Healthcare Fraud Lawyer Somerset County — Federal & State Defense
Healthcare fraud charges in Somerset County, New Jersey, are serious federal and state offenses under 18 U.S.C. § 1347 and N.J.S.A. 2C:21-4.3, carrying severe penalties including decades in prison, massive fines, and mandatory restitution. As a healthcare fraud lawyer Somerset County, Law Offices Of SRIS, P.C.
Last verified: April 2026 | Superior Court of NJ, Somerset Vicinage | New Jersey Legislature
What Is Healthcare Fraud in New Jersey?
Healthcare fraud involves knowingly and willfully executing a scheme to defraud any healthcare benefit program or to obtain money or property from such a program through false pretenses. In New Jersey, this is prosecuted at both the federal and state levels. Federal charges are typically brought by the U.S. Attorney’s Office for the District of New Jersey under statutes like 18 U.S.C. § 1347 (Healthcare Fraud) and 42 U.S.C. § 1320a-7b (Anti-Kickback Statute). State charges fall under N.J.S.A. 2C:21-4.3 (Health Care Claims Fraud) and are handled by the Somerset County Prosecutor’s Office and the NJ Division of Criminal Justice. Founded in 1997 by former prosecutor Mr. Sris, our firm understands the technical interplay between federal and state investigations.
Official Legal Resources
For the official text of the federal healthcare fraud statute, see 18 U.S.C. § 1347 (U.S. Code). For New Jersey court procedures and locations, visit the Superior Court of NJ, Somerset Vicinage website.
Facing a Healthcare Fraud Investigation in Somerset County
Healthcare fraud investigations in Somerset County often begin with a subpoena, search warrant, or interview request from federal agents (FBI, HHS-OIG) or state investigators. The key local procedural fact is that these cases are frequently investigated jointly. A federal indictment would be filed in the U.S. District Court for the District of New Jersey, while a state indictment would be filed in the Somerset County Superior Court, Criminal Division, at 20 North Bridge Street in Somerville. The the issues involved demands immediate action from a skilled fraud charge defense lawyer Somerset County.
- Secure Immediate Legal Counsel: Do not speak to investigators without an attorney present. Contact a healthcare fraud lawyer Somerset County as early as possible upon learning of an investigation.
- Preserve and Review Records: Begin a thorough internal review of all relevant billing records, patient files, and communications under the guidance of counsel to understand potential exposure.
- Case Assessment and Strategy: Your attorney will analyze the allegations, identify weaknesses in the government’s case, and develop a defense strategy, which may involve challenging intent, demonstrating compliance, or negotiating a pre-indictment resolution.
- handle Court Proceedings: If charged, your lawyer will handle all arraignments, motions, discovery, and, if necessary, trial in the appropriate federal or state court.
Potential Penalties for Healthcare Fraud
In Somerset County, healthcare fraud penalties are severe, with federal convictions carrying up to 10 years per count (20+ years if injury results) and fines up to $250,000 for individuals.
| Offense Level | Classification | Incarceration | Fine | Additional Consequences |
|---|---|---|---|---|
| Federal Healthcare Fraud (18 U.S.C. § 1347) | Felony | Up to 10 years; 20+ years if injury | Up to $250,000 (individual) | Mandatory restitution, exclusion from Medicare/Medicaid, asset forfeiture. |
| NJ Health Care Claims Fraud (N.J.S.A. 2C:21-4.3) | 2nd/3rd Degree Crime | 5-10 years (2nd); 3-5 years (3rd) | Up to $150,000 | Civil penalties, license revocation by NJ boards, restitution. |
| Anti-Kickback Violations (42 U.S.C. § 1320a-7b) | Felony | Up to 5 years | Up to $25,000 | Exclusion from federal health programs. |
Results may vary. Prior results do not guarantee a similar outcome.
Why Choose Our Firm for Your Healthcare Fraud Defense
Law Offices Of SRIS, P.C. was founded in 1997. Our attorneys bring a combined 120+ years of legal experience to white-collar defense. Mr. Sris, the firm’s founder and a former prosecutor, provides strategic oversight on federal matters. His background in accounting and information systems provides a unique advantage in dissecting the financial and data-driven evidence central to healthcare fraud cases. We approach each case with a detailed, evidence-based strategy.
Our Approach to Healthcare Fraud Cases
Our defense begins with a meticulous review of all billing practices, patient charts, and internal communications. We work with forensic accountants and medical professionals to challenge the government’s allegations of “willfulness” and “materiality.” Strategies may include demonstrating good-faith compliance efforts, attacking the reliability of the government’s data analysis, or negotiating for alternatives to incarceration, such as pretrial diversion. As an experienced white collar crime defense lawyer Somerset County, we understand that protecting your reputation and professional license is as important as the criminal case itself.
Results may vary. Prior results do not guarantee a similar outcome.
Contact Our Somerset County Healthcare Fraud Defense Lawyers
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) 651-3900
By appointment only.
Our New Jersey location serves clients at Somerset County courts. We provide 24/7 phone consultations — (888) 437-7747 — meetings by appointment only. We serve communities including Somerville, Bridgewater, Franklin Township, Bound Brook, Hillsborough, Warren Township, Watchung, Bernardsville, and Bedminster.
Healthcare Fraud Defense FAQs
What agencies investigate healthcare fraud in Somerset County?
Multiple agencies. Federal investigations are typically led by the FBI, U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), or the U.S. Postal Inspection Service. At the state level, the New Jersey Division of Criminal Justice and the Somerset County Prosecutor’s Office handle cases. These agencies often collaborate in joint task forces.
Can I lose my medical license for a healthcare fraud charge?
Yes, it is a significant risk. A conviction, and sometimes even an indictment, can trigger disciplinary action by the New Jersey Board of Medical Examiners or other professional licensing boards. This can result in suspension, revocation, or restrictions on your license to practice. A key part of our defense strategy involves coordinating with licensing board counsel to mitigate these professional consequences.
What is the difference between a civil and criminal healthcare fraud case?
Criminal cases seek imprisonment and fines, requiring proof “beyond a reasonable doubt.” Civil cases, often brought under the False Claims Act (31 U.S.C. §§ 3729-3733), seek monetary penalties and restitution under the lower “preponderance of the evidence” standard. The same conduct can lead to parallel criminal and civil proceedings, which is why you need a lawyer experienced in both arenas.
What are common examples of healthcare fraud allegations?
Common allegations include billing for services not rendered (“phantom billing”), 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 submitting false cost reports. Laboratories, durable medical equipment suppliers, and home health agencies are frequent targets.
Should I talk 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 state you wish to consult with your lawyer. Anything you say can be used against you. Contact a healthcare fraud lawyer Somerset County as early as possible to guide your response.
Internal Resources: If you are facing other federal charges, see our page on federal criminal defense in Somerset County. For related state fraud matters, our Somerset County criminal defense lawyers can assist. Learn more about our firm’s approach on our federal criminal defense hub page.
Page last verified: 2026-04. Laws change — contact Law Offices Of SRIS, P.C. at (888) 437-7747 for current guidance.
If you want to see how a Somerset County case fits into the wider process, our page on healthcare fraud lawyer New Jersey covers it from start to finish.
Your case in Somerset County, New Jersey
Federal charges are heard in the U.S. District Court for the District of New Jersey (Newark, Trenton and Camden), not in county court; related state charges are heard in the Criminal Part of the Law Division. In Somerset County that is the Superior Court of NJ, Somerset Vicinage (13th Vicinage), 20 North Bridge Street, Somerville, NJ 08876, telephone (908) 231-7000, 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 Title 18 of the United States Code and the Federal Rules of Criminal Procedure. Law Offices Of SRIS, P.C. handles Somerset 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: Somerset County NJ lawyers directory · Healthcare Fraud Lawyer Bergen County, NJ · Healthcare Fraud Lawyer Hudson County, NJ · Healthcare Fraud Defense Lawyer Monmouth County, NJ.