Health Care Fraud Lawyer Baltimore — Federal Defense Strategy
Health care fraud in Baltimore is a federal crime under 18 U.S.C. § 1347, prosecuted by the U.S. Attorney’s Office for the District of Maryland. A conviction can mean decades in prison, massive fines, and exclusion from Medicare/Medicaid. As a former prosecutor, Mr. Sris of Law Offices Of SRIS, P.C.
Last verified: March 2026 | U.S. District Court for the District of Maryland | Maryland General Assembly
Federal Health Care Fraud Law in Maryland
Health care fraud is a white-collar crime involving the intentional deception or misrepresentation to obtain an unauthorized benefit from any health care benefit program. In Baltimore, these cases are typically investigated by federal agencies like the FBI, HHS-OIG, and IRS-CI, and prosecuted in the U.S. District Court for the District of Maryland. 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. Penalties are severe and include imprisonment, fines, restitution, and mandatory exclusion from federal health programs.
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 local federal court handling these cases, visit the U.S. District Court for the District of Maryland website.
handling a Federal Health Care Fraud Investigation in Baltimore
Federal health care fraud investigations in Baltimore often begin with a subpoena, search warrant, or an interview request from agents. The key local procedural fact is that these cases are built over months or years by federal task forces. Early intervention by a health care fraud lawyer Baltimore is critical to protect your rights before an indictment is secured. In the U.S. District Court for Maryland, cases often involve voluminous electronic records, experienced witnesses on billing codes, and complex sentencing guidelines calculations.
- If contacted by federal agents, politely decline to answer questions and immediately contact your attorney.
- Your lawyer will analyze the subpoena or warrant to understand the scope of the investigation.
- Counsel will engage in pre-indictment discussions with the Assistant U.S. Attorney to present mitigating facts.
- If indicted, your attorney will file motions to challenge the evidence and negotiate for a favorable resolution.
- Prepare for a potential trial or, if a plea is taken, develop a sentencing mitigation strategy focused on the Federal Sentencing Guidelines.
Potential Penalties for Health Care Fraud
In Baltimore, a federal health care fraud conviction under 18 U.S.C. § 1347 carries a maximum penalty of 10 years in prison, which increases to 20 years if the fraud results in serious bodily injury, and life imprisonment if it results in death.
| Offense | Classification | Incarceration | Fine | Additional Consequences |
|---|---|---|---|---|
| Health Care Fraud (18 U.S.C. § 1347) | Federal Felony | Up to 10 years (20+ years with aggravators) | Up to $250,000 (individual) or $500,000 (organization) | Restitution, forfeiture, exclusion from Medicare/Medicaid, loss of professional license. |
| Conspiracy to Commit Health Care Fraud (18 U.S.C. § 1349) | Federal Felony | Same as underlying fraud | Same as underlying fraud | All conspirators liable for total loss amount. |
| False Statements (18 U.S.C. § 1035) | Federal Felony | Up to 5 years | Up to $250,000 | Often charged alongside main fraud counts. |
Results may vary. Prior results do not aim for a similar outcome.
Why Choose Our Firm for Your Health Care Fraud Defense
Founded in 1997 by former prosecutor Mr. Sris, Law Offices Of SRIS, P.C. brings over 120 years of combined legal experience to complex federal defense. Our “Advocacy Without Borders” approach means we use deep knowledge of federal procedure and the local Baltimore court field. We understand how federal agencies build healthcare scheme charge lawyer Baltimore cases and work to counter them from the earliest investigative stage.
Our Approach to Health Care Fraud Cases
We approach every health care fraud lawyer Baltimore case with a detailed review of billing records, patient charts, and communications. We frequently work with forensic accountants and medical coding experts to challenge the government’s loss calculations—a key driver of sentencing exposure. In one firm-wide matter, our analysis of complex billing data was instrumental in securing a favorable resolution for a medical practice. Mr. Sris, the firm’s founder and a former prosecutor with a background in accounting, provides senior oversight on these financially complex cases.
Results may vary. Prior results do not aim for a similar outcome.
Contact Our Baltimore County Federal Defense Lawyers
Our Rockville/MD location serves clients at Baltimore County courts and the U.S. District Court in Baltimore. We represent individuals in Towson, Dundalk, Essex, Catonsville, Pikesville, and surrounding communities.
Law Offices Of SRIS, P.C.
Rockville/MD Location — Montgomery County area (by appointment)
Toll-Free: (888) 437-7747 | Local: (301) 363-4040
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Health Care Fraud Defense FAQs in Baltimore
What agencies investigate health care fraud in Baltimore?
Multiple federal agencies. The FBI, Department of Health and Human Services Office of Inspector General (HHS-OIG), and IRS Criminal Investigation are the primary investigators. The U.S. Attorney’s Office for the District of Maryland leads the prosecution.
What are common examples of health care fraud?
Common schemes include billing for services not rendered, upcoding (billing for a more expensive service), unbundling (billing separately for grouped procedures), kickbacks for patient referrals, and providing medically unnecessary services. A medical billing fraud defense lawyer Baltimore can analyze the specific allegations against you.
Can I go to jail for a billing error?
It depends. The government must prove you acted “knowingly and willfully.” Honest mistakes or negligence are not criminal fraud. A strong defense often focuses on intent, using training records and industry standards to show lack of criminal knowledge.
What is the False Claims Act in health care fraud?
The False Claims Act (31 U.S.C. §§ 3729–3733) allows the government to sue for treble damages and penalties for knowingly submitting false claims. It also has a “qui tam” provision that lets whistleblowers (relators) file suits on the government’s behalf and share in any recovery.
Should I speak to investigators if they call me?
No. You have the right to remain silent and the right to an attorney. Politely decline to answer questions and immediately contact a health care fraud lawyer Baltimore. Anything you say can be used against you.
For more information, see our Maryland Federal Criminal Defense hub page. We also assist clients in Anne Arundel County and with related issues like business law in Baltimore County.
Page last verified and updated: April 2026. Federal laws and procedures change. Contact Law Offices Of SRIS, P.C. at (888) 437-7747 for current guidance regarding your specific situation.