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Medicare/Medicaid (Healthcare) Fraud

Medicare/Medicaid (Healthcare) Fraud Defense Lawyers in Northwest Indiana

The federal government works diligently to root out healthcare fraud, and it has vast resources to prosecute violators.  Medicare, Medicaid, and Healthcare fraud allegations have the potential to destroy careers and devastate families.  Those who are charged face both professional and personal loss in the form of loss of income, loss of professional reputation, loss of professional licensing, and oftentimes the loss of liberty.  

If you are under investigation for or charged with Medicare, Medicaid, or Healthcare fraud, we can help.  Call our team of federal Medicare, Medicaid, and Healthcare fraud defense attorneys at Stracci Law Group immediately by calling (219) 525-1000 or by contacting us online to schedule a consultation.

Stracci Law Group Is the Federal Healthcare Fraud Defense Team You Can Trust

We offer the following advantages:

Mitigation of legal risk:  Medicare and Medicaid fraud law is complex. It involves federal and state regulations and has both civil and criminal aspects.  One of the greatest challenges for  Medicare and Medicaid fraud defense lawyers is convincing the government to focus on civil sanctions, like repayment and damages, instead of criminal charges which more often than not result in prison sentences.

Industry familiarity:  Medicare and Medicaid fraud attorneys must be experienced in billing and coding issues like upcoding and unbundling, and know how to distinguish a valid claim from one involving medically unnecessary or unperformed services.  

Diverse team:  Defending Medicare and Medicaid fraud cases is both complex and document intensive.  The majority of cases require careful scrutiny of tens of thousands of medical, billing, and coding records.  Our Medicare and Medicaid fraud defense team includes aggressive federal litigators and longtime federal criminal defense attorneys who are familiar with federal and state regulations and experienced in reviewing voluminous records to decipher exactly what happened and who is responsible. 

Healthcare Practices That We Serve In Northwest Indiana

Federal enforcement of all types of healthcare fraud laws is on the rise.  Medical providers and related businesses bearing the brunt of this renewed vigilance include:

  • Doctors
  • Nurses
  • Nurse Practitioners
  • Pharmacists
  • Physical Therapists
  • Medical Students
  • Medical Laboratories
  • Medical Equipment Providers
  • Specialty Practice Groups
  • Ambulance and Transport Services
  • Other Licensed Medical Professionals

Common Forms Of Healthcare Fraud

There are a number of avenues open to the federal government’s pursuit of Medicare, Medicaid, and Healthcare fraud allegations that will require you to attain a medical billing fraud lawyer. Some of the most common are:

Upcoding:  Billing Medicare or Medicaid for services under a billing code that pays more than the code assigned to the services.

Unbundling:  Billing Medicare or Medicaid for services under multiple billing codes that should be billed together under a single billing code.

Services:  Billing Medicare or Medicaid for services that were not provided, or were provided but lacked medical necessity. 

Kickbacks:  Giving money or anything of value to induce or reward medical referrals to a provider that receives reimbursement from Medicare or Medicaid.

If you are accused of any of the listed practices, you need a Medicare, Medicaid, or federal healthcare defense attorney to protect your interests.

Is Your Medicare, Medicaid, or Healthcare fraud Case Civil or Criminal?

Medicaid, Medicare, and Healthcare fraud cases can be filed as civil cases, criminal cases, or both. 

If your case starts with the filing of a lawsuit under the False Claims Act, it is a civil case.  Both government agencies and everyday people can file False Claims Act civil lawsuits.  Although civil lawsuits don’t expose providers to prison sentences, financial penalties like restitution, treble damages, and fines, can easily add up to millions of dollars.

When the government believes a medical provider billed government programs in a particularly egregious manner, it usually files criminal charges.  Those convicted of Medicare, Medicaid, or other Healthcare Fraud criminal crimes risk losing their medical or professional licensing and the ability to bill Medicare and Medicaid for their services.  

For some providers, it is a career-ending event.  In addition, those convicted of Medicaid, Medicare, or other Healthcare fraud crimes face a recommended prison sentence and restitution payments based on monetary loss. The federal government typically alleges crimes occurring over a period of years, not days or months, which exposes medical professionals to significant restitution payments and prison sentences.

Threats of federal criminal prosecution are always real.  The federal government charges more than a thousand healthcare fraud cases across the country each year. Our Medicare, Medicaid, and Health care defense lawyers can help you fight back.  

Healthcare fraud Criminal Penalties You Can Expect

Depending on the circumstanced and seriousness of the charged crime, a conviction exposes you to a variety of penalties, including:

  • Incarceration
  • Restitution
  • Fines
  • Criminal Forfeiture
  • Loss of Professional Licensure
  • Exclusion from Medicare and Medicaid

Most federal healthcare fraud criminal cases are serious felonies that carry the potential for long prison sentences, restitution, fines, and criminal forfeiture of money or property.  But the federal courts consider a myriad of factors when deciding the appropriate sentence, including your own personal history and characteristics. That means you need a team of Medicare, Medicaid, or Healthcare fraud attorneys known for their federal sentencing advocacy.  Our team prides itself on its sentencing advocacy and works to develop and present federal judges with a basis for them to impose the most lenient sentence possible.

Our Criminal Defense Lawyers

The Team Behind You

Paul G. Stracci, the leader of our team, defended a murder case only 10 months out of law school and won a complete acquittal. He has since developed a powerful reputation as a devastatingly effective criminal trial attorney.

The Team Behind You

Alison L. Benjamin began her legal career years ago as a state court prosecutor. She is known to be a thoughtful and passionate litigator, and now focuses her practice on representing clients charged with federal crimes. Her tenacity makes her well-suited to resolve the complexities that arise in defending clients charged with federal crimes.

The Team Behind You

a former prosecutor, has risen rapidly through the ranks of criminal defense attorneys as a result of her focus, work ethic, singleness of purpose, and relentless pursuit of justice.


“Stracci handled my personal injury case and exceeded all expectations. My family and I are thrilled with the recovery. I would never go anywhere else. His staff went above and beyond. Thank you very much for everything.”
Niko P., Injury Case
“Paul Stracci and his entire legal team are not only aggressive and insanely knowledgeable, but they also make you feel at ease during what is already a stressful situation. They know what they are doing, they are honest, and you can trust you’ll get the best possible outcome. They have a phenomenal criminal court and personal injury practice. Only the best works at this firm and I highly recommend them to anyone who needs great representation. You won't be disappointed.”
Jen, Injury Case
“Attorney Stracci and the team treated me and my case like I was their only client. Very professional and stayed in constant communication until receiving the disposition we aimed for!  I would highly recommend Stracci Criminal Defense to all for any legal concerns or issues.”
Paul M., Criminal Case
“With being suspended from my job for allegedly costing them money through a workman compensation injury. Not only was Mr. Stracci very detailed and kept in touch constantly he prove that I was completely innocent and got the bogus case completely dismissed quickly. He personally contacted me throughout the entire case, not like other lawyers that you don't speak to at all besides in the courtroom. I will recommend him to anyone and everyone.”
Amanda, Injury Case
“I hired Paul Stracci to represent me in a felony firearms case. He and his team were able to reach a very favorable outcome within 3 months. They are competent and professional in every way. You will not regret seeking his counsel.”
Aaron, Criminal Case
“Hired Paul the day after I got out of Lake County for a DUI. I explained my situation and told him about priors. He was still confident even after I explained that this was a 3rd. I hired him and about a month later the charge was dropped! Wish I had a Paul Stracci to hire in my younger years.”
Michael, Criminal Case
“Joshua Malher is a fantastic attorney. We reached out to him for a case, and he responded immediately, and we began the process. He explained the situation with clarity, and the results were outstanding. I highly recommend Joshua to anyone who may need a criminal or personal injury attorney.”
Sonia Mendez, Injury Case
“Paul Stracci is the best lawyer I’ve ever had in my life. Throughout the times I’ve been misfortunate enough to have legal troubles or needed legal advice Stracci Law Group has always had my best interest at heart and it has always worked out in my favor. I’d personally recommend Stracci Law Group to anyone who may need legal counsel for whatever reason.”
Anthony Davis, Personal Case
“I couldn't be more satisfied with the services Paul provided and the results he was able to achieve for me in my criminal case.”
Cory, Criminal Case
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How can we help?

Committed professionals providing unmatched service for your personal injury and criminal defense needs.

Stracci Law Group is proud of the multifaceted team it has assembled and looks forward to putting its combined talents and resources to work on your case.
How can we help?

Is Healthcare Fraud a Felony?

It typically is. But even a misdemeanor conviction may impact your professional license and exclude you from participating in the Medicare and Medicaid reimbursement programs.

Is Medicaid Fraud a Federal Offense?

Yes.  Medicaid is a federal reimbursement program governed by federal law.

What medical or healthcare entities are potentially liable?

Most medical providers across the nation treat patients whose healthcare is covered by either Medicare or Medicaid.  Some common providers are:

  • Doctors
  • Nurses
  • Nurse Practitioners
  • Pharmacists
  • Physical Therapists
  • Medical Students
  • Medical Laboratories
  • Medical Equipment Providers
  • Specialty Practice Groups
  • Ambulance and Transport Services
  • Other Licensed Medical Professionals

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