DC Federal Healthcare Fraud Lawyer

Do you need a federal healthcare fraud lawyer in DC?Look no further than Scrofano Law. We have attorneys who can help you. Get in touch with us today!

What Is the Role of a DC Healthcare Fraud Attorney?

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Fraud is a significant problem in the healthcare industry. There are many reasons people commit fraud, but they all come down to money. Federal prosecuting attorneys work hard to prosecute those accused of committing any type of fraud, including health care fraud.

DC healthcare fraud defense attorneys provide legal counsel and representation to victims of healthcare fraud. If you find out that you are under investigation or are accused of healthcare fraud by health care providers, contact an experienced attorney who is knowledgeable about federal law.

With DC federal healthcare fraud lawyer Christopher J. Mutimer, you can create a lasting attorney-client relationship that can give you peace of mind.


Healthcare Fraud Defined

The crime of healthcare fraud involves dishonestly submitting healthcare claims to profit from reimbursements illegally. The Federal Bureau of Investigation (FBI) defines healthcare fraud as “a type of white-collar crime that involves the deliberate intent to deceive for profit or personal gain.”

The term “healthcare fraud” is often used to refer to various criminal offenses in the healthcare industry. These crimes include Medicare and Medicaid fraud, kickbacks, and false claims. Healthcare fraud can be committed by a medical provider, patient, or someone else who intentionally deceives a healthcare system to receive unlawful health benefits or compensation. It also includes intentional attempts to defraud any health care benefit program.

If you feel you were wrongly accused of committing or attempting to commit health care fraud, a federal criminal lawyer may be able to assist your defense. Working with a health care fraud attorney who has a better understanding of federal government laws can save you from the huge turmoil you might face in the process.

How Can You Know If You Are a Victim of Healthcare Fraud?


Healthcare fraud does not just include billing for services that were not delivered. Common warning signs of healthcare fraud include:

  • Receiving prescriptions for drugs without any medical reason

  • Requesting excessive quantities of expensive drugs or equipment, such as oxygen tanks, wheelchairs, and hospital beds

  • Requests for referrals to specialists without any medical reason

  • Requests for services that would be medically unnecessary

  • Claiming to be a doctor when they are not

If you have encountered any of the above, be sure to inform law enforcement officials or the human services office as soon as possible. Having the right information at the right time can help you proceed with confidence while staying on the safe side. Your attorney will share all the important information with you to better understand your situation and available legal options.


Types of Healthcare Fraud

There are several different types of healthcare fraud. The most common fraudulent actions include:

  • Billing for goods or prescription drugs that haven’t been provided or for services that haven’t been rendered

  • Overcharging for goods and services

  • Billing for more expensive medical equipment or treatments than those actually received

  • Charging patients without their consent

In addition, defendants may be charged with Medicare and Medicaid fraud if they submit false claims for reimbursement. The False Claims Act is often used to prosecute this federal crime.

Healthcare fraud investigations can be stressful, and if you feel you are being wrongfully targeted, seek local counsel for information and advice.


Penalties for Healthcare Fraud

Healthcare fraud is a serious crime that can lead to significant penalties for those convicted of it. Although the severity of the penalties depends on the severity of the crime, those who are convicted of healthcare fraud face any combination of the following:

  • Heavy fines

  • Jail time

  • Revocation of professional licenses

  • Restitution to the victims

Federal prosecution of fraudulent schemes or fraudulent behavior can lead to long-term consequences. Contact Christopher J. Mutimer for a free consultation.

How a DC Healthcare Fraud Lawyer Can Help You

Healthcare fraud lawyers practice federal fraud laws in relation to the healthcare industry. They often deal with the federal agencies that regulate healthcare providers and their business transactions. Health care fraud attorneys at our firm represent doctors, pharmacists, and employees who are being investigated or charged with fraud.

It may seem unnecessary to hire a lawyer if you feel you are innocent, but hiring a DC healthcare fraud attorney may save you money on fines and penalties. As your healthcare fraud defense attorneys, we can:

  • Prepare a meticulous review of the evidence against you and conduct our investigation of your case

  • Work diligently to present overwhelming evidence that the US Attorney’s Office has no case to prosecute.

  • Ensure that the federal justice system upholds your rights

An experienced lawyer can explain the federal laws and how they pertain to your situation. Criminal cases are scary, but the right law firm may be able to offer a free case evaluation.

DC Healthcare Fraud Defense Attorney


Accusations of healthcare fraud may result in severe legal and professional repercussions, some of which can last a lifetime. Due to the complexity of many federal laws, healthcare fraud charges may also be brought against people who had a minor involvement in the alleged crime. A reputable attorney’s office may offer information, advice, and representation to help defend your case.

An experienced DC criminal lawyer with healthcare fraud experience can help you with your case if you are accused of Medicare fraud or anti-kickback laws violations. Our goal is to help you resolve your case as early as possible. Reach out to us as soon as you become aware you are under investigation.


Frequently Asked Questions

Is Healthcare Fraud the Same as Insurance Fraud?

Healthcare fraud and insurance fraud are two separate crimes. Healthcare fraud is an intentionally dishonest healthcare claim made to receive undue payments, medical treatment, or medications, thereby profiting illegally.

In contrast, insurance fraud is committed to defraud the insurance process. Claimants engage in this practice when they attempt to obtain benefits or advantages they are not entitled to or when an insurer knowingly denies any benefits a claimant should receive.


What Is Upcoding in Healthcare Fraud?

Upcoding is a type of fraud that occurs when healthcare providers submit claims to insurers for procedures they did not perform. It can result in increased payments to the provider.

The Centers for Medicare and Medicaid Services (CMS) defines upcoding as a practice in which providers submit claims with a higher service level than the one performed. The intent behind upcoding is to increase reimbursement from insurers by claiming that more services were done than was actually the case.


Can a Law Firm Help with Healthcare Fraud Cases?

The answer is yes and no. Federal crimes are complicated and require a niche set of skills. Although a general law professional may be unable to assist you, one who practices white-collar law should be able to.

The experience and knowledge of a fraud attorney from a reputable law firm can be helpful in healthcare fraud cases.


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