Health Care Fraud Lawyer in Fairfax County, Virginia — Federal Defense
Health care fraud in Fairfax County is a federal crime under 18 U.S.C. § 1347, prosecuted by the U.S. Attorney’s Office for the Eastern District of Virginia. Conviction can mean decades in federal prison, massive fines, and mandatory exclusion from Medicare/Medicaid. As a health care fraud lawyer in Fairfax County Virginia, Law Offices Of SRIS, P.C.
Last verified: April 2026 | U.S. District Court for the Eastern District of Virginia | Virginia General Assembly
Federal Health Care Fraud Law in Virginia
Health care fraud is a serious white-collar crime involving the intentional deception or misrepresentation to obtain an unauthorized benefit from any health care benefit program, including Medicare, Medicaid, TRICARE, and private insurers. The primary federal statute is 18 U.S.C. § 1347, which makes it a felony to knowingly execute a scheme to defraud any health care benefit program. In Fairfax County, these cases are investigated by federal agencies like the FBI, the Department of Health and Human Services Office of Inspector General (HHS-OIG), and the Drug Enforcement Administration (DEA), and are prosecuted by the U.S. Attorney’s Office for the Eastern District of Virginia in Alexandria.
Common schemes include billing for services not rendered, upcoding (billing for a more expensive service than provided), unbundling (billing separately for services that should be bundled), kickbacks for patient referrals in violation of the Anti-Kickback Statute (42 U.S.C. § 1320a-7b), and Stark Law violations (physician self-referrals). A skilled fraud attorney is essential from the earliest stages of a federal investigation.
Official Legal Resources
For the official text of the federal health care fraud statute, see 18 U.S.C. § 1347 (Cornell Legal Information Institute). For local federal court procedures and rules in the Eastern District of Virginia, visit the U.S. District Court for the Eastern District of Virginia website.
handling a Federal Health Care Fraud Case in Fairfax County
Federal health care fraud cases in Fairfax County follow a distinct procedural path, beginning with a lengthy investigation before any charges are filed. The U.S. Attorney’s Office for the Eastern District of Virginia is known for its aggressive prosecution of complex financial crimes. A financial crime lawyer with federal experience understands that early intervention during the investigative phase—often involving subpoenas, search warrants, and interviews—is critical to shaping the defense.
- Initial Investigation: You may receive a subpoena for records, or agents may execute a search warrant. Do not speak to investigators without your attorney present.
- Target Letter or Indictment: The government may notify you that you are a target, or a grand jury may issue an indictment, formally charging you.
- Arraignment & Detention Hearing: You will appear before a federal magistrate judge to hear the charges and enter a plea. Your lawyer will argue for release on bond.
- Discovery & Motions: Your defense team will review thousands of pages of evidence and file pre-trial motions to challenge the prosecution’s case.
- Plea Negotiations or Trial: Most federal cases are resolved by plea agreement. If no agreement is reached, your case proceeds to a jury trial in federal district court.
- Sentencing: If convicted, sentencing follows the U.S. Sentencing Guidelines, which consider the “loss amount,” a key factor driving prison time.
Potential Penalties for Health Care Fraud
In Fairfax County, a federal health care fraud conviction under 18 U.S.C. § 1347 carries a maximum penalty of 10 years in prison, or 20 years if the violation results in serious bodily injury, and life imprisonment if a death results.
| Offense | Classification | Incarceration | Fine | Additional Consequences |
|---|---|---|---|---|
| Health Care Fraud (18 U.S.C. § 1347) | Federal Felony | Up to 10 years (20+ years if injury/death) | Up to $250,000 (individual) or $500,000 (organization) | Mandatory restitution; exclusion from federal health programs; forfeiture of assets |
| 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 acts of co-conspirators |
| Anti-Kickback Statute Violation (42 U.S.C. § 1320a-7b) | Federal Felony | Up to 10 years | Up to $100,000 | Civil penalties up to $50,000 per violation; program exclusion |
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 the most serious federal cases. Our firm’s tagline, “Advocacy Without Borders,” reflects our commitment to defending clients across jurisdictions. We understand the high-stakes nature of federal health care fraud charges and the significant impact they have on your livelihood, reputation, and freedom. Our white collar defense lawyer team includes Matthew Greene, who brings over 30 years of experience, including a 14-year contract with Child Protective Services in Alexandria, providing him with deep insight into government agency procedures and courtroom strategy.
Our Approach to Fraud Charges Defense
We mount an aggressive, multi-faceted defense. This begins with a forensic analysis of billing records and a challenge to the government’s calculated “loss amount,” which directly dictates sentencing under the guidelines. We explore every avenue, from negotiating for pre-indictment diversion programs to filing motions to suppress improperly obtained evidence. Our goal is always to seek a dismissal or reduction of charges. If a trial is necessary, we are prepared to litigate complex factual and legal issues before a jury.
Law Offices Of SRIS, P.C.
Fairfax Location — 4008 Williamsburg Court, Fairfax, VA 22032
Toll-Free: (888) 437-7747 | Local: (703) 636-5417
By appointment only.
Our Fairfax location serves clients facing federal proceedings in the Eastern District of Virginia. We represent individuals and professionals from communities across Fairfax County, including Fairfax, Burke, Centreville, Chantilly, Herndon, Reston, McLean, Vienna, Tysons, Oakton, Springfield, Annandale, and the Falls Church area. We offer 24/7 phone consultations at (888) 437-7747. Meetings are by appointment only.
Health Care Fraud Defense FAQs for Fairfax County
What is the most common type of health care fraud?
Yes. The most common is billing for services not rendered, followed by upcoding and kickback schemes. Federal prosecutors in the Eastern District of Virginia aggressively pursue all types, using data analysis to spot irregularities in claims submitted to Medicare and Medicaid.
Can I go to jail for a billing mistake?
It depends. The law requires the government to prove you acted “knowingly and willfully” to defraud. Honest errors or negligence are not criminal. A strong fraud charges defense will focus on intent, using documentation and experienced testimony to show a lack of criminal knowledge.
What agencies investigate health care fraud in Virginia?
The FBI and HHS-OIG lead most investigations. The DEA may be involved in prescription fraud cases, and the IRS may investigate tax violations related to fraud proceeds. State agencies like the Virginia Attorney General’s Medicaid Fraud Control Unit may also participate.
What is the “loss amount” and why does it matter?
The “loss amount” is the dollar value the government claims was fraudulently obtained. It is the single most important factor under the U.S. Sentencing Guidelines, directly determining the recommended prison sentence range. Challenging the prosecution’s loss calculation is a primary defense strategy.
Should I speak to investigators if they contact 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 in Fairfax County Virginia. Anything you say can be used against you, even if you are trying to explain an innocent mistake.
Internal Resources: For more on federal defense, see our Virginia Federal Criminal Defense hub page. For related charges, consider our Fairfax County business lawyer or civil litigation attorney pages. For defense in nearby jurisdictions, view our Arlington County federal criminal lawyer page.
Last verified: April 2026. Laws change. Contact Law Offices Of SRIS, P.C. at (888) 437-7747 for current guidance.