Florida Federal Health Care Fraud Lawyer

Are you looking for a federal health care fraud lawyer?

At StechLaw Criminal Defense, we are federal health care fraud lawyers with nearly 15 years of experience guiding clients through complex federal cases.

If you are a physician, pharmacist, or health care business owner facing a federal health care fraud investigation, an experienced defense lawyer can help protect your rights and respond to the government’s case. Our federal health care fraud lawyer at StechLaw Criminal Defense has defended professionals against financial crime allegations in federal court for nearly 15 years. Ben Stechschulte has tried over 60 cases to verdict and is board certified in criminal trial law by The Florida Bar. We offer a free and confidential consultation to review the allegations and explain your options.

Federal Health Care Fraud Lawyer 

Federal health care fraud generally involves knowingly executing, or attempting to execute, a scheme to defraud a health care benefit program or to obtain money from one through false or fraudulent claims. The programs at the center of most cases are Medicare, Medicaid, and TRICARE, though private insurers are also covered. The government must prove that the claims were false and that the defendant acted knowingly and with intent to defraud. The people charged range from physicians and pharmacists to clinic owners, laboratories, billing companies, and marketers.

These matters are document intensive and often data driven. They are investigated by agencies such as the Department of Health and Human Services Office of Inspector General and the FBI, and they are prosecuted by the Department of Justice’s Health Care Fraud Unit and local United States Attorneys. A case can begin with an audit, a billing anomaly flagged by data analytics, or a subpoena for patient and billing records.

Types of Federal Health Care Fraud Cases We Handle

Health care fraud is charged under several federal statutes, and the scheme alleged shapes the evidence, the loss calculation, and the penalties. We represent providers, owners, and employees at every stage, from an initial audit through indictment and trial. The categories below reflect the allegations we see most often in federal court.

• Billing for services not provided. These cases allege that a provider submitted claims for appointments, procedures, or supplies that never occurred. The government builds them from claims data, patient interviews, and scheduling records.
• Upcoding. This involves billing for a more expensive service or procedure than the one actually performed. Prosecutors compare the codes submitted against the documentation in the patient file.
• Unbundling. This category alleges that a provider billed separately for services that should have been billed together at a lower combined rate. The result is a higher total reimbursement than the rules allow.
• Medically unnecessary services. These allegations involve procedures, tests, or equipment that the government contends were not needed for the patient’s care. Clinical judgment is frequently at the center of the dispute.
• Kickbacks and referral schemes. These cases allege that money or something of value was paid or received in exchange for patient referrals or for ordering covered items and services. They often reach marketers, laboratories, and equipment suppliers as well as physicians.
• Illegal prescribing and diversion. These matters involve prescribing controlled substances outside the usual course of practice or without a legitimate medical purpose. Pill mill allegations and opioid cases fall within this category.
• Durable medical equipment schemes. This involves claims for braces, tests, or equipment that patients did not request, need, or receive. Telemarketing and telehealth referrals are common features of these cases.

Why Choose StechLaw Criminal Defense as my Federal Health Care Fraud Lawyer?

Trial Experience and Former Prosecutor Insight

Our founder, Ben Stechschulte, has tried over 60 cases to verdict during nearly 15 years defending clients in the Tampa Bay area. He served as a Hillsborough County prosecutor before entering private practice, so we understand how the government assembles billing evidence and works with cooperating witnesses. Ben is board certified in criminal trial law by The Florida Bar, a credential held by a small percentage of attorneys in the state. Super Lawyers named him a Rising Star in 2015, and he earned his law degree from Stetson University College of Law.

A Practice Built for Federal Cases

A health care fraud charge can affect your liberty, your finances, and your professional license at the same time. Our track record in criminal matters includes dismissals, reduced charges, and acquittals. We defend these cases as part of our federal fraud defense practice and our broader federal criminal defense work, which lets us handle related counts, forfeiture, and program exclusion together rather than in isolation.

What Is Important To Understand About Federal Health Care Fraud Cases?

Charges, Penalties, and Defense Strategies for Federal Health Care Fraud Cases

The government pursues health care fraud through the federal fraud statutes, the false claims laws, and the laws against kickbacks. A single billing scheme can produce several counts, and prosecutors frequently add wire fraud, money laundering, and conspiracy charges when claims and proceeds move electronically. Because most prosecutions involve Medicare and Medicaid, the penalties for Medicare fraud are a central concern from the earliest stage of a case.

• Prison and financial exposure. Convictions can bring significant prison terms, fines, and orders of restitution, and the recommended sentence climbs as the alleged loss grows.
• Program exclusion. Beyond any criminal sentence, a conviction can lead to exclusion from Medicare, Medicaid, and other federal programs, along with action against a professional license, which for many providers ends a career.
• Forfeiture. The government often seeks to forfeit funds and property it links to the alleged scheme.
• Intent defenses. Many cases depend on whether a billing error was a mistake or a knowing act, and honest errors and reasonable coding disagreements are not crimes.
• Medical necessity and reliance. Where clinical judgment or reliance on billing staff is at issue, the defense examines the records, the applicable rules, and who actually made each decision. The federal sentencing guidelines tie the offense level to the loss figure, so contesting the loss amount is often central.

Federal health care fraud charges generally carry a five-year statute of limitations.

What Are Important Aspects of a Federal Health Care Fraud Case?

A few issues tend to determine how a health care fraud case develops, and each rewards early attention.

• The intent question usually turns on documents, billing patterns, and what the provider knew, rather than on direct proof.
• The loss amount drives both the charging decision and the sentence, so its calculation is contested closely.
• Compliance policies, audits, and prior warnings can either help the defense or strengthen the government’s case.
• The matter may involve one provider or a wider network of clinics, marketers, and suppliers charged together.
• The point at which counsel becomes involved can shape whether the case is resolved before charges are filed.

What Is The Federal Health Care Fraud Case Timeline?

Federal cases follow a longer and more formal path than state prosecutions, and most health care fraud matters move through similar stages.

• The process often opens with an audit, a civil investigative demand, or a subpoena, and many clients first realize they are under federal investigation at that point.
• The government may issue a target letter once it identifies a person it intends to charge.
• A grand jury reviews the evidence and decides whether to return an indictment.
• During pretrial litigation, the defense examines the claims data and records and can file motions challenging the search, the evidence, or the loss theory.
• The case resolves through declination, dismissal, a negotiated plea, or trial, with sentencing to follow any conviction.

What Should You Bring to Your Federal Health Care Fraud Consultation?

Bringing the right records helps us assess the exposure and the defenses quickly.

• Any subpoena, civil investigative demand, target letter, or charging document you have received.
• Billing records, claims data, and the patient files tied to the claims at issue.
• Correspondence with Medicare or Medicaid contractors, auditors, or private payers.
• Your practice’s compliance policies and any prior audit results.

During the consultation, we will review these materials, explain the likely charges and exposure, and lay out the next steps. The meeting is free and confidential.

What Are Important Florida Legal Resources for Federal Health Care Fraud Cases?

Federal health care fraud is investigated and prosecuted by several agencies, and the resources below explain how these cases work and where to find reliable information. They are general references and do not replace advice about your specific situation.

• The HHS Inspector General investigates fraud against federal health programs and publishes enforcement actions and consumer alerts.
• CMS explains how Medicare and Medicaid fraud, waste, and abuse are identified and reported.
• The U.S. Attorney’s Office for the Middle District of Florida prosecutes federal cases in the district and posts announcements about charges and convictions.

Reach Out to StechLaw Criminal Defense to Schedule a Consultation

If you are under investigation or facing federal health care fraud charges, we are ready to review the allegations and explain your options. The initial consultation is free and confidential. Contact us to arrange a time to speak with a defense attorney who understands how these cases are investigated, charged, and defended. We handle federal cases across the Middle District of Florida.

Federal Health Care Fraud Statistics in Florida

Federal health care fraud enforcement often arrives in coordinated national actions, and Florida is a regular focus of them. The Department of Justice announced its 2026 national takedown in June, with charges against 455 defendants in 56 federal districts. Those defendants included 90 doctors and other licensed medical professionals, and the alleged false claims totaled more than $6.5 billion.

Sentencing data shows how those prosecutions end and where they are concentrated. According to the Sentencing Commission’s figures for fiscal year 2025, the Southern District of Florida tied for the most health care fraud sentencings of any district in the country. The same report describes the people sentenced and the losses involved:

• Federal courts sentenced 340 people for health care fraud in fiscal year 2025, and 30 of them were sentenced in the Southern District of Florida.
• The median loss in these cases was $1,279,436.
• Judges imposed a prison sentence in 68% of the cases, and the average sentence was 21 months.
• In 33% of the cases, the sentence was increased because the person abused a position of trust or used a special skill.
• Most of the people sentenced had little or no prior criminal history, at 91%.

Types of Evidence Used in Federal Health Care Fraud Cases

A health care fraud prosecution is assembled from several kinds of evidence, and investigators usually collect them in a predictable order. A Florida federal health care fraud lawyer needs to know what the government holds at each stage, because each type of evidence calls for a different response.

• Claims data. Most investigations begin with the billing data that Medicare, Medicaid, or a private insurer already has. Analysts compare a provider’s claims against those of similar providers and flag the codes or volumes that stand out.
• Patient and billing records. Once the data points to a provider, agents request the charts and billing files behind the flagged claims. They then check whether each record supports the service that was billed.
• Patient interviews. Agents often contact patients to ask whether they received the services listed on their statements. A patient’s memory of a visit from years earlier can be incomplete, which is one reason these interviews deserve close review.
• Employee statements. Current and former billers, nurses, and office managers are interviewed about how claims were prepared and who gave the instructions. Their accounts are frequently the government’s main evidence of intent.
• Whistleblower complaints. Some cases start when a former employee or competitor reports the provider, and whistleblower lawsuits are a common source of those reports. The provider often does not learn of the complaint until the investigation is well advanced.
• Financial records. Investigators trace payments between providers, laboratories, and marketers to look for referral arrangements. Bank records also show where the claim proceeds went.
• Emails and text messages. Internal messages about coding, billing targets, or audits are used to show what a person knew at the time. A single message is easy to read out of context, so the surrounding conversation matters.
• Medical review. The government often hires a physician or coder to review a sample of files and give an opinion on medical necessity. The defense can retain its own reviewer to test that opinion and the sampling method behind it.

Florida Federal Health Care Fraud Lawyer FAQs

What Should I Do if My Practice Receives a Subpoena or an Audit Request?

A records request is often the first sign of an investigation, so it should not be handled as routine paperwork. Preserve every record, and do not have staff assemble a response on their own. A federal grand jury subpoena in particular should go to a defense attorney before anyone answers it.

Is a Billing Error the Same as Health Care Fraud?

An honest billing error is not a crime. Prosecutors try to show that errors were intentional by pointing to patterns, such as the same error repeated across many patients. Training records, compliance policies, and corrected claims can show that the errors were mistakes instead.

Can I Be Charged for Claims That My Billing Staff Submitted?

Owners and treating providers are sometimes charged for claims that other people prepared. The government’s case then depends on what the provider knew about how the claims were coded. For that reason, a federal health care fraud attorney looks closely at who reviewed the claims and what instructions were given.

I Am an Employee and Not the Owner. Do I Need My Own Lawyer?

Employees usually benefit from having separate counsel. The lawyer for a practice or company represents the business, and the interests of the business can differ from yours. A consultation with your own attorney is confidential, and it lets you understand your position before you speak with agents or company counsel.

Will an Investigation Affect My Professional License?

A federal investigation and a licensing matter can proceed at the same time. In Florida, the Department of Health reviews complaints against physicians and other practitioners, and statements made in one proceeding can be used in the other. A health care fraud defense attorney should plan the criminal defense with the license in mind for that reason.

How Far Back Can the Government Go?

Criminal health care fraud charges generally must be filed within five years of the offense. That limitations period applies to criminal charges, and civil claims by the government follow different deadlines. The end of the criminal period therefore does not always end the matter.

Can an Investigation End Without Criminal Charges?

Some investigations close without charges, and others are resolved through a civil settlement or repayment. The chance of that outcome is highest when counsel presents the provider’s records and explanation to prosecutors before an indictment. We review the claims data and the patient files ourselves before we recommend that approach.

What if I Have Already Been Indicted?

An indictment starts the court case, but it does not decide the outcome. Counts can be dismissed after an indictment when the evidence is weak or a pretrial motion succeeds. We tell you plainly whether the records support a defense at trial or whether a negotiated resolution would serve you better.

Where Are Florida Health Care Fraud Cases Prosecuted?

Federal prosecutors bring these cases in all three of Florida’s federal districts. The Southern District handles the largest number, and the Middle District prosecutes cases from Tampa, Orlando, and Jacksonville. An FL federal health care fraud lawyer should be prepared to appear in whichever district filed the charges.

Does StechLaw Criminal Defense Offer Free Consultations for Health Care Fraud Cases?

StechLaw Criminal Defense offers a free and confidential consultation for federal health care fraud matters. Owners, licensed providers, and employees can all request one. Bring any subpoena, audit letter, or correspondence from an insurer, because those documents show us which stage the investigation has reached.

Important Resources for Florida Federal Health Care Fraud Cases

Florida Federal Courthouses and Local Criminal Justice Resources

Health care fraud charges in Florida are heard in the federal courthouse for the division where the case was filed. The Southern District of Florida, which sentences more of these cases than any other Florida district, holds court in five locations from Key West to Fort Pierce. In the Middle District, a provider from the Orlando or Jacksonville area will usually appear in that city’s federal courthouse.

What Are Important Local Resources for Florida Federal Health Care Fraud Cases?

A health care fraud case in Florida often involves a federal court and a state licensing board at the same time. We provide the following contacts for general information only, and listing them is not an endorsement by StechLaw Criminal Defense.

• The George C. Young Courthouse in Orlando hears federal criminal cases for the Orlando Division. Its clerk’s office can be reached at (407) 835-4200.
• The Bryan Simpson Courthouse in Jacksonville hears federal criminal cases for the Jacksonville Division. Its clerk’s office can be reached at (904) 549-1900.
• The Florida Board of Medicine licenses and disciplines physicians in the state. The board office can be reached at (850) 245-4131.
• The Florida Board of Pharmacy licenses and oversees pharmacists and pharmacies. The board office can be reached at (850) 245-4474.

About StechLaw Criminal Defense

Our founder, Ben Stechschulte, is a Florida native and a father of two. Under his direction, we represent providers and the people who work for them in health care fraud matters, and we do not represent the government or whistleblowers. A Florida federal health care fraud attorney at our firm therefore approaches every record from the provider’s side.

What Our Clients Say

★★★★★

“Very professional & consistent. From day one, Ben made sure to communicate the seriousness of my charges and the worst possible outcomes we could face. He confindentally led me throughout the process, being transparent and keeping my best interest in mind. I’m happy to say Ben exceeded my expectations, and I was granted the best sentence I never saw likely.” — Myeisha Riddick

Read more reviews on our Google Business Profile.

Additional Resources for Florida Federal Health Care Fraud Cases

• Accused of Healthcare Fraud? What to Do
• Understanding Federal Healthcare Fraud
• The Penalties for Federal Healthcare Fraud
• Common Types of Medicaid Fraud
• Innocent Until Proven Guilty: Debunking Myths about Medicaid Fraud Defense

Contact StechLaw Criminal Defense

An audit letter, a subpoena, or a visit from an agent is the right time to speak with a federal health care fraud attorney. StechLaw Criminal Defense offers a free and confidential consultation for providers and employees who are in that position. Ben Stechschulte will review the request you received and explain what the government appears to be examining. He will then outline how to respond and how to protect your license while the matter is open. We answer calls at all hours, including nights and weekends. Contact us to schedule your consultation with a Florida health care fraud defense lawyer.