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How Can I Defend Against Health Care Fraud Charges?

Federal health care fraud charges need to be taken extremely seriously by anyone who is under investigation, and by anyone who has been arrested or charged with health care fraud or a related offense. Although health care fraud is a type of white collar crime, the penalties for a conviction can be just as serious—if not more serious—than the penalties associated with a conviction for a violent crime. Accordingly, it is critical to begin working on a defense strategy as soon as possible. Your defense strategy should always be tailored to the specific facts of your case and the particular elements of the fraud offense you have been accused of committing.

In order to defend against health care fraud charges, you should learn more about the elements of health care fraud charges and the various defenses that may be applicable to your case.

What is Health Care Fraud Under Federal Law

Health care fraud is defined generally under federal law (18 U.S.C. § 1347) as an “attempt to execute a scheme or artifice . . . to defraud any health care benefit program or to obtain, by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any health care benefit program.”

The definition can include many different types of health care fraud, such as fraud committed by health care providers who are billing Medicaid or Medicare, other insurers, for services, or fraud committed by patients who are getting medical care by fraudulently using another person’s medical insurance. Health care fraud can also involve allegations concerning prescription forgeries, or providing medical services without having a valid license to do so.

Common Defenses Strategies for Health Care Fraud Charges

Given that there are many different forms of health care fraud, it will be critical to work with a Dallas federal fraud defense lawyer to identify the key facts of your case and the best way to defend against charges. In general, however, the following are common defense strategies for federal health care fraud charges:

  • No intent: As you can see in the language of the federal statute, health care fraud requires an intent to defraud. Accordingly, if you can prove a lack of intent, you may be able to beat the charges.

  • Mistaken identity: You have been accused of health care fraud, but another person might have used your identity to commit health care fraud, or investigators might have mistakenly identified you as a person involved in a fraud scheme.

  • Entrapment: You can prove that a law enforcement official or agent induced you to commit health care fraud when you otherwise would never have done so on your own.

  • Lack of evidence: You may be able to show that the prosecution has insufficient evidence for a conviction.

Contact a Dallas Health Care Fraud Defense Attorney

Anyone who is facing federal health care fraud charges should seek advice from one of our experienced Dallas health care fraud defense lawyers as soon as possible. The quicker you begin developing a defense strategy, the better your chances of an acquittal. Contact the Law Office of Patrick J. McLain, PLLC today for more information.


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