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Medicare Fraud and Embezzlement

When federal prosecutors have charged you with Medicare fraud or embezzlement, turn to an experienced criminal defense lawyer to discuss your legal options for resolving your charges. Don’t leave the outcome of your charges to chance. Contact SMT Legal for a free initial case evaluation to learn how our team will fight to protect your rights, reputation, and future from the potential consequences of an arrest or conviction for Medicare offenses.

Why Choose a Criminal Defense Attorney from SMT Legal?

Federal charges for Medicare fraud and embezzlement can have long-lasting consequences, as federal criminal law imposes harsh penalties for convictions. As a result, hiring experienced legal representation can make a difference in the outcome of your criminal case. For years, clients facing federal prosecution have trusted the attorneys from SMT Legal to help them seek favorable resolutions to charges because:

  • Our attorneys have decades of combined legal experience representing clients facing federal charges in complex cases.
  • Our firm works tirelessly to evaluate your legal options and prepare a comprehensive strategy that gives you the best chance to obtain a positive outcome for your criminal case.
  • We treat your criminal case with the same importance it has for you, doing everything we can to fight for your rights and interests.
  • Our team leaves no stone unturned when investigating and pursuing available defenses in your Medicare fraud case.

Understanding Medicare Fraud and Embezzlement Laws

Under federal law, a person may commit Medicare fraud by violating the health care fraud statute. This statute makes it a crime for a person to knowingly and willfully execute or attempt to execute a scheme to:

  • Defraud any health care benefit program (such as Medicare)
  • Obtain by false or fraudulent pretenses, reputations, or promises any money or property owned by or under the custody or control of any health care benefit program

A person who violates the statute must execute the scheme in connection with the delivery of or payment for health care benefits, items, and services. The statute clarifies that a violation can occur without a person knowing the health care fraud law or having the specific intent to violate the statute.

Furthermore, federal law makes it a crime for a person to embezzle, steal, or knowingly convert, or without authority sell, convey, or dispose of any money or thing of value belonging to the U.S. government or any property made under contract for the federal government. A person also commits embezzlement by receiving, concealing, or retaining U.S. money or property, knowing another party had embezzled or stolen it with the intent to convert it to their gain or use.

Penalties for Medicare Fraud and Embezzlement

A person convicted of Medicare fraud or embezzlement may face various penalties following a conviction. For example, a conviction for health care fraud carries penalties of up to ten years in federal prison plus potential fines; however, if an offense results in severe injury to another person, the maximum prison term increases to 20 years, and if the offense results in a death, the maximum term increases to life imprisonment.

A conviction under the federal embezzlement statute may impose a sentence that includes up to ten years in prison plus potential fines; however, if the offense involved the embezzlement of less than $1,000 of public money or property, a defendant may face up to one year in prison.

Courts may also order a convicted defendant to reimburse the government for unrecovered funds or property taken from the Medicare program as part of the defendant’s crime.

Convictions for Medicare fraud or embezzlement can have other long-term consequences beyond a prison term or fines. First, a conviction may result in a defendant’s disqualification from future participation in the Medicare program, including as a healthcare provider or another party that submits reimbursement claims to Medicare. Medicare fraud convictions can also disqualify individuals from other government benefits/services or professional licenses.

Finally, a conviction will result in a person having a criminal record. A record with a Medicare fraud or embezzlement conviction can make pursuing employment, educational, or housing opportunities challenging due to the stigma of having committed an offense involving dishonesty or theft.

The various penalties and consequences that may arise from a Medicare fraud or embezzlement convictions make having legal advocacy critical to protecting one’s rights and interests.

Defenses to Medicare Fraud and Embezzlement Charges

A person facing charges of Medicare fraud or embezzlement may pursue various defense strategies based on the facts and evidence in the case. Defense strategies seek to prove that the government’s case has insufficient evidence to prove each element of the charged statute beyond a reasonable doubt. Common defenses raised against Medicare fraud/embezzlement charges include:

  • Lack of intent: A defendant may assert that the prosecution’s case fails to prove beyond a reasonable doubt that the defendant acted knowingly, willfully, or with the intent to defraud Medicare or embezzle U.S. government funds or property.
  • Mistake of fact: Defendants facing Medicare fraud or embezzlement charges may assert that they acted in good faith under a mistake of fact and thus did not intend to defraud Medicare or embezzle government funds or property.
  • Reliance on professional advice: A defendant may deny having the intent to commit the charged offense by asserting that they acted under the advice of professionals, such as lawyers, accountants, or billing services, regarding the legality and accuracy of their conduct.
  • Statute of limitations: In most cases, the government must file charges within five years of the date that the alleged Medicare fraud occurred. However, specific circumstances can alter the deadline by which federal prosecutors must file criminal charges against a defendant.
  • Calculation of loss: The amount of money or property involved in a Medicare fraud/embezzlement case may affect the potential penalties a defendant may face if convicted.
  • Unlawfully obtained evidence/statements: A defendant may file motions to exclude evidence from the government’s case by arguing that federal investigators obtained the evidence through unlawful searches or other acts that violated the defendant’s rights.

How Can an Attorney Help You Face Your Charges?

When facing federal Medicare fraud/embezzlement charges, you don’t have to stand up to the criminal justice system alone. A criminal defense attorney from SMT Legal can help you resolve Medicare fraud or embezzlement charges by:

  • Independently investigating your charges to ensure you have all available evidence, including evidence not uncovered by federal investigators and prosecutors, to help you and our team build a compelling defense
  • Reviewing the facts of your case to identify potential defenses you might pursue
  • Explaining your charges and discussing the possible outcomes of your case to help you make informed decisions for your interests and future
  • Aggressively challenging the government’s case at each step, including by filing motions to exclude irrelevant or unlawfully obtained evidence
  • Vigorously pursuing the best possible resolution to your charges, even if that means going to trial to fight the case or maintain your innocence

Contact Our Firm Today to Discuss Your Legal Options

After federal officials have arrested and charged you with Medicare fraud or embezzlement, you need experienced legal guidance to protect your rights and interests. Contact SMT Legal today for a free, confidential consultation with a white-collar crimes defense attorney to discuss your options for seeking a favorable resolution to your case.

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