Healthcare Fraud Defense Attorneys – 18 U.S.C. § 1347
Healthcare fraud allegations are among the most aggressively prosecuted white-collar offenses in the United States.
Under 18 U.S.C. § 1347, federal prosecutors target doctors, clinics, billing companies, executives, and other healthcare professionals accused of defrauding healthcare benefit programs such as Medicare, Medicaid, Medi-Cal, TRICARE, and private insurers.
A conviction can lead to years in federal prison, massive fines, restitution, probation, exclusion from federal healthcare programs, and permanent damage to your professional license and reputation.
These cases are complex, evidence-heavy, and often predating formal charges.
If you are under investigation or facing charges for healthcare fraud, early intervention by experienced federal defense counsel is critical.
Cron, Israels & Stark represents healthcare providers and professionals accused of federal healthcare fraud throughout California and nationwide. To schedule a consultation, call (424) 372-3112 or contact us here.
What Is Healthcare Fraud Under 18 U.S.C. § 1347?
18 U.S.C. § 1347 makes it a federal crime to knowingly and willfully execute, or attempt to execute, a scheme to:
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Defraud a healthcare benefit program, or
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Obtain money or property controlled by a healthcare benefit program through false or fraudulent pretenses, representations, or promises
In simple terms, the law criminalizes intentional deception used to obtain healthcare payments or services that the defendant knew they were not entitled to receive.
The Most Important Element: Intent to Defraud
The intent to defraud is the centerpiece of every federal healthcare fraud case.
To convict, prosecutors must prove that the defendant:
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Acted knowingly and willfully, and
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Intended to deceive a healthcare benefit program
The government does not need to prove the defendant knew their actions violated federal law—only that they knew the statements or representations were false and used them to obtain money or services.
This distinction is critical and often forms the foundation of an effective defense.
Common Types of Healthcare Fraud Allegations
Federal healthcare fraud cases arise from a wide range of alleged conduct, including:
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Billing for services or products not provided
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Billing for more expensive services or equipment than delivered (“upcoding”)
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Billing for medically unnecessary treatment
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Double-billing or unbundling services
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Falsifying claims or patient records
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Billing personal or unrelated expenses
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Paying or receiving illegal kickbacks
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Overpricing services or products
Even billing errors or administrative mistakes can escalate into criminal cases if prosecutors believe they reflect a pattern of intentional fraud.
Medicare Fraud and Federal Investigations
Medicare fraud is one of the most common forms of healthcare fraud prosecuted under § 1347. These cases frequently involve:
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Doctors and medical clinics
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Diagnostic and testing facilities
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Home health and durable medical equipment providers
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Billing and coding companies
Federal authorities use advanced data analytics and task forces to identify suspicious billing patterns. Investigations often begin quietly—through audits, subpoenas, or record requests—before criminal charges are ever filed.
Once a case is referred for criminal prosecution, federal agents may attempt to interview you. Anything you say can be used against you, which is why legal counsel should be retained immediately.
Healthcare Fraud vs. Related Crimes
Healthcare fraud prosecutions often involve overlapping statutes, including:
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Healthcare fraud conspiracy under 18 U.S.C. § 1349
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Bank fraud under 18 U.S.C. § 1344
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False Claims Act violations (civil liability)
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State-level healthcare fraud (such as California Penal Code § 550)
Prosecutors often “stack” charges to increase leverage and sentencing exposure.
Penalties for Federal Healthcare Fraud
A conviction under 18 U.S.C. § 1347 carries severe consequences:
Criminal Penalties
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Up to 10 years in federal prison
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Up to 20 years if serious bodily injury results
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Life imprisonment if death results
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Substantial fines
Additional Consequences
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Court-ordered restitution
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Long-term probation or supervised release
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Exclusion from Medicare, Medicaid, and other programs
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Loss of professional licenses
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Permanent damage to career and reputation
These consequences often extend far beyond incarceration.
Challenging Federal Healthcare Fraud Allegations
A healthcare fraud investigation can be devastating—even if the allegations are false. Federal prosecutors must prove deliberate intent to deceive, and that burden creates opportunities for a strong defense.
Common defense strategies include:
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Lack of intent to defraud
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Good-faith billing practices
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Regulatory ambiguity or complex billing rules
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Clerical or administrative errors
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Reliance on billing consultants or third-party services
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Insufficient or unreliable evidence
Early legal representation can influence how—or whether—charges are filed.
Why Early Defense Matters
Most federal healthcare fraud cases are built during the investigation phase. Waiting until formal charges are filed can limit your options.
An experienced healthcare fraud defense attorney can:
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Communicate with investigators on your behalf
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Prevent damaging statements
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Challenge subpoenas and evidence
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Seek pre-indictment resolutions
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Position your case for dismissal or reduced charges
Early action can significantly affect the outcome of your case.
Speak With a Healthcare Fraud Defense Attorney
If you are under investigation or facing federal healthcare fraud charges under 18 U.S.C. § 1347, do not wait. The earlier you involve experienced counsel, the more options you may have.
Contact Cron, Israels & Stark for a confidential consultation. Our attorneys defend healthcare professionals accused of complex federal fraud cases throughout California and across the United States.
📞 Call today at 424-372-3112 to protect your license, your freedom, and your future.