Health Care Fraud Lawyer Washington County, NY — Federal Defense
Health care fraud in Washington County is a serious federal offense under 18 U.S.C. § 1347, investigated by agencies like the FBI and HHS-OIG, carrying severe penalties. As a former prosecutor, Mr. Sris of Law Offices Of SRIS, P.C. provides strategic defense for medical professionals and entities. Our firm has a documented record of handling complex federal cases.
What Is Health Care Fraud Under Federal Law?
Last verified: March 2026 | U.S. District Court for the Northern District of New York | New York State Legislature
Health care fraud is a federal crime involving the intentional deception or misrepresentation to obtain an unauthorized benefit from a health care benefit program, such as Medicare, Medicaid, or TRICARE. The primary statute is 18 U.S.C. § 1347, which makes it a felony to knowingly execute a scheme to defraud any health care benefit program. This can include a wide range of activities, from billing for services not rendered (phantom billing) and upcoding services to providing medically unnecessary treatments or paying/receiving illegal kickbacks for patient referrals. The federal government aggressively pursues these cases, often involving multi-agency investigations. Founded in 1997 by former prosecutor Mr. Sris, our firm understands the intricate nature of these federal allegations.
Official Legal Resources
For the full text of the federal health care fraud statute, see 18 U.S.C. § 1347 (official U.S. Code). For information on the federal court serving Washington County, visit the U.S. District Court for the Northern District of New York website.
Washington County Federal Health Care Fraud Defense Strategy
Federal health care fraud cases in Washington County typically originate from investigations by the FBI, Department of Health and Human Services Office of Inspector General (HHS-OIG), or the New York Attorney General’s Medicaid Fraud Control Unit. These investigations are complex and data-driven, often involving audits, subpoenas for patient and billing records, and interviews with employees. The case will be prosecuted in the U.S. District Court for the Northern District of New York. A critical early step is to secure experienced counsel to handle the pre-indictment phase, which may involve negotiating with prosecutors or challenging the basis of the investigation.
- Immediate Legal Intervention: If you are aware of an investigation, contact counsel immediately. Do not speak to investigators without an attorney present.
- Internal Audit & Document Review: Conduct a privileged internal review of billing practices, medical records, and compliance protocols to identify potential vulnerabilities.
- Engage with Prosecutors: Your attorney will communicate with the U.S. Attorney’s Office, potentially presenting exculpatory evidence to avoid indictment or negotiate favorable terms.
- Grand Jury Proceedings: If indicted, your lawyer will analyze the grand jury process for any procedural errors and begin building the defense case.
- Pre-Trial Motions & Negotiation: File motions to suppress evidence or dismiss charges. Explore all options, including pre-trial diversion or plea agreements that may mitigate penalties.
- Trial Preparation: If the case proceeds to trial, prepare a strong defense focusing on lack of intent, compliance with complex regulations, and attacking the government’s evidence.
Potential Penalties for Health Care Fraud Convictions
In Washington County, a federal health care fraud conviction under 18 U.S.C. § 1347 carries a baseline penalty of up to 10 years in federal prison, fines, and mandatory restitution; if the fraud results in serious bodily injury, the maximum prison term increases to 20 years, and if a death results, it can be life imprisonment.
| Offense Level | Classification | Incarceration | Fine | Additional Consequences |
|---|---|---|---|---|
| Basic Health Care Fraud | Federal Felony | Up to 10 years | Up to $250,000 (individual) / $500,000 (organization) | Mandatory restitution, exclusion from federal health programs, asset forfeiture. |
| Fraud Causing Serious Bodily Injury | Federal Felony | Up to 20 years | Up to $250,000 (individual) / $500,000 (organization) | Same as above, with enhanced sentencing under U.S. Sentencing Guidelines. |
| Fraud Causing Death | Federal Felony | Any term of years up to life | Up to $250,000 (individual) / $500,000 (organization) | Severe enhancements, permanent program exclusion, devastating professional and personal impact. |
Results may vary. Prior results do not aim for a similar outcome.
Why Choose Our Firm for Your Health Care Fraud Defense
Law Offices Of SRIS, P.C. was founded in 1997 by former prosecutor Mr. Sris. Our approach to defending against healthcare scheme charges in Washington County is grounded in a deep understanding of both federal prosecution tactics and the details of medical billing and compliance. We do not simply react to charges; we work to intervene during investigations, challenge the government’s evidence, and protect our clients’ professional licenses and livelihoods. Our collaborative team brings a multi-faceted perspective to building a strong defense.
Representation in Washington County Health Care Fraud Matters
While specific case counts are not published for this jurisdiction, our firm-wide experience includes over 4,739 documented case results with a favorable outcome rate exceeding 93%. We apply this extensive litigation experience to every case, including those involving federal health care fraud allegations. A favorable outcome in these cases can mean avoiding indictment, securing a dismissal, negotiating a non-custodial resolution, or achieving an acquittal at trial.
Results may vary. Prior results do not aim for a similar outcome.
Local Health Care Fraud Defense in Washington County, NY
Law Offices Of SRIS, P.C.
New York Location — Buffalo/NY area
By appointment only.
Toll-Free: (888) 437-7747
24/7 phone consultations — meetings by appointment only.
Our firm represents clients facing federal health care fraud charges originating in Washington County, which falls under the jurisdiction of the U.S. District Court for the Northern District of New York. We serve medical professionals and entities throughout the area, including Fort Edward, Hudson Falls, Greenwich, Cambridge, Granville, Salem, Whitehall, and Kingsbury. If you need a health care fraud lawyer Washington County who understands federal court procedures, call us for a consultation.
Health Care Fraud Lawyer Washington County FAQ
What agencies investigate health care fraud in New York?
Yes. Multiple federal and state agencies investigate, including the FBI, HHS-OIG, DEA, IRS, and the New York Attorney General’s Medicaid Fraud Control Unit (MFCU). These agencies often work together on task forces to build cases against providers.
Can I lose my medical license if charged with health care fraud?
It depends. A charge alone may trigger an investigation by your state licensing board (e.g., New York State Office of Professional Medical Conduct). A conviction will almost certainly lead to license revocation or suspension. A medical billing fraud defense lawyer Washington County can work to protect your license throughout the criminal case.
What is the difference between a billing error and fraud?
The key difference is intent. An honest mistake or clerical error is not a crime. Fraud requires the government to prove you knowingly and willfully made a false statement or misrepresentation to obtain a payment. Proving lack of intent is a central defense strategy in these cases.
What should I do if a federal agent contacts me about my practice?
Politely decline to answer questions and state you wish to speak with your attorney. Do not provide any documents or explanations. Immediately contact a healthcare scheme charge lawyer Washington County with federal experience. Anything you say can be used against you, and early legal intervention is critical.
Are there alternatives to trial for health care fraud charges?
Yes. Alternatives may include pre-trial diversion programs for first-time offenders, negotiating a plea agreement to reduced charges, or entering into a Corporate Integrity Agreement (CIA) with HHS-OIG. The best path depends on the strength of the evidence and your specific circumstances.
Related Practice Areas: Federal Criminal Lawyer Washington County | Business Lawyer Washington County
Nearby Locations: Federal Criminal Lawyer Albany County | Federal Criminal Lawyer Broome County
Learn More: New York Federal Criminal Defense Lawyer
Page last verified: 2026-04. Laws and procedures change. For current advice regarding a health care fraud investigation in Washington County, contact Law Offices Of SRIS, P.C. at (888) 437-7747.