Typically, a healthcare fraud indictment, which is the document that charges healthcare fraud, contains a charge of healthcare fraud conspiracy along with several individual executions of healthcare fraud. The indictment may also contain a money laundering charge in addition to a forfeiture charge.
The government charges healthcare fraud conspiracy because the federal conspiracy rules are extremely relaxed and only require that the government prove an agreement to commit healthcare fraud and an act in furtherance of the scheme.
The government also attempts to seize a significant amount of assets from those charged with healthcare fraud, chiefly to prevent the defendant from using allegedly unlawful proceeds to defend healthcare fraud charges.
Federal prosecutors are getting very creative in prosecuting and charging healthcare fraud. Our attorneys have significant experience dealing with the Department of Justice (DOJ), Department of Health and Human Services (HHS), and federal prosecutors. But we at Chapman Law Group know their playbook and how to defend against it.
Here are some of the federal statutes charged in a common healthcare fraud indictment.
These different charges each have different “elements” that the prosecutors must prove beyond a reasonable doubt.
For instance, the elements of healthcare fraud are that a defendant (1) knowingly, and (2) willfully, (3) devised a scheme or artifice to defraud a healthcare program, and (4) executed the scheme. The government would have to prove each and every element to a jury beyond a reasonable doubt to a jury.
Defending a federal healthcare fraud case requires your defense counsel to convince the government that they will not be able to prove the elements to a jury — thereby resulting in a dismissal or by presenting a compelling case to the jury that prosecutors cannot prove the elements of the offense beyond a reasonable doubt.
These statutes are far from simple. Volumes of cases have been decided interpreting each of these statutes and their application.
Healthcare fraud defense is much like tax law: it’s so highly specific, only practitioners who regularly work in this field are experienced enough to litigate. Many clients who consult us for a second opinion have been told by their inexperienced healthcare fraud attorney that they are guilty and should accept a plea — when they are in fact not. This is because many believe that simple failure to conform to Medicare and Medicaid regulations constitutes fraud. It does not.