How Can a Licensed Healthcare Professional Get a Healthcare Fraud Indictment Dismissed?

Healthcare providers shaking hands with a Chapman Law Group healthcare defense attorney.

Healthcare fraud is one of the most difficult offenses to plead in an indictment. Yet, prosecutors who are not familiar with charging healthcare fraud routinely fail to properly draft the indictment. And general criminal law attorneys who are not skilled and experienced at defending healthcare fraud cases easily overlook these mistakes  to the detriment of their client.

This is precisely why physicians and other health professionals, or healthcare companies, must choose an experienced healthcare defense firm to defend their case.

But what is a healthcare fraud indictment all about? And how can it be dismissed?

Our national healthcare fraud and criminal defense have your answers.

The Factors That Make Up a Healthcare Fraud Indictment

Most healthcare fraud charges start with the issuance of an indictment by a grand jury. The indictment is a document that sets forth the charges and is intended to put the defendant on notice of the charges and the conduct at issue. 

Generally, Rule 7(c)(1) of the Federal Rules of Criminal Procedure requires a health care fraud indictment provide a “plain, concise and definite written statement of the essential facts constituting the offense charged.” Fraud offenses, such as healthcare fraud, should contain a detailed description of the health care fraud scheme to ensure the defendant has sufficient notice of the offense. This usually means the indictment must set forth all the elements of health care fraud.

To establish health care fraud under 18 U.S.C. §1347, the government must prove beyond a reasonable doubt that the defendant:

    1. devised a scheme or artifice to defraud a health care benefit program in connection with the delivery of or payment for health care benefits, items, or services;
    2. executed or attempted to execute this scheme or artifice to defraud;
    3. acted knowingly and willfully with the intent to defraud; and
    4. the scheme to defraud employed false pretenses, representations, or promises. 

More specifically, an indictment in a health care fraud case must set forth what the scheme was designed to deprive the victim of (money, items or services) and then describe the means the scheme was designed to be accomplished. 

An indictment must also allege that the fraud related to a material element of the conditions of participation for the health benefit program (MedicaidMedicare, private insurance). For instance, if a provider billed a 99215 but did not spend any face-to-face time with the patient, the government must allege that failure to see the patient was a material element.

There are many other factors that may make a health care fraud indictment insufficient. For instance, payment of a kickback alone is not enough to establish health care fraud.

An attorney must also review the statute of limitations to see if the indictment is time barred by the five-year statute of limitations set forth in 18 U.S.C. § 3282(a), although the statute of limitations generally begins to run when the crime is complete.

In addition, healthcare fraud will generally be considered a continuing offense, meaning that it is considered complete when all the fraudulent actions alleged are finished. 

At Chapman Law Group, Our National Healthcare-Based Criminal Law Attorneys Have the Expertise and Experience That Matter

Chapman Law Group is a multi-state health care defense firm. We have handled health care fraud cases across the country and are ready to review your case today. 

For more than three decades, our healthcare fraud lawyers have defended dentistsphysicians, pharmacistspain management specialistschiropractors, and many other licensed medical professionals, with great results. 

Our healthcare-based criminal law attorneys include former healthcare fraud prosecutors and healthcare law experts who can review your health care fraud case and provide you with the best defense.

We serve licensed healthcare professionals across the U.S. Our four national health care defense law offices are in Detroit, MichiganMiami and Sarasota, Florida; and; Los Angeles/Southern California

Put our team to work for you today. Call Chapman Law Group at (248) 644-6326.

Need an Attorney? Contact us now!

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Ronald W. Chapman II, LL.M.
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Chairperson of White Collar Defense & Government Investigations

Michigan Office
1441 W. Long Lake Road, Suite 310
Troy, MI 48098
Phone: (248) 644-6326

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