Health Care Fraud Lawyer Monmouth County — Federal Defense
Health care fraud in Monmouth County is a serious federal crime prosecuted under 18 U.S.C. § 1347, carrying severe penalties. If you are under investigation by the FBI, HHS-OIG, or the U.S. Attorney’s Office for the District of New Jersey, you need a strategic defense. Law Offices Of SRIS, P.C.
Federal Health Care Fraud Law in New Jersey
Health care fraud is a federal offense defined under 18 U.S.C. § 1347. The statute makes it a crime to knowingly and willfully execute, or attempt to execute, a scheme to defraud any health care benefit program, or to obtain money or property owned by, or under the custody or control of, such a program, by means of false or fraudulent pretenses, representations, or promises. This includes a wide range of activities, from billing for services not rendered to upcoding, kickbacks, and false certifications.
Last verified: March 2026 | U.S. District Court for the District of New Jersey | New Jersey Legislature
Founded in 1997 by former prosecutor Mr. Sris, our firm has over 120 years of combined legal experience. We understand the high stakes of federal prosecutions, which are often pursued by the U.S. Attorney’s Office in Newark or Camden and involve agencies like the FBI and the Department of Health and Human Services Office of Inspector General (HHS-OIG).
Official Legal Resources
For the full text of the federal statute, see 18 U.S.C. § 1347 (Cornell Legal Information Institute). For information on the federal court handling these cases in New Jersey, visit the U.S. District Court for the District of New Jersey website.
Strategic Defense for Monmouth County Federal Cases
Federal health care fraud investigations are methodical and can target individuals, medical practices, clinics, and corporate entities. A common procedural fact in these cases is the use of parallel proceedings, where both criminal charges and civil False Claims Act (31 U.S.C. § 3729) actions may proceed simultaneously, amplifying the pressure and potential penalties.
- Initial Investigation & Grand Jury: The case typically begins with a subpoena for records or a search warrant. A federal grand jury may issue an indictment.
- Arraignment & Detention Hearing: Following indictment, you will be arraigned. Your attorney can argue for pretrial release conditions.
- Discovery & Motion Practice: Your defense lawyer will review voluminous discovery, file motions to suppress evidence, and challenge the legal sufficiency of the charges.
- Plea Negotiations or Trial: Most federal cases are resolved by plea agreement. If not, your case proceeds to a jury trial in federal court.
- Sentencing: If convicted, sentencing follows the advisory U.S. Sentencing Guidelines, which consider the “loss amount,” a key factor driving prison time.
Potential Penalties for Health Care Fraud
In federal court, a conviction for health care fraud under 18 U.S.C. § 1347 can result in decades of imprisonment, massive fines, and mandatory restitution.
| Offense Level | Potential Incarceration | Potential Fines | Additional Consequences |
|---|---|---|---|
| Basic Violation | Up to 10 years | Up to $250,000 (individual) / $500,000 (organization) | Restitution, forfeiture of assets, exclusion from federal health programs. |
| Violation Resulting in Serious Bodily Injury | Up to 20 years | Up to $250,000 (individual) / $500,000 (organization) | All of the above, with enhanced penalties. |
| Violation Resulting in Death | Any term of years or life | Up to $250,000 (individual) / $500,000 (organization) | Maximum penalties apply. |
Results may vary. Prior results do not guarantee a similar outcome.
Why Choose Our Firm for Your Federal Defense
Law Offices Of SRIS, P.C. was founded in 1997. With a background as a former prosecutor, Mr. Sris brings a strategic understanding of government tactics to the defense table. Our firm-wide experience includes handling federal investigations and white-collar defenses. We approach each health care fraud case by meticulously analyzing the evidence, challenging the prosecution’s calculation of loss, and exploring all procedural and substantive defenses.
Documented Case Results
While specific results are confidential, our firm-wide practice has achieved over 4,739 documented case results with a favorable outcome rate exceeding 93%. In federal courts, our defense strategies have included securing dismissals, favorable plea agreements that avoid prison time, and successful challenges to sentencing enhancements.
Results may vary. Prior results do not guarantee a similar outcome.
Local Federal Defense in Monmouth County
Law Offices Of SRIS, P.C.
New Jersey Location — 44 Apple St, 1st Floor
Tinton Falls, NJ 07724
Toll-Free: (888) 437-7747 | Local: (732) 337-5507
By appointment only.
Our New Jersey location serves clients throughout Monmouth County, including Freehold, Tinton Falls, Red Bank, Long Branch, Asbury Park, Middletown, Holmdel, Marlboro, Manalapan, Howell, Wall Township, Neptune, and Colts Neck. We represent clients at the U.S. District Court for the District of New Jersey. We offer 24/7 phone consultations — call (888) 437-7747 — with meetings by appointment only.
Health Care Fraud Defense FAQs
What should I do if I am contacted by a federal agent about a health care scheme?
No. Do not speak to them. Politely decline to answer questions and immediately contact a federal health care fraud defense lawyer. Anything you say can be used against you. Your attorney will communicate with investigators on your behalf.
What is the difference between a civil and criminal health care fraud investigation?
It depends. A civil investigation, often under the False Claims Act, seeks monetary penalties and restitution. A criminal investigation seeks imprisonment. These proceedings can run in parallel. A healthcare scheme charge lawyer Monmouth County can handle both tracks to protect you from the most severe consequences.
Can I go to jail for a billing error?
No, not for a genuine error. The government must prove you acted “knowingly and willfully” to defraud. An honest mistake is not a crime. A strong defense often focuses on intent, lack of knowledge, or good-faith reliance on professional advice.
What role does a whistleblower play in these cases?
Whistleblowers (relators) file “qui tam” lawsuits under the False Claims Act. These lawsuits are sealed while the government investigates. If the government intervenes, the case becomes a major federal matter. A medical billing fraud defense lawyer Monmouth County can assess whether a whistleblower’s allegations have merit and develop a defense strategy accordingly.
How is the “loss amount” determined in a health care fraud case?
The prosecution calculates a total dollar figure intended to represent the fraud. This amount is the single most important factor at sentencing under the U.S. Sentencing Guidelines. Your defense lawyer will vigorously challenge this calculation, as even a minor reduction can significantly lower the recommended prison sentence.
Related Practice Areas: For other federal defense needs, see our page on Federal Criminal Defense in Monmouth County. For state-level fraud allegations, visit our Monmouth County Criminal Defense Lawyer page. Learn more about our firm’s approach on our Federal Criminal Defense hub.
Page Last verified: March 2026. The law changes. Contact Law Offices Of SRIS, P.C. at (888) 437-7747 for current guidance.
For the full picture beyond Monmouth County, our page on health care fraud cases in New Jersey covers the process end to end.
Your case in Monmouth County, New Jersey
Indictable charges are heard in the Criminal Part of the Law Division; disorderly-persons offenses are heard in the municipal court where the charge was filed. In Monmouth County that is the Superior Court of NJ, Monmouth Vicinage (9th Vicinage), 71 Monument Park, Freehold, NJ 07728, telephone (732) 677-4200, open Mon-Fri 8:30AM-4:30PM. Court procedures change; confirm the current schedule on the official vicinage website or with the clerk before you file or appear.
The governing law for this topic is the New Jersey Code of Criminal Justice, N.J.S.A. Title 2C. Law Offices Of SRIS, P.C. handles Monmouth County matters from its New Jersey location at 44 Apple St 1st Floor, Tinton Falls, NJ 07724; meetings are by appointment. Request a New Jersey consultation at (888) 437-7747 or (609) 983-0003.
Related New Jersey pages: Monmouth County NJ lawyers directory · Health Care Fraud Defense Lawyer Bergen County, NJ · Health Care Fraud Defense Lawyer Hudson County, NJ.