No matter what type of criminal charges you may be faced with, I can defend your rights and your future.

  1. Home
  2.  — 
  3. Federal Criminal Defense
  4.  — Health Care Fraud

Understanding The Scope Of Health Care Fraud Charges

Health care fraud includes marketing ineffective curative products as well as health insurance fraud. If you have been charged with defrauding an insurer or government health care program, it is important that you retain qualified legal representation.

Health care fraud is frequently charged by federal prosecutors. I am attorney Peter Katz, and I have successfully represented numerous people who have faced these charges. I know what an effective defense requires. At my firm, the Law Offices of Peter Katz, I offer a free and confidential consultation. Call 609-900-2648 to speak with me and arrange a meeting.

Health Care Fraud And Special New York Penalties

In 1996, Congress passed the crime of health care fraud under Title 18 U.S.C. Section 1347. The elements of health care fraud are similar to those of both mail and wire fraud. Anyone who executes a scheme to defraud any health care benefit program is guilty of health care fraud.

In essence, anyone who lies or uses deceit to get paid by Medicare, Tricare, Medicaid or another federal health care program is guilty of health care fraud. New York has a special unit to investigate and prosecute health care fraud such as Medicaid fraud. Article 177 of New York’s Penal Law enumerates the crimes related to health care fraud. Some important things to understand about health care fraud are:

  • Under this law, a health plan covers both public and private health care plans.
  • There are different degrees of New York health care fraud. Under New York Penal Law Section 177.25, health care fraud in the first degree happens if someone intends to defraud a health plan and then willfully and knowingly provides incomplete or false information with the goal of obtaining reimbursement or payment from a health care plan to which they are not entitled.
  • Generally, first-degree fraud involves $1 million that is stolen over the course of one year. The penalties can extend up to a maximum sentence of 25 years.
  • Lesser monetary amounts are involved with lesser degrees of health care fraud. For example, health care fraud in the second degree involves a stolen sum of up to $50,000 over the course of a year.

Federal health care fraud is punishable by up to 10 years in prison and a $250,000 fine, however, if serious injury results from the offense, it is punishable by up to 20 years in prison, and, if death results, it is punishable by life in prison. These charges may brought against you in concert with wire or mail fraud charges. In instances where a crime has not actually been committed, prosecutors may include conspiracy charges.

In addition to the description listed above, charges of health care fraud may be related to kickbacks or prescription fraud.

Start A Discussion About Your Situation

If you are facing health care fraud charges, it will serve you to understand your rights. I offer a free consultation. We can discuss the scope of the charges and how I can help. Call 609-900-2648 or connect with me via website contact email, and I will be in touch. I serve clients facing charges in New York and New Jersey as well as in Princeton and throughout Mercer County.