Health Care Fraud and Medicare Fraud

Health care fraud is a white collar crime that involves the filing of fraudulent health care claims for a monetary gain and is governed by 18 U.S.C. § 1347.  Recently, there has been an increase in health care fraud cases.  According to USA Today, investigators recovered $4.1 billion in health care fraud money in 2011.  Some types of health care fraud include the following:

•   Overbilling                                         •  Receipt of Kickbacks

•   False Invoices                                    •  HIPPA Violations

•   Medicare Fraud                                 •  Falsifying Medical Records

•   Upcoding                                           •  Illegal Bundling

This has lead to numerous cases in which doctors and other healthcare professionals are under investigation for healthcare fraud, often when they have not committed any crime.  Even if you know you are innocent, do not take the risk of jeopardizing your professional and personal career.  Our fraud attorneys at The Mace Firm represent a wide variety of individuals charged with this type of crime including, but not limited to, doctors, dentists, physicians, nurses, medical clinics, hospitals, medical equipment providers, billing companies, and home care companies.  We have a great deal of experience in this area and will do everything possible to ensure that your reputation is not tarnished.  We have the resources and knowledge necessary to aggressively investigate and defend your federal criminal charges.  The Mace Firm has attorneys licensed in South Carolina, Florida, Georgia, and New York and have the ability to defend federal indictments in multiple jurisdictions.

Possible Penalties

Because of the impact that fraud has on the healthcare system, federal health care fraud charges can result in large fines and even imprisonment for up to ten years.  The penalties may be more severe if the fraud results in serious bodily injury or death.  There is also the possibility of both civil and criminal sanctions, and the potential for disbarment.

Possible Defenses

The potential defenses always depend on the nature and circumstances of any given case.  Possible defenses to health care fraud and Medicare fraud include the following:

•   Clerical Error                                     •  Vindictive Employees

•   Lack of Supervision of Billing           •  Government Error

Many of these defenses indicate a lack of intent on the part of the accused.  The Government must establish an intent to commit fraud in order to prove its case.  One of the best arguments in a health care fraud case is lack of intent.  If we were able to prove that you acted without knowledge of the fraud or in good faith, then the Government would have failed to meet its burden of establishing intent.

However, possible defenses always depend on the circumstances of your case.  In order to ensure that you are provided the best defenses possible, you must contact an experienced health care fraud attorney immediately.  Our federal fraud attorneys are highly experienced in defending these types of crimes.  We work with investigators, forensic analysts, billing experts, and accountants in order to discover any weaknesses in the Government’s case.  Our trial lawyers have over fifteen years of trial experience in criminal defense and have represented individuals accused of Health Care Fraud, Medicare Fraud, and Medicaid Fraud.  We aggressively defend our clients through every step of the process.  If you or your business is being investigated or is facing federal health care fraud charges, contact Russell Mace & Associates, P.A. for a free consultation at 1-800-94-TRIAL or contact us online.


Our health care fraud attorneys in Charleston, Myrtle Beach, Florence, Columbia, North Myrtle Beach, Hilton Head, Miami, and Miami Beach are able to defend all federal indictments.

Prescription Fraud – Medicare Fraud – Medicaid Fraud – Insurance Fraud – Health Care Fraud – Medical Fraud