Healthcare Fraud Conspiracy Cases
Our criminal attorneys have spent their careers combating healthcare fraud charges. Our clients come from all walks of life, with potential penalties ranging from fines to decades in prison. Whatever your specific situation, our approach is designed to dramatically improve the outcome of your case beyond what you thought possible.
Whether you are facing formal federal charges, suspect you are under investigation or are simply concerned about potential liability, our firm is available to provide the counsel you need to navigate the overwhelming and stressful nature of criminal liability.
When Can Someone be Charged for Conspiracy to Defraud the US ?
If you have committed healthcare fraud, charges against you may be brought under a number of federal statutes, including the False Claims Act, the Federal Healthcare Fraud Statute, and the Anti-Kickback statute, among others.
In addition to underlying healthcare fraud charges, you may face additional charges for non-healthcare specific crimes. If convicted, these charges come with their own penalties, which can be stacked on top of the penalties arising from other charges you face.
Conspiracy to defraud the United States is a common example. It occur through fraud, and includes:
- Attempting to deprive the government of money or property,
- Attempting to interfere or obstruct a government activity,
- Attempting to make wrongful use of a government instrumentality.
In the context of healthcare fraud, this charge usually arises in connection with fraudulent Medicare or Medicare billing. Because Medicare is a federal benefit program funded by tax dollars, the reimbursements you obtain through Medicare are considered government money.
Accordingly, when you are obtaining these reimbursements through fraudulent conduct, and you are knowingly committing this fraud with at least one other person, you are liable to face charges under the relevant statute, which we explain in detail below.
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What Statute Governs “Conspiracy to Defraud the U.S.?”
Under 18 U.S.C. section 371, conspiracy to defraud the United States occurs whenever “two or more persons conspire either to commit any offense against the United States or to defraud the United States or any agency thereof in any manner or for any purpose.”
What Does It Mean to “Defraud?”
The term “defraud” has been given the following definitions by the supreme court:
- “A conspiracy for the purpose of impairing, obstructing, or defeating the lawful function of any department of government.”
- “A conspiracy calculated to obstruct or impair its efficiency and destroy the value of its operation and reports as fair, impartial and reasonably accurate,”
- “To cheat the government out of property or money,”
- “To interfere with or obstruct one of its lawful government functions by deceit, craft, or trickery, or at least by means which are dishonest.”
In Hammerschmidt v. the United States (1924), Justice Taft wrote regarding the impact of the fraud,
It is unnecessary that the Government shall be subjected to property or pecuniary loss by the fraud, but only that its legitimate official action and purpose shall be defeated by misrepresentation, chicane or the overreaching of those charged with carrying out the governmental intention.
To simplify, conspiracy to defraud the United States in a healthcare fraud context occurs when you take an action with at least one other person, which at least attempts to deprive the government of money. Thus, even if your first attempt at fraudulent billing is detected, you could potentially still face charges under the statute.
Maximum penalties include fines and up to 5 years in federal prison. If you are convicted, the severity of your sentence will depend on the length and breadth of your scheme, the amount of money you defrauded, the degree to which your conduct endangered others, as well as any prior convictions you have faced.
Conspiracy Defenses:
Our criminal attorneys feel there is no substitute for effort, and are proud of the excellent reputation we have earned through a consistently demonstrated work ethic. In addition to the respect this approach earns us from prosecutors, judges, and the legal community, our approach puts our firm in an ideal place to uphold your best interests.
By analyzing every detail of your case and fully familiarizing ourselves with your story from day one, we achieve the expert knowledge that enables us to represent you best. That includes arguing on your behalf, as well as assisting you with the often difficult choices you have to make.
Our approach also creates the possibility for highly favorable plea deals and even dismissals, both of which offer our clients the opportunity to cap the time and energy investments involved in defending a criminal case and begin the work of rebuilding their lives. These outcomes have occurred for our clients with impressive frequency.
But if your case reaches trial, we are the firm you want on your side. One of the most frequently asserted and often successful defenses in a conspiracy case is intent, and we have won a large assortment of cases asserting the insufficiency of evidence proving this necessary element.
In a conspiracy to defraud the US charge, the intent requirement can be satisfied by a showing of one of the following:
- Intent to defraud,
- Intent to make false statements or representations to the government or its agencies to obtain property of the government,
- Evidence that the defendant performed acts or made statements that he or she knew to be false, fraudulent or deceitful to a government agency.
We will show why, even if the prosecution’s evidence shows you may have acted intentionally, their evidence does not establish this element. As intent is subjective, proving it to a jury can be challenging, when a skilled defense counsel is alert to every weakness and prepared to demonstrate every possible alternative to your guilt.
The art of instilling doubt in the minds of the jury is one that requires great talent, practice, and presence – the very qualities our criminal defense attorneys are known for.
It is important to understand that even if the facts of your case make a conviction nearly impossible, you could face numerous potential penalties. From a maximum sentence of five years to a simple fine, the right defense could make the difference between the permanent derailment of your life and a manageable detour.
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Healthcare Conspiracy in the News
Healthcare cases involving conspiracy to defraud the United States often occur in tandem with Medicare or Medicaid Fraud, as the cases below demonstrate.
Example #1
In 2014, two people were charged with conspiracy to defraud the United States following a 10-year healthcare fraud conspiracy they partook in. One of the conspirators was barred from Medicaid participation following a prior conviction.
The scheme involved an effort to get around his conviction by operating a facility that provided services to Medicaid beneficiaries under a relative’s name. Meanwhile, the excluded participants ran the operation and received financial benefits from the Medicaid reimbursements.
Example #2
In 2017, pharmacist Benjamin Nundin pleaded guilty to a conspiracy to pay healthcare kickbacks. Nundin, who co-owned a Tampa pharmacy, agreed to pay a licensed physician to write expensive prescriptions which his pharmacy then filled.
He also participated in a marketing scheme to promote the medications to Medicaid beneficiaries.
Example #3
In 2018, two behavioral health clinic operators were convicted for their conspiracy to commit healthcare fraud. Similar to the 2014 example, one of the two had been excluded from billing federal healthcare programs following a prior conviction, but he still performed many functions in the organization under an alias.
Although the co-conspirator was aware of his exclusion, he never disclosed this fact to Medicaid. As a result, the excluded conspirator received 4 years and 9 months in federal prison, as well as over $1 million dollars in fines. His co-conspirator received 2 years imprisonment and $200,000 in fines.
These examples demonstrate that conspiracy to defraud the United States need not be as extreme as submitting bills for unprovided services to a federal benefit program, or billing for testing a patient doesn’t actually need.
Simply participating in an otherwise lawful healthcare business with a person barred from Medicare participation could potentially give rise to years in prison
What to Do if You Have Are Under Investigation for Conspiracy?
If you have been charged with conspiracy to defraud the US, or if you are concerned you might be, you may not realize you can get confidential counsel from a qualified criminal defense attorney at no cost. Our firm offers risk-free consultations, as we feel you should understand your circumstances before making any financial commitments.
With that said, the right criminal defense attorney is the best investment you can make for your future. From saving you time behind bars to saving hundreds of thousands of dollars off your fine, our clients consistently walk away praising the invaluable impact our firm’s assistance has made on their lives.
The only way to find out if an investment in our firm is the right decision for you is to come in for a risk-free consultation. We will hear your story, help you sort out your options and possibilities, and give you the knowledge you need to walk away clear-headed and motivated to begin rebuilding your life.