Federal Healthcare Fraud

Federal Healthcare Fraud: How Josh Tomsheck of Hofland & Tomsheck Can Defend You Against Federal Healthcare Fraud Charges

Healthcare fraud is a serious federal offense that involves the submission of false or misleading claims to government healthcare programs, such as Medicare, Medicaid, or private insurance companies, in order to receive payment for services or products that were not provided or were unnecessary. Federal healthcare fraud charges are aggressively prosecuted, particularly by agencies like the Department of Health and Human Services Office of Inspector General (HHSOIG) and the Federal Bureau of Investigation (FBI). Convictions for healthcare fraud can result in long prison sentences, hefty fines, and the loss of medical licenses.

If you or someone you know is facing federal healthcare fraud charges, it is essential to have an experienced attorney who understands the intricacies of healthcare law and can develop a strong defense. Josh Tomsheck, a nationally Board Certified criminal defense attorney with Hofland & Tomsheck, has successfully defended clients against federal healthcare fraud charges. His knowledge of the law and his aggressive defense strategies make him a trusted advocate in these complex cases.

Understanding Federal Healthcare Fraud Laws

Federal healthcare fraud is prosecuted under several statutes, depending on the type of fraud and the entities involved. Common healthcare fraud cases involve false claims, kickbacks, and the misuse of healthcare benefits.

• Healthcare Fraud (18 U.S.C. § 1347): This statute makes it a federal crime to knowingly execute or attempt to execute a scheme to defraud a healthcare benefit program. This includes filing false claims for reimbursement, billing for services that were not provided, or upcoding (billing for a more expensive service than was performed).
• False Claims Act (31 U.S.C. § 3729): The False Claims Act is one of the most powerful tools used by federal prosecutors to combat healthcare fraud. It allows the government to impose substantial penalties on individuals or entities that submit false claims to government healthcare programs, such as Medicare or Medicaid.
• Anti-Kickback Statute (42 U.S.C. § 1320a7b): This statute makes it illegal to offer, solicit, or receive any form of kickback or bribe in exchange for referrals or the purchase of goods or services that are reimbursed by federal healthcare programs.
• Stark Law (42 U.S.C. § 1395nn): The Stark Law prohibits physicians from referring patients to entities with which they have a financial relationship for certain healthcare services reimbursed by Medicare or Medicaid, unless an exception applies.

Penalties for Federal Healthcare Fraud Convictions

• Federal healthcare fraud convictions can result in severe penalties, including long prison sentences, significant fines, and the loss of professional licenses. The severity of the penalties depends on the amount of money involved in the fraud, the defendant’s role in the scheme, and any prior convictions.
• Imprisonment: Convictions for healthcare fraud can result in prison sentences ranging from 5 to 20 years, depending on the amount of money defrauded and whether the fraud involved patient harm or injury.
• Fines: Healthcare fraud convictions can result in substantial fines, with penalties often reaching into the hundreds of thousands or millions of dollars, particularly in cases involving largescale fraud or false claims submitted to government healthcare programs.
• Restitution: Defendants convicted of healthcare fraud are often required to pay restitution to the government or private insurers to cover the financial losses resulting from the fraud.
• Loss of Licenses: Healthcare professionals convicted of fraud may face the revocation of their medical, nursing, or professional licenses, effectively ending their careers in the healthcare field.

Common Defenses in Federal Healthcare Fraud Cases

When defending against federal healthcare fraud charges, Josh Tomsheck uses a variety of defense strategies tailored to the specifics of each case. Some common defenses include:

• Lack of Intent to Defraud: One of the key elements of healthcare fraud is the intent to defraud. Josh Tomsheck will argue that the defendant did not intend to submit false claims or engage in fraudulent conduct, and that any errors were unintentional or administrative mistakes.
• Challenging the Evidence: Healthcare fraud cases often rely on billing records, patient files, and testimony from coworkers or patients. Josh Tomsheck will thoroughly review the evidence to determine if it was lawfully obtained and whether it supports the charges. He may file motions to suppress improperly obtained evidence or challenge the credibility of witnesses.
• Lack of Knowledge: In some cases, healthcare providers may unknowingly submit false claims due to clerical errors, billing mistakes, or lack of knowledge about the complexities of healthcare billing. Josh Tomsheck will work to demonstrate that the defendant was not aware of the fraudulent conduct and did not intentionally participate in the scheme.

• Statutory Exceptions: Healthcare fraud cases involving violations of the Stark Law or AntiKickback Statute may include defenses based on statutory exceptions. Josh Tomsheck will carefully analyze the facts of the case to determine if any exceptions apply to the defendant’s conduct, potentially resulting in a dismissal of the charges.

How Josh Tomsheck Can Help You in Federal Healthcare Fraud Cases

Federal healthcare fraud cases are complex and require an attorney with a deep understanding of both healthcare regulations and criminal law. Josh Tomsheck is an experienced, nationally Board-Certified criminal defense lawyer who has successfully defended clients against a wide range of federal healthcare fraud charges.

Here’s why Josh Tomsheck is the best choice for your defense:

• Expertise in Federal Healthcare Fraud Law: Tomsheck’s knowledge of 18 U.S.C. § 1347, the False Claims Act, the Anti-Kickback Statute, and other federal statutes allows him to build strong defense strategies tailored to the specific facts of each case.
• Proven Track Record in Federal Court: Josh Tomsheck has extensive experience defending clients in federal court and has successfully secured reduced sentences, dismissals, and acquittals for his clients in healthcare fraud cases.
• Personalized Defense Strategy: Every case is different, and Josh Tomsheck takes the time to understand the specific facts and circumstances of each client’s case. He develops a personalized defense strategy aimed at minimizing penalties and protecting your rights.
• Aggressive Defense: Known for his dedication and tenacity, Josh Tomsheck will fight for you at every stage of the case, from pretrial motions to trial and sentencing. He is committed to securing the best possible outcome for his clients.

Contact Josh Tomsheck for a Consultation

If you or a loved one is facing federal healthcare fraud charges, don’t wait to seek legal representation. Contact Josh Tomsheck at the Law Firm of Hofland & Tomsheck today for a consultation. With his experience, knowledge, and dedication, you can trust that your case is in capable hands.