Fort Lauderdale Healthcare Fraud Lawyers

Defending Healthcare Providers Against Allegations

Healthcare fraud (18 U.S.C. § 1347) is a serious offense that involves deliberately misleading or deceiving healthcare programs, such as Medicare or Medicaid, for financial gain. This fraud can take many forms, including fraudulent billing, kickbacks for patient referrals, improper self-referrals, and falsified medical records. While some cases involve intentional wrongdoing, many healthcare professionals find themselves accused due to clerical errors, regulatory misunderstandings, or complex billing processes.

Given the rising costs of healthcare and the federal government’s commitment to preventing fraud, enforcement agencies like the Department of Justice (DOJ), the Office of Inspector General (OIG), and the Centers for Medicare & Medicaid Services (CMS) are cracking down on healthcare-related financial crimes. Investigators actively scrutinize billing practices, referral relationships, and reimbursement claims to identify fraudulent activity. Unfortunately, this increased oversight has also led to legitimate healthcare providers being wrongfully accused or facing severe penalties for minor infractions.

If you or your practice is under investigation for healthcare fraud, immediate legal intervention is crucial. The sooner you seek legal counsel, the better your chances are to build a strong defense and mitigate potential penalties.

At Hager & Schwartz, P.A., we understand the complexities of federal healthcare laws and are committed to protecting your rights, career, and future. Contact us for a confidential consultation.

Common Types of Federal Healthcare Fraud

Medicare and Medicaid are essential government programs that provide millions of Americans with healthcare coverage. However, fraudulent activities targeting these programs are aggressively investigated and prosecuted.

Below are the most common types of Medicare and Medicaid fraud that federal authorities actively pursue:

• Billing fraud and duplicate claims. Medical billing fraud occurs when a healthcare provider deliberately manipulates billing codes or charges for unnecessary services to maximize reimbursement. The False Claims Act (31 U.S.C. §§ 3729-3733) is frequently used by federal prosecutors to hold individuals and institutions accountable for fraudulent billing practices, including upcoding, unbundling, and billing for unnecessary procedures.
• Kickbacks and improper referrals. Under the Anti-Kickback Statute (42 U.S.C. § 1320a-7b(b)), it is illegal for healthcare providers to receive financial incentives—such as cash payments or gifts—in exchange for referring patients to specific healthcare services or facilities.
• Stark Law violations. Also called the Physician Self-Referral Law (42 U.S.C. § 1395nn), this statute prohibits physicians from referring patients to healthcare entities where they or their immediate family members have a financial interest unless an exception applies.
• Prescription fraud and drug diversion. Federal healthcare fraud enforcement focuses on the misuse and distribution of prescription medications. The Controlled Substances Act (21 U.S.C. § 841) governs the prescribing and distribution of controlled substances, and violations can include unlawful distribution, forged prescriptions, or patient fraud.
• Durable medical equipment fraud. Durable medical equipment (DME) includes wheelchairs, oxygen tanks, and prosthetic devices. While these devices are essential for many patients, DME fraud occurs when providers submit false claims for unnecessary or non-existent medical equipment.
• Emergency Medical Treatment and Active Labor Act (EMTALA) violations. Under EMTALA (42 U.S.C. § 1395dd), hospitals with emergency departments must provide a medical screening and stabilizing treatment to any patient, regardless of their ability to pay. Failure to comply can result in significant penalties.

Healthcare Fraud Penalties and Fines

When healthcare fraud involves intentional deception—such as submitting false claims, receiving unlawful kickbacks, or prescribing medications without medical necessity—criminal charges may follow.

Under federal law, penalties can be severe:

• Up to 10 years in prison for general healthcare fraud offenses.
• Up to 20 years in prison if the fraud results in serious bodily injury to a patient.
• Life imprisonment if the fraud leads to a patient’s death.

In addition to imprisonment, courts may impose steep fines, often reaching hundreds of thousands or even millions of dollars. These fines can be stacked per offense, meaning each fraudulent claim could add to the penalty.

Exclusion from Medicare and Medicaid

Under 42 U.S.C. § 1320a-7, individuals and organizations guilty of fraudulent practices may be excluded from Medicare and Medicaid. This exclusion can be career-ending for physicians, hospitals, and medical facilities that rely on government reimbursements.

Asset Forfeiture and Professional License Revocation

In addition to prison time and fines, a conviction for healthcare fraud can result in asset forfeiture—the government may seize bank accounts, real estate, medical offices, or other property connected to fraudulent earnings.

Healthcare professionals also risk losing their medical licenses. Licensing boards often conduct their own investigations following fraud convictions, which can result in suspension or permanent revocation of professional licenses.

The Importance of a Fort Lauderdale Healthcare Fraud Lawyer

Facing healthcare fraud allegations can be overwhelming. The federal government has vast resources dedicated to investigating and prosecuting these cases, and even an unintentional billing mistake can trigger a full-scale investigation. If you are under scrutiny or have been formally charged, securing experienced legal representation is critical to protecting your career, reputation, and financial future.

Your attorney can assist by:

• Conducting a thorough investigation and gathering evidence. Your lawyer may analyze all available evidence, including billing records, medical documentation, and communication logs, to uncover inconsistencies and build a strong defense. They may also work with forensic accountants, medical coding experts, and compliance professionals to challenge the prosecution’s claims.
• Negotiating with federal prosecutors. Federal prosecutors aggressively pursue healthcare fraud cases, but many charges can be negotiated or dismissed with the right legal strategy. Your attorney can engage with prosecutors early in the case, advocating for you by demonstrating lack of intent, challenging weak or circumstantial evidence, or seeking alternative resolutions.
• Crafting a strong legal defense. A successful defense against healthcare fraud charges requires a strategy tailored to the case's facts. Your lawyer may use a range of legal defenses to protect your rights and future.

Contact Us for Healthcare Fraud Defense

If you are under investigation or facing healthcare fraud charges, securing experienced legal representation as early as possible is crucial. At Hager & Schwartz, P.A., we have a proven track record in federal criminal defense, skillfully navigating complex healthcare fraud cases to protect our clients' rights, careers, and reputations. Federal investigations move quickly, and delays in mounting a defense can lead to severe financial and legal consequences, including exclusion from Medicare and Medicaid, substantial fines, and imprisonment.

Don’t wait—contact us for a free, confidential consultation to discuss your case.