Health Care Fraud Lawyer Gloucester County — Federal Defense Strategy
Health care fraud is a serious federal crime prosecuted in the Eastern District of Virginia, carrying severe penalties including lengthy prison terms and massive fines. If you are under investigation or have been charged, you need a Health Care Fraud lawyer Gloucester County with federal experience. Law Offices Of SRIS, P.C.
Federal Health Care Fraud Law and Penalties
Health care fraud is primarily prosecuted under 18 U.S.C. § 1347, which makes it a crime to knowingly execute a scheme to defraud any health care benefit program or to obtain money or property from such a program through false pretenses. This statute is often used alongside other charges like wire fraud (18 U.S.C. § 1343) and anti-kickback statute violations (42 U.S.C. § 1320a-7b).
Last verified: April 2026 | Federal Courts | Virginia General Assembly
The penalties for a health care fraud conviction are severe. Each violation of 18 U.S.C. § 1347 can result in up to 10 years in federal prison. If the violation results in serious bodily injury, the maximum penalty increases to 20 years; if it results in death, the penalty can be life imprisonment. Fines can reach $250,000 for individuals and $500,000 for organizations per count, or twice the gross gain or loss from the scheme, whichever is greater. Convictions also lead to mandatory restitution, exclusion from federal health care programs, and asset forfeiture.
Official Legal Resources
For the official text of the federal health care fraud statute, see 18 U.S.C. § 1347 (Cornell Legal Information Institute). For information on federal court procedures in Virginia, visit the U.S. District Court for the Eastern District of Virginia website.
handling a Federal Health Care Fraud Case in Gloucester County
Federal health care fraud investigations in Virginia are typically conducted by agencies like the FBI, HHS-OIG, or the Medicaid Fraud Control Unit. These investigations are complex and can target individuals, medical practices, clinics, or healthcare facilities. A medical billing fraud defense lawyer Gloucester County must understand the intricate web of federal regulations and the aggressive tactics of federal prosecutors. The key local procedural fact is that while Gloucester County itself does not host a federal courthouse, cases from the area are prosecuted in the Newport News or Norfolk divisions of the U.S. District Court for the Eastern District of Virginia (EDVA).
- Initial Investigation & Grand Jury: A federal investigation begins, often with subpoenas for records. A grand jury may be convened to determine if there is probable cause for an indictment.
- Charging & Initial Appearance: If indicted, you will be arrested or summoned for an initial appearance in federal court, where charges are formally read.
- Arraignment & Plea: At arraignment, you will enter a plea of guilty or not guilty. This is a critical stage for filing pre-trial motions.
- Discovery & Motions: Your attorney will review all evidence (discovery) from the prosecution and file motions to challenge the admissibility of evidence or dismiss charges.
- Plea Negotiations or Trial: Most federal cases are resolved by plea agreement. If no agreement is reached, the case proceeds to a jury trial.
- Sentencing: If convicted, either by plea or trial, sentencing follows federal guidelines, which are often harsh for fraud offenses.
Potential Penalties for Health Care Fraud
In federal court, a health care fraud conviction under 18 U.S.C. § 1347 carries a baseline penalty of up to 10 years in prison, with dramatically increased penalties if the fraud resulted in injury or death.
| 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) | Restitution, program exclusion, forfeiture |
| Health Care Fraud Causing Injury | Federal Felony | Up to 20 years | Up to $250,000 (individual) | Same as above |
| Health Care Fraud Causing Death | Federal Felony | Any term up to life | Up to $250,000 (individual) | Same as above |
| Conspiracy to Commit Health Care Fraud (18 U.S.C. § 1349) | Federal Felony | Same as underlying fraud | Same as underlying fraud | Same as above |
Results may vary. Prior results do not guarantee a similar outcome.
Why Choose Our Firm for Your Federal Defense
Law Offices Of SRIS, P.C. was founded in 1997 and brings a focused approach to federal criminal defense. Our attorneys understand the high stakes of a healthcare scheme charge lawyer Gloucester County clients face. We analyze the specific allegations—whether they involve upcoding, billing for services not rendered, kickbacks, or false certifications—to build a defense that challenges the government’s evidence on intent, knowledge, and materiality. We have a documented history of handling complex cases and work to protect your freedom and professional future.
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
Documented Case Results
Our firm has a documented history of achieving favorable outcomes in complex cases. For example, in a federal case involving multiple fraud counts, our defense strategy resulted in a favorable resolution for the client. In another matter, strategic pre-trial motions led to the suppression of key evidence. Results may vary. Prior results do not guarantee a similar outcome.
Our secondary attorney on complex federal matters, Matthew Greene, brings over 30 years of experience, including former death penalty certification and a 14-year contract with Child Protective Services, providing deep insight into high-stakes litigation.
Contact Our Gloucester County Health Care Fraud Lawyers
Our Richmond location serves clients in Gloucester County facing federal charges. We are accessible from Gloucester via major highways and provide dedicated representation for those under investigation or charged with health care fraud.
Law Offices Of SRIS, P.C. — Richmond
7400 Beaufont Springs Dr Suite 300 Room 359, Richmond, VA 23225
Toll-Free: (888) 437-7747 | Local: (804)201-9009
By appointment only. 24/7 phone consultations.
Serving: Gloucester, Gloucester Point, and surrounding communities.
Health Care Fraud Defense FAQs
What is the federal definition of health care fraud?
It depends. The core federal statute (18 U.S.C. § 1347) defines it as knowingly executing a scheme to defraud any health care benefit program or to obtain money from such a program through false pretenses. This can include a wide range of activities like billing for services not rendered, upcoding, kickbacks, or falsifying patient records.
Who investigates health care fraud in Virginia?
Federal health care fraud is investigated by agencies like the Federal Bureau of Investigation (FBI), the Department of Health and Human Services Office of Inspector General (HHS-OIG), and the Virginia Attorney General’s Medicaid Fraud Control Unit (MFCU). These investigations are often lengthy and involve subpoenas, interviews, and undercover operations.
What are the best defenses against health care fraud charges?
Common defenses include lack of intent to defraud (mistake or negligence), lack of materiality of the false statement, insufficient evidence, entrapment, or challenging the legality of the investigation itself. A medical billing fraud defense lawyer Gloucester County residents trust will scrutinize every aspect of the prosecution’s case to identify weaknesses.
Can I go to prison for a first-time health care fraud offense?
Yes. Federal sentencing guidelines are strict, and even first-time offenders face a significant risk of prison time, especially if the alleged financial loss is substantial. The base offense level under the guidelines increases with the dollar amount of the loss, directly impacting the recommended prison sentence.
What should I do if I am contacted by a federal agent about health care fraud?
Politely decline to answer questions and immediately contact a federal criminal defense attorney. You have the right to remain silent and the right to an attorney. Anything you say can be used against you. An attorney can communicate with investigators on your behalf to protect your rights from the very start.
How long does a federal health care fraud case take?
It depends on the case’s complexity. While the Speedy Trial Act sets a framework, complex fraud cases often take one to three years from indictment to resolution. Investigations can last even longer before charges are ever filed. A healthcare scheme charge lawyer Gloucester County clients rely on must be prepared for a protracted legal battle.
Related Pages: If you are facing other federal charges, see our pages on Virginia Federal Criminal Defense and Federal Criminal Lawyer Henrico County. For other legal issues in Gloucester County, visit our Gloucester County Criminal Defense Lawyer page.
Page last verified and updated: April 2026. Federal laws and procedures change. Contact Law Offices Of SRIS, P.C. at (888) 437-7747 for current legal guidance regarding your specific situation.