Health Care Fraud Lawyer Fairfax — Federal Defense Strategies
Federal health care fraud charges in Fairfax are prosecuted under 18 U.S.C. § 1347, carrying severe penalties including decades in prison and multi-million dollar fines. Law Offices Of SRIS, P.C. provides defense for individuals and entities facing federal investigations by the FBI, HHS-OIG, or the U.S. Attorney’s Office for the Eastern District of Virginia.
Last verified: April 2026 | Information current as of 2026-02-20. Laws change — contact Law Offices Of SRIS, P.C. at (888) 437-7747 for current guidance.
Federal Health Care Fraud Law in Fairfax
Health care fraud is a federal crime defined under 18 U.S.C. § 1347. The statute makes it illegal to knowingly and willfully execute, or attempt to execute, a scheme to defraud any health care benefit program or to obtain money or property from such a program through false pretenses. In Fairfax, these cases are typically investigated by federal agencies like the FBI, the Department of Health and Human Services Office of Inspector General (HHS-OIG), and the Drug Enforcement Administration (DEA), and prosecuted by the U.S. Attorney’s Office for the Eastern District of Virginia in Alexandria.
The law covers a wide range of activities, including billing for services not rendered, upcoding services, performing medically unnecessary procedures, paying or receiving kickbacks for patient referrals (violating the Anti-Kickback Statute, 42 U.S.C. § 1320a-7b), and making false statements related to health care matters (18 U.S.C. § 1035). Mr. Sris, the firm’s managing attorney, leverages his background in accounting and information systems to dissect complex billing records and financial data central to these cases.
Official Legal Resources
For the full text of the primary federal health care fraud statute, see 18 U.S.C. § 1347 (Health care fraud). For local court procedures and rules, refer to the U.S. District Court for the Eastern District of Virginia website.
handling a Federal Health Care Fraud Case in Fairfax
Federal health care fraud investigations in Fairfax often begin with a subpoena, a search warrant, or an interview request from a federal agent. The process is markedly different from state court proceedings. An experienced health care fraud lawyer Fairfax from our firm can intervene at the investigative stage to protect your rights and potentially influence the direction of the case before charges are filed.
- Initial Investigation: Federal agents may issue subpoenas for records, execute search warrants, or attempt interviews. Do not speak to agents without an attorney present.
- Grand Jury Proceedings: The prosecution presents evidence to a secret grand jury. If indicted, the case moves to federal court.
- Arraignment & Detention Hearing: You will be formally charged and enter a plea. The court will also determine if you will be released pending trial.
- Discovery & Motions: Your defense attorney will review the government’s evidence and file pre-trial motions to challenge the admissibility of evidence or dismiss charges.
- Plea Negotiations or Trial: Most federal cases are resolved by plea agreement. If a plea cannot be reached, the case proceeds to a jury trial in U.S. District Court.
- Sentencing: If convicted, sentencing follows the advisory U.S. Sentencing Guidelines, which consider the “loss amount,” a key factor in fraud cases.
Potential Penalties for Health Care Fraud
In Fairfax, a federal health care fraud 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, and up to life imprisonment if a death results.
| Offense | Classification | Incarceration | Fine | Additional Consequences |
|---|---|---|---|---|
| Health Care Fraud (18 U.S.C. § 1347) | Federal Felony | Up to 10 years* | Up to $250,000 (individual) / $500,000 (organization) | Mandatory restitution; forfeiture of assets; exclusion from federal health care programs. |
| Health Care Fraud Causing Serious Bodily Injury | Federal Felony | Up to 20 years | Up to $250,000 (individual) / $500,000 (organization) | Same as above. |
| Health Care Fraud Causing Death | Federal Felony | Any term of years up to life | Up to $250,000 (individual) / $500,000 (organization) | Same as above. |
Results may vary. Prior results do not guarantee a similar outcome.
*Sentences are guided by the U.S. Sentencing Guidelines, which heavily weigh the financial loss attributed to the fraud.
Our Firm’s Experience in 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+ documented case results with a 93%+ favorable outcome rate. Mr. Sris’s unique background in accounting and information systems provides a distinct advantage in deconstructing the financial and data-driven evidence typical in health care fraud and healthcare scheme charge lawyer Fairfax cases. The firm’s collaborative approach ensures every client benefits from multiple legal perspectives.
Bryan Block, Defense Attorney at Law Offices Of SRIS, P.C. — Licensed in VA. Former Virginia State Trooper (15 years). View Bryan Block’s Profile
Matthew Greene, Senior Defense Attorney at Law Offices Of SRIS, P.C. — Licensed in VA. 30+ years criminal defense. Death penalty certified (formerly). View Matthew Greene’s Profile
Case Results & Client Advocacy
Our defense strategies are informed by extensive experience. For instance, our team has successfully negotiated resolutions in complex fraud cases, avoiding the most severe penalties clients initially faced. In one matter involving multiple counts of fraud, we secured a resolution that resulted in a suspended sentence and probation, avoiding active incarceration. Results may vary. Prior results do not guarantee a similar outcome.
When facing a medical billing fraud defense lawyer Fairfax scenario, the details of the billing codes, provider agreements, and medical necessity documentation are paramount. We work with medical and forensic accounting experts to audit records and build a compelling defense narrative.
Contact Our Fairfax Federal Defense Team
Law Offices Of SRIS, P.C. — Fairfax
4008 Williamsburg Ct, Fairfax, VA 22032, United States
Toll-Free: (888) 437-7747 | Local: (703) 636-5417
Phones answered 24/7/365. Office meetings by appointment only.
Serving Fairfax County and the Eastern District of Virginia.
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 schemes to defraud any health care benefit program, including Medicare, Medicaid, and private insurers. Related laws like the Anti-Kickback Statute (42 U.S.C. § 1320a-7b) and the False Claims Act (31 U.S.C. §§ 3729–3733) are often charged alongside it.
What should I do if I am contacted by a federal agent about a health care fraud investigation?
It depends. Politely decline to answer questions and state you wish to speak with an attorney. Do not provide any documents or statements. Contact a federal health care fraud lawyer Fairfax immediately. Anything you say can be used against you, and agents are not required to inform you if you are a target or just a witness.
What are common examples of health care fraud?
Common examples include billing for services not performed (phantom billing), upcoding (billing for a more expensive service than provided), performing unnecessary procedures, unbundling (billing each step of a procedure separately), and receiving kickbacks for patient referrals or prescribing certain drugs.
What is the “loss amount” and why is it important?
The “loss amount” is the dollar value the government claims was fraudulently obtained. It is the single most important factor in determining sentencing guidelines under the U.S. Sentencing Manual. A skilled medical billing fraud defense lawyer Fairfax will vigorously challenge the government’s loss calculation, which can significantly reduce potential penalties.
Can a health care provider be excluded from Medicare/Medicaid?
Yes. A conviction for health care fraud, or even a settlement in certain cases, can lead to mandatory exclusion from participation in all federal health care programs (Medicare, Medicaid) for a minimum of five years, often effectively ending a medical professional’s career.
What defenses are available against health care fraud charges?
Potential defenses include lack of intent (the act was a mistake or negligence), insufficient evidence, challenging the accuracy of billing or medical records, entrapment, and procedural defenses like statute of limitations. Each healthcare scheme charge lawyer Fairfax case requires a unique strategy based on the specific evidence.
Internal Resources: For more on our federal practice, see our Virginia Federal Criminal Defense hub. For related defense services in Fairfax, consider our Fairfax business lawyers or Fairfax criminal defense attorneys.
Last verified: April 2026. The information on this page is for general informational purposes and does not constitute legal advice.