Steps to Take After a Healthcare Fraud Indictment

Being indicted for healthcare fraud is a stressful and overwhelming experience. Whether you’re a medical provider, healthcare business owner, or administrator, facing criminal charges can jeopardize your career, finances, and personal freedom. Knowing the right steps to take after a healthcare fraud indictment is critical to protecting your rights and building a strong defense.

What Is a Federal Indictment for Healthcare Fraud?

A federal indictment for healthcare fraud is a formal accusation that charges an individual or organization with committing fraudulent activities related to healthcare services. Unlike a typical criminal charge, an indictment is issued after a grand jury reviews the evidence presented by federal prosecutors and determines there is enough probable cause to proceed with criminal charges.

Healthcare fraud indictments often involve allegations such as billing for services not rendered, falsifying medical records, upcoding, or engaging in illegal kickback schemes. These cases are typically prosecuted under federal laws such as the False Claims Act, Anti-Kickback Statute, and Stark Law.

It’s important to understand that an indictment does not mean you are guilty — it simply means the government believes there is enough evidence to bring your case to trial. The prosecution must still prove its case beyond a reasonable doubt in court. Facing a federal indictment is serious, as convictions can result in significant fines, exclusion from federal healthcare programs, and even imprisonment.

If you or your healthcare organization has been indicted, seeking immediate legal representation from a skilled healthcare fraud defense attorney is crucial. An experienced attorney can assess the charges, identify weaknesses in the prosecution’s case, and build a strong defense strategy to protect your rights and future.

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Can a Healthcare Fraud Indictment Be Dismissed? Here’s What You Need to Know

Getting a healthcare fraud indictment dismissed can be a difficult and complex process, but having an experienced healthcare fraud defense attorney on your side can significantly improve your chances. Dismissal may be possible if your attorney can demonstrate that the indictment was based on insufficient evidence, procedural errors, or constitutional violations.

For example, if the prosecution failed to disclose key facts to the grand jury or relied on misleading information, your healthcare fraud defense attorney may argue that the charges lack legal merit. In some cases, your attorney may also show that the actions in question do not meet the legal definition of fraud. Since federal prosecutors often spend considerable time gathering evidence before pursuing an indictment, successfully challenging it requires strategic preparation, detailed investigation, and a strong legal argument. Consulting with a skilled healthcare fraud defense attorney as early as possible is critical to exploring all possible avenues for dismissal.

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What is a Federal Indictment for Healthcare Fraud? What to Do Next If You Are Indicted?

A healthcare fraud criminal indictment does not mean you are guilty. Instead, an indictment is simply a formal accusation that charges you with a crime — not proof that you committed one. It is the result of a grand jury determining there is enough evidence to proceed with a trial, but it does not reflect a final judgment. The burden of proof still rests entirely on the prosecution, which means federal prosecutors must now present compelling evidence in court and prove beyond a reasonable doubt that you knowingly engaged in fraudulent activity. While an indictment can feel overwhelming and damaging to your reputation, it’s important to remember that you still have the opportunity to build a strong defense, challenge the allegations, and protect your future.

This guide will walk you through the immediate actions you should take, common legal strategies, and how to avoid mistakes that could hurt your case.

Contact a Healthcare Fraud Defense Attorney Immediately

The most urgent step to take after a healthcare fraud indictment is to hire an experienced healthcare fraud defense attorney. Federal healthcare cases are complex, often involving extensive evidence, complicated billing regulations, and aggressive prosecution. Without skilled legal representation, you risk making costly mistakes that could harm your defense.

An experienced attorney will analyze your case, explain the charges against you, and begin developing a defense strategy right away. They will also manage communications with federal investigators and prosecutors, ensuring you don’t inadvertently say something that could be used against you.

 Understand the Charges Against You

Understanding the nature of your indictment is crucial. Healthcare fraud cases often involve allegations such as billing for services not provided, upcoding, unbundling, or accepting illegal kickbacks.

Federal agencies like the Department of Justice (DOJ) and the Office of Inspector General (OIG) typically spend months or even years building a case before issuing an indictment. This means they may already have substantial evidence when they charge you.

Your attorney can help you break down the charges, identify weaknesses in the prosecution’s case, and explore possible defenses.

Preserve Evidence and Documentation

One of the most important steps to take after a healthcare fraud indictment is to preserve all relevant documents and records. This includes billing statements, patient files, emails, contracts, and any communications tied to the allegations.

Even if you believe certain documents are damaging, do not attempt to alter or destroy them. Doing so may lead to obstruction of justice charges, making your situation far worse. Instead, organize these materials and provide them to your attorney for review.

Avoid Speaking to Federal Investigators Without Your Attorney

Federal agents or prosecutors may attempt to contact you directly for statements, interviews, or explanations. While you may feel tempted to cooperate to “clear things up,” this can be risky without legal representation.

Even casual conversations can be used as evidence against you. If investigators contact you, politely decline to answer questions and inform them that your attorney will respond on your behalf. This protects you from making statements that could harm your case.

Develop a Strong Legal Defense Strategy

A well-planned defense strategy is crucial in fighting healthcare fraud charges. Depending on your situation, your attorney may employ one or more of the following strategies:

• Lack of Intent: If the alleged fraud resulted from honest billing errors, miscommunication, or administrative mistakes, proving there was no intent to commit fraud can be a strong defense.

• Insufficient Evidence: Prosecutors must prove their case beyond a reasonable doubt. If their evidence is incomplete or circumstantial, your attorney may challenge its credibility.

• Compliance Program Defense: If your healthcare practice had compliance protocols in place to prevent fraud, this may demonstrate that you took proactive steps to follow legal standards.

Your attorney will tailor the strategy based on the details of your case and the evidence presented by prosecutors.

Understand the Possible Consequences

Being indicted for healthcare fraud can lead to serious penalties, including hefty fines, prison time, and exclusion from federal healthcare programs such as Medicare or Medicaid. In some cases, healthcare professionals may also lose their medical licenses, jeopardizing their careers.

Knowing the potential outcomes can help you make informed decisions throughout the legal process. With a strong defense strategy, it may be possible to reduce charges, negotiate a plea deal, or even have the case dismissed.

Manage the Investigation Process Carefully

Healthcare fraud investigations often involve multiple stages, including audits, subpoenas, and document requests. These investigations are typically led by federal agencies such as the FBI, OIG, or DOJ.

Your attorney will guide you on how to respond to requests for information and ensure you remain compliant throughout the investigation. Cooperation is important, but only under the guidance of your legal team to avoid jeopardizing your defense.

Protect Your Professional License

Healthcare professionals facing fraud charges may be at risk of losing their medical license. Licensing boards often investigate fraud-related allegations separately from the criminal case, and disciplinary action could occur even before your case is resolved.

Working with an attorney experienced in both healthcare fraud defense and professional license defense can help you develop strategies to protect your career. This may involve presenting mitigating evidence, cooperating with board inquiries, or negotiating settlements to maintain your credentials.

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Get Immediate Help

If you are indicted for healthcare fraud, call our nationwide defense attorneys for immediate help. Call 1.866.601.5518 (toll free).