Virginia Healthcare Fraud Lawyer

Federal healthcare fraud investigations often begin quietly, sometimes before you may even realize you are under scrutiny. If you are facing allegations of healthcare fraud, the potential consequences are extremely serious. Early involvement from a skilled defense attorney can be key to protecting your reputation, career, and freedom.

A Virginia healthcare fraud lawyer at Price Benowitz can assess the allegations, help you avoid early missteps, and begin developing a strong, strategic defense.

What Is Healthcare Fraud?

Healthcare fraud refers to any attempt to unlawfully obtain funds from a healthcare benefits program. These cases often involve federal programs such as Medicare, Medicaid, or the Department of Labor’s healthcare benefits. Allegations may stem from issues like:

• Submitting claims for services not rendered
• Billing for the same service multiple times
• Providing inaccurate codes for more expensive procedures (upcoding)
• Accepting or offering financial kickbacks for referrals

Charges can arise from these issues or from  routine billing errors, miscommunication, or oversight within a practice or facility. The federal government, including agencies like the FBI and Department of Health and Human Services (HHS), aggressively investigates these matters, sometimes for months or years, before bringing formal charges. If you’re facing charges, a Virginia healthcare fraud attorney can help you understand their legal rights and options.

Potential Penalties for Healthcare Fraud

Federal healthcare fraud is charged as a felony. The severity of the penalties depends on the specific allegations and the financial amount involved. Consequences may include:

• Up to 10 years in federal prison per offense
• Fines reaching $250,000 for individuals and $500,000 for organizations
• Restitution for funds allegedly obtained through fraudulent claims
• Loss of professional licenses or medical credentials
• Permanent damage to personal and professional reputation

In cases involving harm to patients or fraud tied to controlled substances, penalties may increase further. For professionals, a conviction can result in career-ending consequences, even before sentencing. Working with a Virginia healthcare fraud attorney as early in the process as possible is vital.

Defenses Against Healthcare Fraud

Being charged does not equate to guilt. Many individuals accused of healthcare fraud are facing misunderstandings, inaccurate audits, or misinterpretations of complex billing practices. An experienced Virginia defense lawyer can challenge the healthcare fraud case by examining issues such as:

• Lack of intent: Fraud requires intentional deception. Demonstrating that the conduct was accidental can undermine the prosecution’s theory.
• Insufficient evidence: The government must meet a high standard of proof. If the evidence is weak or incomplete, the case may not hold.
• Clerical or coding mistakes: Errors in documentation or billing systems are common. Showing that these were unintentional can support a strong defense.

A knowledgeable attorney can conduct an investigation,  identify defenses early and begin preserving records and securing expert involvement to support them.

Speak With a Virginia Healthcare Fraud Attorney at Price Benowitz

If you are being investigated for or have been accused of healthcare fraud, there is no time to delay. A Virginia healthcare fraud lawyer at Price Benowitz can review the facts of your case, guide your next steps, and help you protect your rights and professional standing.

Contact us today for a free case evaluation and take the first step toward building your defense with experienced legal support.