Penalties for Healthcare Fraud Convictions

A healthcare fraud investigation can upend your career, reputation, and freedom in a matter of days. Federal prosecutors pursue these cases aggressively, and the penalties upon conviction can be severe and life-altering. Whether you are a physician, pharmacist, billing specialist, or executive, the stakes are too high to face alone. At the Law Offices of Peter Katz, our healthcare fraud defense lawyer team brings the focused experience needed to challenge the government’s case and protect everything you have built.

What Is Healthcare Fraud?

Healthcare fraud involves intentionally submitting false information to obtain payment from a healthcare benefit program. Common examples include the following:

• Billing for services never rendered
• Upcoding procedures
• Ordering medically unnecessary tests
• Accepting kickbacks in exchange for referrals

Penalties for Healthcare Fraud

Federal penalties for a conviction can trigger prison time, massive financial liability, loss of licensure, and permanent exclusion from federal programs. The collateral damage often continues long after any sentence is served.

Imprisonment

Under 18 U.S.C. § 1347, a standard healthcare fraud conviction can result in up to 10 years in a federal prison per count. When prosecutors file multiple counts, those sentences may run consecutively, transforming one case into decades behind bars.

Enhanced Prison Sentences

Sentences climb sharply when the fraud causes harm. If the scheme results in serious bodily injury, the maximum rises to 20 years. When a patient dies as a result of the fraudulent conduct, federal law allows a sentence of up to life in prison.

Fines and Restitution

Monetary consequences can be staggering. Individual defendants may face fines up to $250,000 per count, while organizations can be fined up to $500,000 per count. Civil penalties under the False Claims Act can exceed three times the government’s loss plus per-claim penalties.

Under the Anti-Kickback Statute, fines can reach up to $100,000. Courts also routinely order full restitution to victims, including government programs and private insurers.

Exclusion from Programs

A conviction usually results in mandatory exclusion from Medicare, Medicaid, and other federal healthcare programs. For providers who rely on federal reimbursement, this exclusion can effectively end their careers in healthcare.

Professional Loss

State licensing boards act quickly after a federal conviction. Physicians, nurses, pharmacists, and other professionals can lose their licenses, hospital privileges, and board certifications, cutting off their ability to practice regardless of future employment prospects.

Forfeiture of Assets

Federal prosecutors regularly pursue forfeiture alongside criminal charges, seeking to strip defendants of assets tied to the alleged scheme. Commonly targeted properties include:

• Bank accounts and investment holdings
• Real estate and vacation properties
• Vehicles, boats, and aircraft
• Business interests and equipment
• Cash and valuable personal property

Speak to Our Qualified Healthcare Defense Attorney Now

Federal healthcare fraud cases move fast, and the decisions you make early often shape the outcome. The Law Offices of Peter Katz has the federal experience, trial skill, and strategic insight these cases demand, and is ready to step in on your behalf.

Call us at 609-849-3179 or contact us through our online form to schedule a consultation with our healthcare defense lawyer, who will defend your rights and your future, and get you the protection you need when facing healthcare fraud allegations.