Federal Healthcare Fraud Lawyer

Are you looking for a federal healthcare fraud lawyer?

At StechLaw Criminal Defense, we have built a federal healthcare fraud practice on nearly 15 years of trial work.

If a federal agent has appeared at your office asking about billing records, the investigation began well before that visit. Prosecutors pull claims data, interview former employees, and review submissions to Medicare or Medicaid long before anyone knocks on a door. Our federal healthcare fraud lawyer defends physicians, pharmacy owners, clinic operators, and billing staff against these allegations. We take cases at the investigative stage as readily as after indictment. Contact our office to arrange a consultation.

Federal Healthcare Fraud Lawyer

A federal healthcare fraud attorney represents people and companies accused of obtaining money from a health care benefit program through false claims, falsified records, or concealed financial arrangements. Most accusations start with data rather than a complaint. Federal analysts compare a provider’s billing patterns against peers in the same specialty, flag the outliers, and pass the results to investigators.

The Justice Department’s 2026 national takedown charged 455 defendants across 56 federal districts in schemes involving more than $6.5 billion in false claims. A records request from a federal agency deserves a response prepared by counsel rather than an internal memo. Our federal health care fraud lawyer reviews what the government already holds before deciding how to answer it.

Types of Federal Healthcare Fraud Cases We Handle

Healthcare fraud charges rarely arrive alone. Prosecutors pair the billing count with financial offenses, and every added count shifts the sentencing exposure. These are the matters our federal healthcare fraud attorney handles.

• Medicare and Medicaid billing fraud. Claims for services never rendered, upcoded office visits, and equipment billed without a supporting order account for much of what the government charges. Investigators often build the case from a sample of claims and then extrapolate across a period of years. We obtain the underlying data and test whether the coding decisions were defensible at the time they were made, and whether the sample actually supports the number the government reached.
• Kickbacks and bribery. Payments to marketers, referral arrangements with laboratories, and consulting agreements with device companies draw scrutiny when compensation tracks referral volume. We examine the agreements as written and compare them against how the relationship actually operated.
• Wire fraud. Electronic claim submissions give prosecutors a separate count for nearly every bill sent to a payer. That structure inflates the indictment quickly. We look at whether each transmission was part of the alleged scheme or simply routine business.
• Mail fraud. Paper claims, mailed reimbursement checks, and patient statements support the same charging approach. Older billing systems and hybrid paper workflows tend to produce these counts.
• Money laundering. Moving reimbursement proceeds between business and personal accounts can support an additional charge once the government labels the underlying billing fraudulent. We trace the transactions and identify legitimate business purposes the government overlooked.
• Federal conspiracy. An agreement count lets prosecutors reach office managers, marketers, and outside consultants who never submitted a claim themselves. Proximity to a scheme is not participation in one, and we press that distinction.
• Prescription and controlled substance diversion. Allegations about high-volume prescribing combine healthcare fraud with drug charges, and the medical judgment behind each prescription becomes the central question. We work with treating-practice records and prescribing histories to show the clinical basis for the decisions.
• Telemedicine and genetic testing arrangements. Remote consultation companies and testing laboratories have drawn sustained federal attention, and physicians who signed orders for those companies often learn of an investigation years later. We reconstruct the referral chain to show where our client sat within it.

Why Choose StechLaw Criminal Defense as my Federal Healthcare Fraud Lawyer?

Board Certification and a Record at Trial

Ben Stechschulte is board certified in criminal trial law, a credential awarded only after a written examination, peer review, and a documented record of cases tried to verdict. He has tried more than 60 cases to verdict over nearly 15 years of practice in the Tampa Bay area. He attended Stetson University College of Law and was named a Rising Star by Super Lawyers in 2015.

Certification matters here for a practical reason. Healthcare fraud cases are document-heavy and slow, and most resolve without a jury. Prosecutors calibrate their offers to the lawyer across the table, and an attorney who tries cases changes that calculation.

Federal Fraud Work Beyond Billing Cases

Billing prosecutions share investigative machinery with the rest of our federal practice. The same agencies, the same reliance on data analysis, and the same charging patterns appear in matters we handle as a federal fraud defense lawyer. That familiarity matters when an indictment attaches financial counts to the healthcare allegation, because each count carries its own proof problems for the government.

We also handle these matters at the stage most clients would prefer to skip. Providers frequently call after receiving a subpoena but before anyone has been charged, and that window is when the record can still be shaped. What a client says to agents in the first week often follows the case to sentencing.

Understanding Federal Healthcare Fraud Cases

Charges, Penalties, and Defense Strategies for Federal Healthcare Fraud Cases

Federal healthcare fraud prosecutions rest on a handful of recurring questions. These are the ones that shape the outcome.

• Intent. The government has to prove a knowing and willful scheme. Coding errors, staff mistakes, and reliance on outside billing companies are not crimes, and the distinction between error and intent is where many of these cases are won.
• Loss amount. The figure the court adopts drives the federal sentencing guidelines range more than any other single factor. Prosecutors often propose the total billed rather than the amount actually paid.
• Related counts. Allegations about healthcare kickbacks frequently accompany billing charges and carry separate penalties.
• Collateral consequences. A conviction can trigger exclusion from federal health care programs and action against a professional license. For a practitioner, those results often matter more than the sentence itself.
• Defense approaches. Attacking the loss calculation, showing reliance on professional coding advice, and challenging how the government selected its sample claims are all available depending on the record.

What Is The Federal Healthcare Fraud Case Timeline?

• Investigation. Subpoenas for records, interviews with former staff, and analysis of claims data. Federal investigations at this stage can run a year or longer without any public filing.
• Grand jury. A grand jury subpoena for documents or testimony often gives the first clear signal of where an investigation is heading.
• Charging. An indictment or, in negotiated matters, an information filed with the defendant’s agreement.
• Pretrial. Arraignment, release conditions, and discovery. Bail in federal court follows different rules than the state system.
• Resolution. A negotiated plea, a trial, and then sentencing. From first contact to sentencing, two years is common.

What Are Important Aspects of a Federal Healthcare Fraud Case?

A few features separate these prosecutions from ordinary criminal matters, and they affect what we do first.

• The government usually knows more than you do at the outset, because it has been reviewing your claims data for months.
• A target letter is an opportunity as well as a warning. Counsel can present information before a charging decision is made.
• Employees interviewed by agents may already have given statements that bind no one but shape everything.
• Parallel civil and administrative proceedings can run alongside the criminal case, and answers given in one can be used in another.
• Cooperating witnesses are common in these prosecutions. A former biller or office manager negotiating their own exposure has an incentive to describe events in a particular way, and their account deserves scrutiny rather than acceptance.

What Should You Bring to Your Federal Healthcare Fraud Consultation?

Bringing the right materials to a first meeting lets us give you a realistic read rather than a general one.

• Any subpoena, target letter, or written correspondence from a federal agency
• Billing records, coding policies, and the name of any outside billing company you use
• Contracts with marketers, laboratories, referral sources, or consultants
• Notes on any contact agents have had with you or your staff, including dates

We will tell you what the material suggests about the government’s theory and where the exposure sits. If we think you don’t need counsel yet, we’ll say so.

Federal Courthouses and Criminal Justice Resources

Several federal agencies publish material that helps clients understand what they’re facing.

• Health Care Fraud Unit at the Department of Justice, which coordinates the strike forces that bring most of these prosecutions
• HHS-OIG exclusion authority, covering the program consequences that follow certain convictions
• Federal court system overview from the Department of Justice, explaining district court structure and procedure
• Types of cases heard in federal court, published by the Administrative Office of the U.S. Courts

Reach Out to StechLaw Criminal Defense to Schedule a Consultation

A federal healthcare fraud investigation is easier to influence before charges are filed than after. We offer a free initial consultation, and we’ll review your records and tell you plainly where things stand. Contact us to schedule a time to discuss your case. We respond to new inquiries promptly, and we can begin work while an investigation is still open.