Federal Healthcare Fraud Defense Attorney
Doctors, physicians, and healthcare providers facing federal charges need a federal healthcare fraud defense attorney who understands both the federal criminal system and the regulatory framework that governs medical practice.
Federal healthcare fraud enforcement has never been more aggressive. The Department of Justice has established dedicated healthcare fraud strike forces in cities nationwide. The Department of Health and Human Services Office of Inspector General coordinates with the FBI, Drug Enforcement Administration (DEA), and United States Attorneys’ Offices. In June 2025, the DOJ announced charges against 324 defendants, including 96 doctors, nurse practitioners, and pharmacists, in connection with over $14.6 billion in alleged fraud. That number reflects the scale of federal enforcement, not the guilt of every practitioner involved in an investigation.
At The Law Offices of Beau B. Brindley, we defend physicians, surgeons, dentists, pharmacists, clinic operators, and other healthcare professionals against the full range of federal charges. Our approach is the same in every case: we prepare for trial. That preparation is what changes the outcome, no matter if the case resolves before trial or goes to verdict.
If you or your practice is under federal investigation, call 312.765.8878. As a federal healthcare fraud defense attorney with national trial experience, we bring the same relentless defense to medical practitioner cases that we bring to every federal matter we accept
Federal Healthcare Fraud Defense Attorney
Healthcare fraud under 18 U.S.C. § 1347 is one of the most broadly charged statutes in the federal system. It applies to any person who knowingly and willfully executes, or attempts to execute, a scheme to defraud a healthcare benefit program. That definition is extraordinarily broad and encompasses physicians, mid-level providers, clinic operators, billing companies, and administrative staff.
As federal healthcare fraud defense attorneys, we challenge the government’s case at every level. Federal healthcare fraud cases are built on billing records, patient files, government databases, and cooperating witnesses. Oftentimes, this includes former employees or co-defendants who have their own reasons to shade their testimony. We meticulously examine every piece of evidence presented by the government and retain our own expert witnesses. Additionally, we rigorously test the government’s theory of fraud against the actual clinical record.
The stakes are severe. Conviction under 18 U.S.C. § 1347 carries up to 10 years in federal prison per count and up to 20 years if the violation results in serious bodily injury, or life imprisonment if death results. Beyond incarceration, practitioners face mandatory restitution, exclusion from Medicare and Medicaid programs, and permanent loss of licensure. For any healthcare professional, these collateral consequences are often as devastating as the prison term.
Medicare and Medicaid Fraud Defense Attorney
Medicare and Medicaid fraud charges are filed when the government alleges that claims submitted to federal healthcare programs were false, inflated, or lacked support by the medical record. The most common allegations include billing
Drug Trafficking and Distribution
Upcoding occurs when a provider bills for a higher-complexity service than was actually performed. Unbundling, on the other hand, involves billing separately for procedures that should be billed together at a reduced rate. Federal prosecutors and the Health and Human Services Office of Inspector General (HHS-OIG) data analysts review years of billing records and compare a provider’s patterns against statistical norms for their specialty and region. Deviation from average billing patterns is not proof of fraud. Many legitimate providers, including specialists, high-volume practices, and providers serving complex patient populations, bill at rates that exceed average. A Medicare fraud defense attorney must present that clinical context to the jury.
Services Not Rendered
Charges involving services not rendered are among the most aggressively prosecuted in the federal system. The government uses patient interviews, medical records, and claims data to allege that billed services were never provided. These cases often hinge on documentation practices — poor recordkeeping can create the appearance of fraud where none existed. Our Medicaid fraud defense attorney practice includes detailed engagement with the clinical record to demonstrate that services were provided, documented, and billed in accordance with accepted practice.
Medically Unnecessary Procedures
Allegations of medical necessity fraud are among the most complex in federal healthcare enforcement. The government retains medical experts to testify that procedures were not medically necessary. Conversely, the defense requires expert witnesses who can speak to the clinical judgment involved in each treatment decision. Medical necessity is ultimately a judgment call, and juries understand that reasonable physicians may disagree. Effective defense of medical professionals on necessity charges requires credible expert testimony and a coherent narrative about the practitioner’s clinical reasoning.
False Claims Act Defense Attorney
The False Claims Act (31 U.S.C. § 3729) imposes civil liability on individuals who knowingly submit false claims to the federal government. In the healthcare industry, False Claims Act cases arise from qui tam lawsuits, which are filed by whistleblowers, often former employees, who bring suit on behalf of the government and share in any recovery. The Department of Justice (DOJ) may elect to intervene and pursue the case directly.
False Claims Act cases carry treble damages, amounting to three times the false claim, plus statutory penalties per claim. For a high-volume practice, the aggregate exposure can reach tens of millions of dollars. Civil False Claims Act liability often runs parallel to criminal healthcare fraud charges. A physician facing both must have defense counsel who understands how the civil and criminal proceedings interact and how to manage both simultaneously.
Our False Claims Act defense work covers qui tam defense, government investigation response, voluntary disclosure strategy, and, where necessary, litigation through trial. We have handled cases where the government’s qui tam relator was a disgruntled former employee with a personal vendetta. We are experts at exposing that bias at deposition and at trial.
Federal Charges Against Doctors: What We Defend
The range of federal charges against doctors and other healthcare professionals is broad. Our doctor defense attorney practice covers every major category of federal healthcare enforcement:
- Medicare and Medicaid fraud (18 U.S.C. § 1347) — false claims, upcoding, services not rendered, medically unnecessary procedures
- Anti-Kickback Statute violations (42 U.S.C. § 1320a-7b) — alleged payments for referrals, illegal fee-splitting arrangements, improper financial relationships
- Stark Law violations — self-referral prohibitions in Medicare and Medicaid billing
- False Claims Act (31 U.S.C. § 3729) — civil and parallel criminal qui tam actions
- Unlawful prescribing under the Controlled Substances Act (21 U.S.C. § 841) — DEA investigations, pill mill allegations, prescribing outside the usual course of professional practice. See our dedicated unlawful prescribing defense page for full coverage of this charge type.
- Telemedicine fraud — allegations involving prescriptions or orders issued without adequate patient examination through telehealth platforms
- Identity theft and aggravated identity theft (18 U.S.C. § 1028A) — use of patient identities to submit fraudulent claims
- Money laundering (18 U.S.C. § 1956) — charged alongside healthcare fraud when alleged proceeds are transferred or concealed
- Obstruction of justice and false statements — charges arising from the investigation itself, including statements to federal agents
Anti-Kickback Defense Attorney
The Law Offices of Beau B. Brindley has a documented trial record in federal medical practitioner defense cases. In the prosecution of Dr. Charles Szyman, a pain management physician, the government charged unlawful prescribing under the Controlled Substances Act and alleged that Dr. Szyman had prescribed opioids to patients at levels 50 to 100 times the usual limits. A government expert testified to that effect. The Law Offices of Beau B. Brindley took the case to trial and proved that Dr. Szyman was not a criminal, but instead a doctor doing his job. In the end, the jury acquitted him.
That result reflects a principle central to our practice: a physician acting in good faith to treat patients in accordance with his clinical judgment should not be a held responsible for a federal enforcement priority. The principle applies to every doctor defense attorney matter we accept, whether the charge is Medicare fraud, Anti-Kickback violations, or any other federal healthcare charge
Healthcare Fraud Defense Attorney Chicago
The Department of Justice’s healthcare fraud strike force has operated in the Chicago area for over a decade. Federal prosecutors in the Northern District of Illinois treat healthcare fraud as an enforcement priority. Investigations are conducted by the FBI’s healthcare fraud unit, HHS-OIG agents, and IRS Criminal Investigation, often in coordination. By the time a target becomes aware of an investigation, the government has typically been building its case for months.
As a healthcare fraud defense attorney Chicago practitioners rely on, The Law Offices of Beau B. Brindley understands how the Northern District investigates and prosecutes these cases. We have in-depth knowledge of the prosecutors, evidentiary patterns, and how to intervene at the earliest stage, before an indictment, to protect our clients’ rights, their licenses, and their practices.
Our firm also represents clients beyond Chicago, as federal healthcare fraud enforcement is a national concern. We have successfully tried federal cases in courthouses across the United States and argued before 10 of the 12 federal circuit courts of appeals. If you face federal healthcare fraud charges anywhere in the country, call 312.765.8878.
Talk to a federal defense attorney
Early representation creates the most options. Speak with us confidentially about your case — there is no obligation.
Results
United States v. Szyman — pain-management physician acquitted at trial on federal unlawful prescribing charges
Federal healthcare fraud indictment — charges dismissed before trial.
Federal Practice Areas
Frequently Asked Questions
Can a doctor go to jail for Medicare fraud?
Yes. Medicare fraud under 18 U.S.C. § 1347 is a federal felony carrying up to 10 years in prison per count, with potentially more if the violation causes serious injury or death. In addition to incarceration, convicted physicians face mandatory restitution, exclusion from federal healthcare programs, and permanent loss of licensure. A federal healthcare fraud defense attorney must proactively challenge both the criminal charge and the collateral consequences from the earliest stage of the investigation.
What is the difference between Medicare fraud and Medicaid fraud?
Medicare is a federal program for adults 65 and older, as well ascertain disabled individuals. Conversely, Medicaid is a joint federal-state program for low-income individuals. Both are covered by the federal healthcare fraud statute and the False Claims Act. A Medicaid fraud defense attorney handles cases involving state-administered programs that receive federal funding. Enforcement agencies, including HHS-OIG, FBI, and state Medicaid fraud control units, frequently coordinate investigations across both programs.
What should I do if federal agents contact me about a healthcare fraud investigation?
Do not speak with federal agents without a federal healthcare fraud defense attorney present. Anything you say can be used against you, including statements you believe are innocent or exculpatory. It is crucial to seek counsel from a federal healthcare fraud defense attorney immediately. Early intervention allows your attorney to thoroughly assess the scope of the investigation, protect your records, and, in some cases, engage the government before charges are filed.
What is the False Claims Act and how does it affect doctors?
The False Claims Act (31 U.S.C. § 3729) imposes civil liability on anyone who submits false claims to the federal government. In healthcare, this law is typically triggered by qui tam lawsuits filed by whistleblowers. Penalties associated include treble damages plus per-claim statutory fines. For high-volume practices, the aggregate exposure can reach millions of dollars. Civil False Claims Act proceedings often run alongside criminal charges, requiring coordinated defense strategy from a False Claims Act defense attorney experienced in both.
Can a doctor lose their medical license because of a federal fraud charge?
Yes. Federal conviction for healthcare fraud triggers mandatory exclusion from Medicare and Medicaid under 42 U.S.C. § 1320a-7. State medical boards independently evaluate federal charges and convictions and may suspend or revoke licensure during the pendency of a case, even before a conviction is rendered. Protecting your license requires a doctor defense attorney who coordinates the criminal defense with the administrative licensing proceeding from the outset.
What is an Anti-Kickback Statute violation and what are the penalties?
The Anti-Kickback Statute (42 U.S.C. § 1320a-7b) prohibits payments intended to induce or reward referrals of services covered by federal healthcare programs. Criminal violations can carry up to 10 years per count, in addition to exclusion from federal programs. The statute has numerous safe harbors for legitimate business arrangements. A kickback defense attorney meticulously analyzes the specific arrangement against the safe harbor regulations and challenges the government’s theory that lawful compensation constituted an illegal inducement.
Defend Your Practice. Defend Your Career..
Call Brindley Law Today.
A federal healthcare fraud investigation can move faster than most practitioners expect. The government builds its case before you know it exists, so the earlier a federal healthcare fraud defense attorney is involved, the more options exist to protect your rights, license, and future. Call The Law Offices of Beau B. Brindley at 312.765.8878 for a confidential consultation. As a healthcare fraud defense attorney Chicago and nationwide medical practitioners rely on, we bring trial-ready defense of medical professionals to every federal case we accept.