Health Care Fraud Lawyer in Arlington, Virginia — Federal Defense Strategy
Health care fraud is a serious federal crime prosecuted in the Eastern District of Virginia, carrying severe penalties. As a health care fraud lawyer in Arlington Virginia, Law Offices Of SRIS, P.C. provides defense against charges like false billing, kickbacks, and upcoding.
Last verified: April 2026 | Verify with lead attorney | Virginia General Assembly
Federal Health Care Fraud Law
Health care fraud is primarily prosecuted under federal statutes, including 18 U.S.C. § 1347. This law makes it a crime to knowingly execute, or attempt to execute, a scheme to defraud any health care benefit program or to obtain money or property from such a program through false pretenses. In Arlington, cases are typically investigated by agencies like the FBI, HHS-OIG, or the Virginia Attorney General’s Medicaid Fraud Control Unit before being presented to the U.S. Attorney’s Office for the Eastern District of Virginia for prosecution.
Common schemes include billing for services not rendered, upcoding services to a higher reimbursement rate, performing medically unnecessary services, paying or receiving kickbacks for patient referrals (violating the Anti-Kickback Statute, 42 U.S.C. § 1320a-7b), and making false statements on applications or claims. A conviction can result in decades in federal prison, massive fines, and mandatory exclusion from participation in Medicare, Medicaid, and all other federal health care programs.
Official Legal Resources
For the official text of the primary federal health care fraud statute, see 18 U.S.C. § 1347 (U.S. Code). For information on the local federal court handling these cases, visit the U.S. District Court for the Eastern District of Virginia website.
Defending Health Care Fraud Charges in Arlington
The procedural path for a federal health care fraud case in Arlington is distinct from state court. After a federal indictment, the case proceeds in the U.S. District Court for the Eastern District of Virginia, Alexandria Division. The federal Speedy Trial Act sets strict timelines, requiring trial within 70 days of indictment, though complex cases often see excludable delays. Early intervention by a skilled fraud attorney is critical, as pre-indictment negotiations with the U.S. Attorney’s Office can sometimes influence whether charges are filed or their scope.
- Initial Investigation & Grand Jury: Federal agents execute search warrants and subpoena records. A grand jury may issue an indictment.
- Arraignment & Initial Appearance: The defendant appears before a federal magistrate judge, is informed of charges, and enters a plea.
- Discovery & Motions Phase: The defense reviews thousands of pages of evidence. Critical motions may challenge the indictment or seek to suppress evidence.
- Plea Negotiations or Trial Preparation: Most federal cases resolve by plea. If not, intensive preparation for a complex federal jury trial begins.
- Sentencing: If convicted, sentencing follows the U.S. Sentencing Guidelines, which consider the “loss amount,” a key driver of the potential penalty.
In Arlington, Virginia, federal health care fraud convictions carry penalties of up to 10 years per count (20 years if the violation results in serious bodily injury), fines up to $250,000 for individuals, and mandatory restitution.
| Offense (18 U.S.C.) | Classification | Incarceration | Fine | Additional Consequences |
|---|---|---|---|---|
| Health Care Fraud (§ 1347) | Federal Felony | Up to 10 years per count | Up to $250,000 (Individual) | Restitution, Program Exclusion, Forfeiture |
| Health Care Fraud Causing Serious Bodily Injury | Federal Felony | Up to 20 years | Up to $250,000 (Individual) | Restitution, Program Exclusion, Forfeiture |
| Anti-Kickback Violations (42 U.S.C. § 1320a-7b) | Federal Felony | Up to 5 years | Up to $25,000 | Civil penalties up to $50,000 per violation |
Results may vary. Prior results do not aim for a similar outcome.
Why Choose Our Firm for Federal Health Care Fraud Defense
Law Offices Of SRIS, P.C. was founded in 1997 by former prosecutor Mr. Sris. Our firm brings a unique combination of over 120 years of combined attorney experience and a background in accounting and information systems, which is invaluable for dissecting complex financial records and billing data at the heart of health care fraud cases. We understand that these charges threaten not just your liberty but your professional license and livelihood.
Case Results & Firm Experience
While specific health care fraud results are highly confidential, our firm’s foundational experience in federal and white-collar defense provides the structure for building strong defenses. Our approach involves early case assessment, engaging forensic accounting experts when necessary, and developing a narrative that counters the prosecution’s theory of intentional fraud. For federal defense, our team includes Matthew Greene, an attorney with over 30 years of experience, including former death penalty certification and a 14-year contract with Child Protective Services in Alexandria, giving him deep insight into government agency procedures.
Results may vary. Prior results do not aim for a similar outcome.
Contact Our Arlington Health Care Fraud Defense Lawyers
Law Offices Of SRIS, P.C.
Arlington Location — 1655 Fort Myer Dr, Suite 700, Room No. 719, Arlington, VA 22209
Toll-Free: (888) 437-7747 | Local: 703-589-9250 | Local: (703) 636-5417
By appointment only. 24/7 phone consultations available.
Our Arlington location serves clients facing federal charges at courts in the Eastern District of Virginia. We represent professionals and entities from neighborhoods including Crystal City, Rosslyn, Clarendon, Ballston, Pentagon City, and Shirlington.
Health Care Fraud Defense FAQs
What is the first step if I’m under investigation for health care fraud?
It depends. The absolute first step is to secure a health care fraud lawyer in Arlington Virginia who practices federal defense. Do not speak with investigators without counsel. Your attorney can communicate with the U.S. Attorney’s Office, assess the investigation’s scope, and advise on strategy, which may include negotiating before an indictment is filed.
Can I go to jail for a billing mistake?
No, not for an honest mistake. Federal health care fraud requires proof of knowingly and willfully executing a scheme to defraud. A skilled fraud attorney will work to demonstrate lack of criminal intent, perhaps showing the billing was a clerical error or based on a good-faith interpretation of complex regulations.
What is the “loss amount” and why does it matter?
It is the dollar amount the government claims was fraudulently obtained. This is the single most important factor under the U.S. Sentencing Guidelines for determining a potential prison sentence. A financial crime lawyer will challenge the prosecution’s loss calculation, often with the help of a forensic accountant, to argue for a lower amount and thus a less severe sentencing range.
What’s the difference between a civil and criminal health care fraud case?
Civil cases, often brought under the False Claims Act, seek monetary penalties and restitution. Criminal cases seek imprisonment. The same conduct can trigger both. The government may use a civil investigation to gather evidence for a criminal case. A white collar defense lawyer must handle both fronts to protect you from all penalties.
What are common defenses to health care fraud charges?
Common defenses include lack of intent (mistake), lack of knowledge, entrapment, insufficient evidence, and challenging the reliability of the government’s data analysis. In some cases, demonstrating full compliance with ambiguous regulations can defeat the “willfulness” element. An effective defense requires a detailed understanding of both law and the specific healthcare billing practices at issue.
For more information on related defenses, see our pages on Arlington criminal defense and Virginia federal criminal defense. We also assist clients in nearby jurisdictions like Alexandria.
Last verified: April 2026. Laws change — contact Law Offices Of SRIS, P.C. at (888) 437-7747 for current guidance.
Arlington County cases follow the same route as the rest of the state, and our page on health care fraud cases in Virginia explains each stage.