Penalties for Health Care Fraud Conviction

Penalties for Health Care Fraud Conviction

Health care fraud is committed when a person or organization defrauds the health care system in order to obtain funds or services. The federal criminal health care fraud statutes are complex. If you are being investigated for or have been accused of health care fraud, we urge you to hire an experienced health care fraud defense attorney.

Penalties for Health Care Fraud Conviction

The penalties for a health care fraud conviction can be steep, and generally include imprisonment, fines, and restitution.

The penalties that may be imposed vary depending on what statute the crime is charged under, the alleged dollar value of the loss to the government, and other factors specific to the case facts and the defendant’s criminal history, if any.

  • Conviction for Health Care Fraud can carry a prison sentence of up to 10 years, and up to 20 years if the violation results in serious bodily injury, and up to life in prison if the violation results in death. U.S.C. 1347.
  • Conviction under the federal criminal False Claims Act can carry a prison sentence of up to five years and a fine of up to $250,000. U.S.C. §287.
  • Conviction under the Fraud and False Statement statute can carry a prison sentence of up to eight years, and a $10,000 fine, which can be assessed for each violation convicted. 18 U.S.C. §1001.
  • Conviction for a single violation of the Anti-Kickback statute can result in imprisonment for up to five years and a fine of up to $25,000, or both. 42 U.S.C §1320a-7b(b).

After conviction, the Judge will use the Federal Sentencing Guidelines to determine a recommended sentence. Specifically, these guidelines are closely tied to the amount of the alleged fraud.

In addition to a prison sentence and fines, there are other penalties that may be imposed. Depending on your specific situation, some of the additional penalties could have serious collateral consequences. For example, if you hold a license to practice medicine and you are accused of health care fraud, a conviction may result in revocation of your medical license. Additional penalties for a corporate defendant could include mandates for ongoing monitoring.

Other potential penalties beyond a prison sentence and fines to be aware of include: mandatory restitution, asset forfeiture, probation, inclusion in the National Practitioner Databank, and disciplinary actions against any professional licenses you hold. The foregoing is not inclusive of all possible penalties.

Whether you choose to go to trial or choose to enter into a plea agreement with the prosecution, consider all of the potential penalties that you may face.

Defending Against Health Care Fraud Charges is Highly Specialized

Defending against health care fraud charges requires specialized knowledge of the complex federal health care and fraud statutes. Hire a former health care fraud prosecutor to defend you. Ashley D. Adams served as an Assistant U.S. Attorney prosecuting health care fraud and other white collar criminal cases. Now she uses her insider knowledge of the tactics the government uses to obtain convictions to defend her clients.

Prosecutors aggressively pursue dramatic punishments against those charged with health care fraud crimes.  If you are under investigation or have been accused of any health care fraud crime, the attorneys of Ashley D. Adams, PLC are prepared to defend your rights and combat aggressive prosecutors.

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.