Health Care Fraud Lawyer Prince William County — Federal Defense Strategy
Health care fraud is a serious federal offense under 18 U.S.C. § 1347, carrying severe penalties. If you are under investigation or charged in Prince William County, you need a health care fraud lawyer Prince William County with federal experience. Law Offices Of SRIS, P.C.
Federal Health Care Fraud Statute and Penalties
Last verified: April 2026 | Federal District Court for the Eastern District of Virginia | U.S. Code.
Health care fraud is prosecuted federally under 18 U.S.C. § 1347. This statute makes it a crime 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. The law applies to both government programs like Medicare and Medicaid and private insurance plans. The statute requires proof of specific intent to defraud.
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 local federal court procedures, visit the U.S. District Court for the Eastern District of Virginia website.
Local Federal Court Process for Health Care Fraud
Health care fraud cases in Prince William County are typically investigated by federal agencies like the FBI, HHS-OIG, or DEA before being presented to a grand jury in the Eastern District of Virginia. The case proceeds through an initial appearance, arraignment, discovery, pre-trial motions, and potentially trial. The key local procedural fact is that these are federal, not state, charges, handled in Alexandria or Richmond federal court.
- Receive a target letter or become aware of a federal investigation (FBI, HHS-OIG).
- Immediately secure a federal criminal defense attorney experienced in health care fraud.
- Your attorney will communicate with federal prosecutors and agents to understand the scope of the allegations.
- Your lawyer will analyze the evidence, which often involves complex medical billing records.
- Develop a defense strategy, which may involve challenging the intent element, the materiality of false statements, or the valuation of the alleged loss.
- handle pre-trial motions, plea negotiations, or prepare for trial in federal court.
Potential Penalties for Health Care Fraud
In federal court, health care fraud under 18 U.S.C. § 1347 carries a potential penalty of up to 10 years in prison. If the violation results in serious bodily injury, the maximum increases to 20 years; if it results in death, the maximum is life imprisonment. Fines can be substantial.
| 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) | Restitution, forfeiture, exclusion from federal health programs. |
| Health Care Fraud Causing Serious Bodily Injury | Federal Felony | Up to 20 years | Up to $250,000 (individual) / $500,000 (organization) | Mandatory restitution, permanent program exclusion. |
| Health Care Fraud Causing Death | Federal Felony | Up to life imprisonment | Up to $250,000 (individual) / $500,000 (organization) | Mandatory restitution, permanent program exclusion. |
Results may vary. Prior results do not guarantee a similar outcome.
*Sentences are guided by the U.S. Sentencing Guidelines, which consider the dollar loss amount, the number of victims, and the defendant’s role.
Why Choose Our Firm for Your Health Care Fraud Defense
Founded in 1997 by former prosecutor Mr. Sris, Law Offices Of SRIS, P.C. brings a deep understanding of both prosecution tactics and defense strategy to federal cases. Our firm-wide experience spans over 120 combined years, with a record of documented results. We understand the high stakes of federal health care fraud charges, which often involve complex financial evidence and require a meticulous, detail-oriented defense.
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
Our Approach to Health Care Fraud Cases
We approach every health care fraud case by first conducting a thorough forensic analysis of the billing and patient records in question. We work with financial and medical experts to challenge the government’s loss calculations—a key driver of sentencing. Our defense strategies often focus on attacking the intent element, arguing a lack of willfulness, or negotiating for a favorable resolution that avoids the most severe penalties. For a medical billing fraud defense lawyer Prince William County residents can rely on, our team has the necessary federal court experience.
Results may vary. Prior results do not guarantee a similar outcome.
Contact Our Prince William County Health Care Fraud Lawyers
Law Offices Of SRIS, P.C. — Fairfax
4008 Williamsburg Ct, Fairfax, VA 22032, United States
Toll-Free: (888) 437-7747 | Local: (804)201-9009
By appointment only.
Our Fairfax location serves clients in Prince William County, including Manassas, Woodbridge, Dale City, Dumfries, Gainesville, Haymarket, Lake Ridge, and Occoquan. We provide 24/7 phone consultations for urgent federal matters. Meetings are by appointment only.
Health Care Fraud Defense FAQs
What is the difference between a mistake and health care fraud?
It depends on intent. A simple billing error or clerical mistake is not a federal crime. Health care fraud requires the government to prove you knowingly and willfully executed a scheme to defraud a health care benefit program. An experienced health care fraud lawyer Prince William County can help demonstrate the absence of criminal intent.
What should I do if I am contacted by a federal agent about a health care fraud investigation?
Do not speak to them without 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 federal defense attorney immediately to understand your rights and develop a strategy before charges are filed.
What are common examples of health care fraud schemes?
Common schemes include billing for services not rendered, 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 providing medically unnecessary services. A healthcare scheme charge lawyer Prince William County can defend against these specific allegations.
Can I go to prison for a first-time health care fraud offense?
Yes. Federal sentencing guidelines are driven primarily by the calculated loss amount, not your prior record. Even a first-time offender can face significant prison time if the alleged loss is high. An aggressive defense focused on reducing the loss calculation is essential.
What is the role of a whistleblower in a health care fraud case?
Whistleblowers (often employees or competitors) can file a qui tam lawsuit under the False Claims Act. This can trigger a parallel civil and criminal investigation. If you are a target, your defense must address both the criminal charges and potential civil liability.