Medicare/Medicaid (Healthcare) Fraud

Healthcare Fraud Attorney

The investigation and prosecution of healthcare fraud offenses seem to be a major priority for the government right now. The government alleges healthcare fraud in a variety of ways.  The most common is billing fraud, where the government alleges a provider submitted billing claims to the federal government through Medicaid or Medicare for medical, dental, vision, physical therapy, ambulance, or other health-related services that were never actually performed.  The government may also allege “upcoding,” where a provider bills for services under a billing code that pays more than the code assigned to the services, or “unbundling,” where a provider uses separate billing codes to bill multiple services that should be billed together under a single code.

Why hire Stracci Law Group?

Many times these cases center around who was responsible for the false claims.  Sometimes it is an employee, often one who receives a percentage of the practice revenue as compensation, who is the responsible party.  In other cases, it might be the provider.  Still, in other cases, it might be low level managers who have directed subordinates to comply with fraudulent billing policies set by higher-ups who find themselves facing criminal investigation and indictment.  No matter which role the government believes you played, Stracci Law Group can help.

Defending Medicaid, Medicare, and Healthcare Fraud cases is both complex and paper-intensive. Your defense team should include both aggressive federal criminal trial attorneys and attorneys able to review and understand voluminous records and documents in a timely and cost-effective manner. Stracci Law Group has and will work strategically and efficiently to defend your case preserve your future.

Moreover, the Stracci Law Group has a long history of defending federal Medicaid, Medicare, and Healthcare Fraud cases and has played a leading role in federal criminal defense advocacy. Our attorneys have served on United States District Court committees, been involved in the selection of federal judges and magistrates, elected to serve leadership roles on the Federal Community Defender Board, and have been recognized by the Seventh Circuit Court of Appeals.

When you hire the Stracci Law Group, you get an entire team of experienced federal criminal defense attorneys, attorneys with a long history of defending federal criminal cases, who will all work together to protect your future.  Contact the Stracci Law Group today.

Is your Medicaid, Medicare, or Healthcare Fraud case civil or criminal?

Medicaid, Medicare, and Healthcare fraud cases can be filed as civil cases, criminal cases, or both. Civilly, these cases start with the filing of a civil lawsuit under the False Claims Act.  These types of civil False Claims Act lawsuits may be filed either by government agencies or by an everyday person (called a relator) who either through personal involvement or another means has gathered evidence that a provider has submitted false claims for payment by the government. Relators generally initiate their lawsuit hoping the federal government will assume their lawsuit and pursue it to fruition because if successful, the relator is paid a portion, oftentimes significant, of whatever the federal government recovers.  Another way for civil lawsuits to start is when a government entity overseeing Medicaid or Medicare practices receives information, sometimes through its own internal audits, that a provider may be submitting false claims.  Civil lawsuits don’t expose providers to prison sentences, but the possible financial penalties, including fines, treble damages, and restitution payments, can easily exceed tens of millions of dollars.

When the government believes a provider has billed in a particularly egregious manner, it usually seeks an indictment for a criminal offense.  The consequences of being convicted of a criminal healthcare fraud offense are very serious.  Those convicted risk the loss of medical or professional licensing and the ability to bill federal healthcare programs.  For most providers, either may be a career-ending event.  In addition, those who are convicted of Medicaid, Medicare, or Healthcare fraud crimes face a recommended prison sentence based upon the higher of the actual or intended loss.  In healthcare fraud cases, the government often charges that a provider fraudulently billed the government over a period of years, not days or months.  As a result, medical professionals are often exposed not only to significant restitution payments but also prison sentences.

Am I facing prison time?

In many Medicaid, Medicare, or Healthcare fraud cases, yes.  Most federal healthcare fraud cases are serious felonies that may result in a lengthy prison sentence, large fines, restitution, and asset forfeiture.  Federal judges will use the federal sentencing guidelines to determine what your recommended sentence should be.  Under the sentencing guidelines, the higher the actual or intended monetary loss, the higher the prison recommendation will be.

It used to be that federal judges had to impose whatever sentence was dictated by the guidelines. That is no longer true. Nowadays, federal judges may consider a myriad of factors and impose a sentence that is more tailored to your individual characteristics.  The ability of judges to impose a sentence lower than that set forth by the guidelines makes it more important than ever that you hire an attorney who is known for federal sentencing advocacy.  The Stracci Law Group prides itself in its federal sentencing advocacy and will work hard to develop and present the court with reasons why the court should mitigate or be lenient in imposing its sentence.

Schedule a Free Consultation about your Medicaid, Medicare, or Healthcare Fraud Criminal Investigation or Case!

We want you to be confident that we are the best choice for you, so the Stracci Law Group offers free, comprehensive, and confidential consultations. Call (219) 525-1000 today to schedule a time to meet with us, personally discuss your situation, and learn more about our services, knowledge, and federal courtroom experience.


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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.
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