Category Archives: Health Care Fraud

Health Care Fraud Arrests for Violation of Federal False Claims Act: Criminal Defense Overview

Schemes to take government money through nefarious means are far from new.  Over 150 years ago, as the Civil War was raging in this country, Congress passed its initial landmark false claims law “…in the wake of a spate of frauds upon the government.” United States v. Bramblett, 348 U.S. 503, 504, 75 S. Ct. 504,…


Texas Health Care Fraud Arrests: The Physician Self-Referral Law aka Stark Law, a Criminal Defense Overview

Health care is an almost incomprehensibly big business in this country.  According to the Centers for Medicare and Medicaid Services (CMS), spending in the U.S. health care industry accounts for almost a fifth (19.7%) of our Gross Domestic Product (GDP) with $4.1 Trillion (yes, trillion) spent in health care during the calendar year 2020 alone….


Texas Physicians’ Risk of Arrest: Criminal Defense Overview of Federal Anti-Kickback Statute (AKS)

All physicians understand that practicing medicine in Texas today involves continuing, widespread governmental oversight at every level, including extensive regulation by the federal government through a variety of federal statutes. Failure to comply can have devastating results.  Doctors, clinicians, hospital administrators, and others can face damage to their professional and personal reputations with even the…


Medical Identity Theft: Texas Criminal Defense of Health Care Fraud Charges

In Texas, both state and federal law enforcement are keenly focused upon the investigation and prosecution of all varieties of health care fraud, which can result in serious prison time upon conviction.  From a criminal defense standpoint, this investigatory zeal into the medical industry is of serious concern in part because of its impact long…


Doctor’s Risk of Arrest: Popular Bases for Texas Health Care Fraud Prosecutions

Law enforcement is more likely to investigate Texas health care providers for certain activities known to be targeted by prosecutors.   Health care is big business in this country.  The U.S. medical industry is defined as not only involving (1) those providing medical services, but also (2) manufacturers of medical equipment or drugs; (3) providers of…


Health Care Fraud Defense: Arrests Based Upon Medicare, Medicaid, or TriCare Insurance Claims

Defending Against Allegations of Fraudulent Billing to Federal Benefit Programs Health care providers in the State of Texas seeking reimbursement or payment for services rendered to persons in their care or charge must understand they are vulnerable to investigation and prosecution by either federal or state law enforcement for health care fraud crimes.  Suspicion can…


Loss Amounts in Federal Sentences: Calculating Economic and Financial Losses in Federal Felonies

Federal Sentencing Guideline 2B1.1 explains how to calculate monetary loss in a variety of crimes, such as tax evasion, structuring, wire fraud, money laundering, and mortgage fraud. Financial crimes prosecuted by the federal government usually involve a lot of money that builds into a large economic loss for its victims.  Criminal creativity being what it…


Federal Crimes and Sentencing Guidelines: Health Care Fraud

Federal Charges for Healthcare Fraud Involving Texas Health Care Providers Texas physicians, as well as pharmacists, clinics, and other health care providers, need to be aware of the growing risk of investigation, arrest, and prosecution for violations of federal criminal laws involving health care fraud. Federal criminal law applying to the practice of medicine in…


The 2018 Boom in Physician Arrests: Characteristics of the Arrested Doctor

It’s happening:  more and more doctors are being arrested and imprisoned on federal charges.  This isn’t a shocker, we’ve been warning about it for a while now.  For details and background info, check out: Health Care Fraud Prosecutions in 2018: Money and Drugs Doctors in Texas Alert: Feds Are Targeting Health Care Fraud Arrests Doctor…


Health Care Fraud Prosecutions in 2018: Money and Drugs

Criminal Investigations, Arrests, and Charges of Doctors, Pharmacists, Psychologists, Billing Services, Clinic Owners, and More on Felony Fraud Charges Anyone involved in the healthcare industry here in Texas need to be prepared for scrutiny by local, state, and federal law enforcement.  Healthcare fraud is a big, big deal these days. The heavy media coverage of…