1) Knowingly or willingly attempting to execute

This means that the defendant must have provided the false information knowing that it was false, a simple mistake of fact would not suffice. 

The defendant must have had the intention that the false information or omitted information be submitted to the insurance company. In addition, the insurance provider would rely on that information and send money or property in return. 

As an example, if a medical clinic nurse submits a code for billing for a procedure or service that she, knowingly, did not actually perform for a patient, that would be a knowing and willful act. 

On the other hand, it would not be considered fraud if at the direction of a doctor or someone licensed to practice medicine, directed a receptionist or some other billing employee to submit an erroneous billing code by mistake without realizing that they have provided the wrong code.

Here, the receptionist would not have had the necessary intent and therefore would most likely not be found culpable. 

2) A scheme or artifice

3) Through false or fraudulent means to

Fraud, generally, is the deliberate deception of another in order to secure an unfair or unlawful gain or to deprive a victim of a legal right.

Fraud differs from abuse of position as a medical professional or employee. 

Abuse is an action that is inconsistent with the general practices of the medical industry. Fraud is the exploitation of fact in order to receive something of value. 

For example, if an employee in the reception area of a medical clinic creates fake patients and forges documents in order to submit them for reimbursement, that would be acting in a fraudulent manner.

On the other hand, a doctor at a medical clinic that performs a diagnostic test that may have been unnecessary will most likely not be charged with fraud but would likely be guilty of abuse. 

3)Obtain property or money from a health care benefit program. 

Under 18 U.S.C. §24(b), a health care benefit program is any public or private plan that  provides medical benefit, item, or service to any individual, or provides the payment for those things. 

If, as a result of submitting false bills to an insurance company, a doctor receives and pockets the payout, then they may be found guilty of health care fraud. 

There is no knowledge of, or intent to violate, the federal statute necessary. By providing an insurance company with false or misleading information and receiving property based on that false information, you may be held culpable for fraud. 

Further, this statute does not simply apply to licensed medical professionals. Non-licensed individuals, medical clinic owners of employees, medical practice owners or employees, health care businesses and even universities may be held culpable for health care fraud. 

The federal statute is incredibly broad, which leaves open the types of schemes or artifices that can be used in the course of committing health care fraud.