Health Care Fraud Lawyer in Madison, Virginia — Federal Defense Strategy
Health care fraud is a serious federal crime prosecuted under 18 U.S.C. § 1347, carrying severe penalties. If you are under investigation in Madison, Virginia, you need a health care fraud lawyer with federal experience. Law Offices Of SRIS, P.C. provides defense for individuals and entities facing these complex financial crime allegations. Contact us 24/7 at (888) 437-7747.
Federal Health Care Fraud Statute and Penalties
Health care fraud is defined under federal law as knowingly and willfully executing a scheme to defraud any health care benefit program, or to obtain money or property from such a program by false pretenses. The primary statute is 18 U.S.C. § 1347. This is a white-collar crime often investigated by agencies like the FBI, HHS-OIG, and IRS.
Last verified: April 2026 | Federal Courts | U.S. Code
Founded in 1997 by former prosecutor Mr. Sris, our firm has a background in accounting and information systems that provides a distinct advantage in dissecting complex billing records and financial data central to these cases.
Official Legal Resources
- 18 U.S.C. § 1347 – Health care fraud (Official U.S. Code)
- U.S. District Court for the Eastern District of Virginia (Court Website)
Defense Strategy for Madison County Cases
Federal health care fraud cases originating in or affecting Madison County are typically prosecuted in the U.S. District Court for the Western District of Virginia (Charlottesville or Harrisonburg divisions) or the Eastern District. These cases are complex, involving voluminous medical records, billing data, and experienced testimony. A key local procedural fact is that many investigations begin with audits or whistleblower complaints under the False Claims Act (31 U.S.C. §§ 3729–3733). Early intervention by a skilled fraud attorney is critical to challenge the government’s evidence before an indictment is secured.
- Initial Investigation & Grand Jury: You may receive a target letter or subpoena. Do not speak to agents without your lawyer present.
- Pre-Indictment Negotiation: Your attorney may negotiate with the U.S. Attorney’s Office to avoid charges or discuss a pre-trial resolution.
- Arraignment & Plea: If indicted, you will be arraigned. Your lawyer will advise on pleading not guilty to begin building your defense.
- Discovery & Motions: Your defense team will review all evidence and file motions to suppress evidence or dismiss charges if procedural errors exist.
- Trial or Resolution: The case may proceed to a jury trial or be resolved through a negotiated plea agreement that minimizes penalties.
- Sentencing: If convicted, your lawyer will advocate at sentencing under the U.S. Sentencing Guidelines, arguing for the most favorable outcome.
Potential Penalties for Health Care Fraud
In federal court, health care fraud convictions carry severe penalties including decades in prison, massive fines, and mandatory restitution.
| Offense | Classification | Incarceration | Fine | Additional Consequences |
|---|---|---|---|---|
| Health Care Fraud (18 U.S.C. § 1347) | Federal Felony | Up to 10 years per count; up to 20 years if injury results; life if death results. | Up to $250,000 (individual) or $500,000 (organization) per count. | Mandatory restitution, asset forfeiture, exclusion from Medicare/Medicaid, professional license revocation. |
| Conspiracy to Commit Health Care Fraud (18 U.S.C. § 1349) | Federal Felony | Same as underlying fraud offense. | Same as underlying fraud offense. | All conspirators liable for foreseeable acts of co-conspirators. |
| 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.
Our Firm’s Experience in Federal Defense
Law Offices Of SRIS, P.C., founded in 1997, brings over 120 years of combined legal experience to complex federal cases. Our founder, Mr. Sris, is a former prosecutor with a background in accounting and information systems—a critical skillset for a financial crime lawyer tackling health care fraud. He leads a team that includes Of Counsel attorney Matthew Greene, who has over 30 years of experience, including a former 14-year contract with Child Protective Services in Alexandria, providing him with deep insight into government investigative procedures. We approach each case with a detailed, evidence-focused strategy.
Case Results and Client Advocacy
While specific case results are confidential, our firm’s approach is to conduct an immediate and thorough investigation to challenge the government’s evidence. We scrutinize billing codes, patient records, and audit trails to identify errors, lack of intent, or improper investigative techniques. In federal cases, negotiation with the U.S. Attorney’s Office for pre-trial diversion or favorable plea terms is often a key component of the defense strategy.
Results may vary. Prior results do not aim for a similar outcome.
Contact Our Madison County Health Care Fraud Defense Lawyers
Our Fairfax location serves clients facing federal charges in Madison County and the Western District of Virginia. We are accessible via Route 29 and Route 231.
Law Offices Of SRIS, P.C.
4008 Williamsburg Court
Fairfax, VA 22032
Toll-Free: (888) 437-7747 | Local: (703) 636-5417
By appointment only.
24/7 phone consultations — (888) 437-7747 — meetings by appointment only. We serve clients in Madison and surrounding communities.
Health Care Fraud Defense FAQs
What is health care fraud under federal law?
It is knowingly executing a scheme to defraud a health care benefit program (like Medicare) or to obtain its money by false promises. Common examples include billing for services not rendered, upcoding, kickbacks, and providing medically unnecessary services. It is prosecuted under 18 U.S.C. § 1347.
Who investigates health care fraud in Virginia?
Multiple federal agencies investigate, including the FBI, the Department of Health and Human Services Office of Inspector General (HHS-OIG), and the IRS. The Virginia Attorney General’s Medicaid Fraud Control Unit may also be involved in state-funded program fraud. A fraud charges defense lawyer experienced with these agencies is essential.
What are the possible defenses to health care fraud charges?
Potential defenses include lack of intent (mistake or negligence), insufficient evidence, entrapment, challenging the credibility of whistleblowers, proving services were medically necessary, and asserting violations of your constitutional rights during the investigation. Each defense depends on the specific facts and evidence of your case.
Should I speak to investigators if contacted?
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. Anything you say can be used against you, and investigators are trained to obtain incriminating statements.
What is the False Claims Act and how does it relate?
The False Claims Act (31 U.S.C. §§ 3729–3733) allows whistleblowers (“relators”) to file suits on the government’s behalf. These “qui tam” suits are a major source of health care fraud cases. If the government intervenes and wins, the whistleblower receives a share of the recovery. Defense often involves challenging the relator’s allegations.
Related Legal Resources
- Virginia Federal Criminal Defense Lawyer (Hub Page)
- Federal Criminal Lawyer in Albemarle County (Sibling Locality)
- Criminal Defense Lawyer in Madison, VA (Related PA)
Page Last verified: April 2026. Federal statutes and procedures can change. Contact Law Offices Of SRIS, P.C. at (888) 437-7747 for current legal guidance regarding your specific situation.
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Madison County cases are handled by our Virginia health care fraud practice, where the whole process is set out.