Health Care Fraud Defense

Health Care Fraud Defense

Health care fraud is a white collar crime that can be carried out in a number of ways, and may involved complex and large-scale schemes. Health care fraud is committed when a person or organization defrauds the health care system in order to obtain funds or services. The fact is that health care fraud costs the U.S. billions each year. The Department of Justice estimates these costs exceed $100 billion a year.

Criminal charges for health care fraud are prosecuted aggressively. The federal government expends an enormous amount of resources to investigate and prosecute health care fraud cases. If you are under investigation for or have been accused of health care fraud, you need an attorney experienced in complex health care fraud cases who can combat aggressive prosecutors.

Common Health Care Fraud Schemes

Health care fraud schemes can take various forms. Common schemes involve fraudulent billing, such as billing for medical services that were never  performed or were not medically necessary, or billing for phantom patients.

Another common billing health care scheme involves “upcoming,” which is the act of using an improper billing code to get paid for a more expensive procedure than was actually performed. Also, accepting kickbacks in exchange for referrals is another common health care fraud scheme.

Charges for Health Care Fraud

Medicare fraud is the most common of all health care fraud prosecutions. It involves the investigation and prosecution of individuals and organizations who are accused of defrauding public health care systems, including Medicare and Medicaid. Medical Equipment Fraud, which is billing for medical equipment that was never provided, is another common health care fraud scheme that is prosecuted.

Health Care Fraud Defense

Those who are convicted of health care fraud have a strong likelihood of facing prison time and other harsh penalties. For a medical practitioner, such a conviction can end a medical career. Mounting a strong defense is critical.

You can be charged with health care fraud even if you did not know you were committing fraud. In such cases, your defense may include showing a compliance plan that was in place to detect fraudulent activity in your practice. A showing that you lacked the requisite intent to engage in health care fraud is a strong defense.

Conducting an early and thorough investigation into the charges against you is a critical component of your defense. This includes discovering relevant documents and scrutinizing the prosecution’s case against you. Also, your white collar criminal defense attorney may want to interview employees, colleagues, or other parties of interest. Your attorney may also need to secure expert witnesses in the event your case moves to trial. The sooner you hire an attorney to defend you, the more likely it is that you will get the best possible outcome in your case.

When you hire us, we will thoroughly investigate the evidence and we may be able to dismantle the case against you:

  • Your rights may have been violated during the investigation.
  • The allegations may have been made unfairly against you.
  • In their zeal to prosecute these types of crimes, officials may unfairly target honest people.

Hire A Former Health Care Fraud Prosecutor To Defend You

Health care fraud is a highly complex area of law requiring specialized knowledge. As a former health care fraud prosecutor with the United States Attorney’s Office, Ashley D. Adams has the requisite knowledge and understands the tactics and procedures the government will use to obtain a conviction. She understands how prosecutors operate, and the best tactics to use to mount a strong defense against health care fraud allegations. Given her prior work, she also has a longstanding and positive relationship with the U.S. Attorney’s Office, the Attorney General’s Office, and the Department of Justice. Put Ashley D. Adam’s experience to work for you.

Contact us or call now (480) 219-1366 for a consultation.


The attorneys at Ashley D. Adams, PLC handles federal criminal cases throughout the United States, including Arizona, Oklahoma, Utah, and California.