What Should Healthcare Providers Do If You Receive a Federal Grand Jury Target Letter?

The first contact to a defendant in a healthcare fraud case is usually by way of a Grand Jury target letter. This letter informs you that “you are the target of a Grand Jury involving possible violations of Federal criminal law.”

The letter will describe the matter under investigation, such as 18 U.S.C. § 1347 (healthcare fraud); 18 U.S.C. § 1349 (conspiracy to commit healthcare fraud); and, possibly, 21 U.S.C. § 841 and 21 U.S.C. § 846 (drug trafficking or prescribing without a legitimate medical purpose).

Once you receive this letter, you can be certain that the federal government has begun an extensive investigation into your practice, Medicare billing, and prescribing practices.

The Grand Jury target letter notifies you that if you have retained a lawyer, he/she should contact the trial attorney or Assistant U.S. Attorney assigned to the case.

Failure to contact an attorney immediately could impact your ability to achieve a favorable outcome at the early stage of the case. Often, other co-defendants have received the same letter and may execute agreements to cooperate with the government in favor of a substantial reduction in jail time, forfeitures, and fines.

Occasionally, early investigation of the issue can even prevent an indictment by showing the government that your billing practices or prescribing practices were acceptable.

The target letter also informs you that if you are indigent, you can seek a court-appointed attorney. However, you should be aware that you will only receive a Court appointed attorney if the following conditions apply:

1. 1. 1. You are indigent, meaning you cannot afford an attorney.
      2. You are actually arrested and/or charged with a crime.
      3. A Grand Jury is convened and you are called to testify before a Grand Jury, 18 U.S.C. § 3006A(a)(1). (See the Eastern District of Michigan CJA Plan for additional guidelines.)

This is rarely the case in healthcare fraud conspiracy cases, and you will not receive a court-appointed attorney merely because you received a Grand Jury target letter.

If a Grand Jury is convened, you may be called as a witness to testify. However, the Fifth Amendment to the U.S. Constitution mandates that you cannot be compelled to testify against yourself. You and your attorney will look closely at the evidence and determine whether or not testifying is in your best interest.