you were induced to commit an offense you would not have otherwise committed, the entire case can unravel.

EXPERIENCED. DEDICATED.

Regardless of whether your case involves Medicare fraud, Medicaid fraud, or private insurance fraud, our attorneys bring extensive knowledge of the healthcare system. We care. We know how to fight these cases.

We have offices throughout Long Island and NYC, and we help clients nationwide.

WHY CHOOSE SPODEK LAW GROUP?

• 50 Years of Combined Experience
  We’ve handled thousands of tough cases, federal and state healthcare fraud cases.

• Locations All Over USA
  We handle coast-to-coast cases, from Los Angeles to NYC, with cases involving multiple agencies as well.

• Risk Free Consultation
  We are available 24/7. Ask us anything, at no charge. Get a risk free consultation today.

• As Seen On Major News Outlets
  We’ve been mentioned for our high-profile representations and legal insights, and have experience dealign with all types of healthcare fraud cases.

When you’re worried about losing your livelihood, your freedom, and your future, you need a criminal defense team that understands every phase of the criminal process.

WHAT SHOULD I DO IF I’M BEING INVESTIGATED FOR HEALTHCARE FRAUD?

1. Stay Calm: Don’t speak to federal agents or investigators without consulting an attorney. Anything you say can be used against you.
2. Consult a Criminal Lawyer Immediately: You want an experienced healthcare fraud defense attorney who can advise you on how to proceed. You want someone who has experience dealing with healthcare fraud cases nationwide.
3. Gather Documents: Keep track of billing records, insurance forms, or communications from Medicare or Medicaid (https://www.cms.gov/).
4. Avoid Self-Incrimination: Do not discuss your case with coworkers, friends, or others who might become witnesses. Those other friends, coworkers, etc, can be compelled to tell investigators what you tell them.

UNDERSTANDING FEDERAL SENTENCING GUIDELINES

When facing federal charges, the judge follows the U.S. Sentencing Guidelines. These guidelines consider the nature of the offense, amount of loss, criminal history, and more. If convicted, you could face:

• Serious prison sentences (depending on the total loss amount)
• Higher fines if the fraud scheme involved multiple co-defendants
• Mandatory restitution to defrauded parties

That’s why it’s crucial to build a strong defense from the start. It means right from the beginning, lawyer up, and hire a criminal attorney.

WE ARE HERE TO HELP YOU

If you’re reading this because you’re under investigation, suspect you’re under investigation, or are already indicted for healthcare fraud, take action today by scheduling a free consultation. At Spodek Law Group, we fight aggressively to protect your rights. We understand the complexity of healthcare regulations, and we know how to negotiate, file motions, or go to trial if necessary.

CALL NOW FOR A RISK-FREE CONSULTATION

When your reputation, career, and freedom are on the line, you need a team that’s unafraid of fighting. We’ll be there at every step—because that’s who we are. We never give up on our clients.