Health Care Fraud Lawyer in Frederick County, Virginia — Federal Defense
Health care fraud is a serious federal crime prosecuted in the Western District of Virginia. If you are under investigation or charged, you need a health care fraud lawyer in Frederick Virginia with federal experience. Law Offices Of SRIS, P.C. provides defense for allegations involving billing for services not rendered, upcoding, kickbacks, and Stark Law violations.
Last verified: April 2026 | Verify with lead attorney | Virginia General Assembly
Federal Health Care Fraud Statutes and Penalties
Health care fraud is primarily prosecuted under 18 U.S.C. § 1347, which makes it a crime to knowingly execute a scheme to defraud any health care benefit program. Related charges often include violations of the Anti-Kickback Statute (42 U.S.C. § 1320a-7b), the False Claims Act (31 U.S.C. §§ 3729-3733), and the Stark Law (42 U.S.C. § 1395nn). These cases are investigated by federal agencies like the FBI, HHS-OIG, and IRS-CI, and prosecuted by the U.S. Attorney’s Office for the Western District of Virginia (WDVA).
As a financial crime lawyer will explain, penalties are severe. A conviction under 18 U.S.C. § 1347 can result in up to 10 years in prison, or up to 20 years if the violation results in serious bodily injury. Fines can reach $250,000 for individuals and $500,000 for organizations, plus mandatory restitution. The Federal Sentencing Guidelines heavily influence the final sentence, considering the dollar loss amount, which is a primary driver of the offense level.
External Legal Resources
- 18 U.S.C. § 1347 (Health Care Fraud) — Official U.S. Code via Legal Information Institute.
- U.S. District Court for the Eastern District of Virginia — Official court website with local rules and procedures.
- Initial Investigation: You may receive a subpoena for records or be contacted by federal agents. Do not speak to investigators without your lawyer present.
- Charging Decision: The U.S. Attorney’s Office will present evidence to a grand jury for an indictment. Your defense team can present exculpatory evidence to try to avert charges.
- Arraignment & Motions: After indictment, you will be arraigned. Your white collar defense lawyer will file pre-trial motions to challenge evidence and define the legal issues.
- Discovery & Negotiation: The government provides its evidence. Your attorney analyzes it for weaknesses and may engage in plea negotiations, often focusing on reducing the alleged loss amount.
- Trial or Sentencing: If no agreement is reached, the case proceeds to a jury trial. If a plea is entered, your attorney advocates for the most favorable sentence under the advisory guidelines.
Potential Penalties for Health Care Fraud
In federal court, health care fraud under 18 U.S.C. § 1347 carries a maximum of 10 years in prison, fines up to $250,000 for individuals, and mandatory restitution to the defrauded program.
| Offense | Classification | Incarceration | Fine | Additional Consequences |
|---|---|---|---|---|
| Health Care Fraud (18 U.S.C. § 1347) | Federal Felony | Up to 10 years (20 if injury) | Up to $250,000 (Individual) | Restitution, Forfeiture, Exclusion from Medicare/Medicaid |
| Anti-Kickback Statute Violation | Federal Felony | Up to 5 years | Up to $25,000 | Civil penalties up to $50,000 per violation |
| False Claims Act Violation | Civil & Criminal | Possible criminal penalties | Treble damages + civil penalties | Whistleblower (Qui Tam) liability |
Results may vary. Prior results do not aim for a similar outcome.
Why Choose Our Firm for Your Federal 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 cases. Our firm-wide track includes 4,739+ case results with a 93%+ favorable outcome rate. We understand that a health care fraud accusation can threaten your professional license, livelihood, and freedom. Our approach combines strategic legal defense with a clear explanation of the process, ensuring you are informed and prepared at every stage.
Documented Case Results
Our firm has a documented history of achieving favorable outcomes in complex cases. For instance, our team has successfully negotiated resolutions that avoided prison time for clients facing serious federal allegations by meticulously challenging the government’s evidence and loss calculations. In other matters, we have secured dismissals or favorable plea agreements that preserved our clients’ professional futures.
Results may vary. Prior results do not aim for a similar outcome.
Of Counsel attorney Matthew Greene, with over 30 years of experience including a former 14-year contract with Child Protective Services in Alexandria, contributes deep investigative and procedural knowledge to building a strong defense.
Contact Our Frederick County Health Care Fraud Defense Team
Law Offices Of SRIS, P.C.
Shenandoah/Woodstock Location — 505 N Main St, Suite 103, Woodstock, VA 22664
Toll-Free: (888) 437-7747 | Local: (703) 636-5417 | Local: (540) 999-9999
By appointment only.
Our Shenandoah/Woodstock location serves clients at federal courts relevant to Frederick County cases. We represent individuals in Winchester, Stephens City, Middletown, Clear Brook, and Gore. 24/7 phone consultations — (888) 437-7747 — meetings by appointment only.
Health Care Fraud Defense FAQs
What is the main federal law for health care fraud?
Yes. The primary statute is 18 U.S.C. § 1347. It criminalizes knowingly executing a scheme to defraud any health care benefit program, like Medicare or Medicaid, or to obtain money or property from such a program through false pretenses.
What agencies investigate health care fraud?
Multiple agencies are involved. The FBI and the Office of Inspector General for the Department of Health and Human Services (HHS-OIG) are primary. The IRS Criminal Investigation division may also be involved if tax violations are suspected. These agencies work together on task forces.
What are common examples of health care fraud?
Common examples include billing for services not rendered, upcoding (billing for a more expensive service than provided), unbundling (billing separately for services that should be bundled), paying or receiving kickbacks for patient referrals, and making false statements on applications for licenses or payments.
Can I go to jail for a billing error?
It depends. The government must prove you acted knowingly and with intent to defraud. Honest mistakes or negligence are not criminal under 18 U.S.C. § 1347. A strong fraud charges defense often focuses on demonstrating a lack of criminal intent.
What is the most important factor in sentencing?
The dollar amount of the loss caused by the fraud is the most significant factor under the Federal Sentencing Guidelines. A skilled white collar defense lawyer will work with forensic experts to contest the government’s loss calculation, which can dramatically reduce the potential sentence.
Internal Resources
- Virginia Federal Criminal Defense Lawyer Hub
- Federal Criminal Lawyer in Augusta County
- Business Lawyer in Frederick County
Last verified: April 2026. Laws change — contact Law Offices Of SRIS, P.C. at (888) 437-7747 for current guidance.