Health Care Fraud lawyer Falls Church, VA
You open your mail—and it is a target letter from the U.S. Attorney’s Office for the Eastern District of Virginia. Federal agents have already interviewed witnesses. They have subpoenaed billing records and bank statements. You face the possibility of indictment under 18 U.S.C. § 1347, the federal health care fraud statute. In Falls Church and across Northern Virginia, health care fraud investigations move quickly, and the consequences of a conviction can be severe. Mr. Sris and the firm’s Of Counsel attorneys concentrate their federal criminal practice on defending individuals and businesses facing these charges. Reach Law Offices Of SRIS, P.C. at (888) 437-7747 to request a consultation. Law Offices Of SRIS, P.C. – Advocacy Without Borders.
Understanding Health Care Fraud Charges in Falls Church, Virginia
Federal health care fraud, defined at 18 U.S.C. § 1347, makes it a crime to knowingly execute a scheme to defraud any health care benefit program—Medicare, Medicaid, TRICARE, or private insurers—or to obtain money or property from such a program by false or fraudulent pretenses. A conviction can carry up to ten years of imprisonment, and a life sentence is possible if the fraud results in a patient’s death. In the Eastern District of Virginia, which covers Falls Church, these cases are prosecuted by Assistant U.S. Attorneys in Alexandria who routinely work with investigators from the FBI, HHS-OIG, and IRS-Criminal Investigation. Federal conviction rates exceed ninety percent in contested trials, and the United States Sentencing Guidelines drive the sentence calculation. There is no parole in the federal system; a defendant serves at least eighty-five percent of the imposed term.
Because Falls Church sits within the seventeen-square-mile independent city adjacent to Fairfax County, many residents and businesses operate in a landscape dense with government contractors, medical practices, and consulting firms that bill federal programs. A routine audit or a former employee’s qui tam filing under the False Claims Act can escalate into a criminal referral. The U.S. Attorney’s Office for the Eastern District of Virginia is known for moving cases from investigation to indictment quickly. Engaging experienced defense counsel at the earliest sign of an investigation—before charges are filed—can significantly affect the direction of the matter.
How Mr. Sris and the Firm’s Of Counsel Attorneys Defend Federal Health Care Fraud Cases
Defending a health care fraud charge in the Eastern District of Virginia requires an approach tailored to the investigative and charging practices of that district. The firm’s defense work begins with a thorough review of the government’s allegations: analyzing billing data, coding documentation, medical-necessity determinations, and any statements taken during interviews or grand jury proceedings. Mr. Sris and the firm’s Of Counsel attorneys identify factual gaps, challenges to intent, and procedural errors that may lead to a motion to suppress evidence or dismiss charges.
Pretrial strategy focuses on reducing the scope of the indictment before trial. Federal prosecutors often charge multiple counts for what is essentially a single course of conduct, and each count carries its own sentencing exposure. The firm negotiates with the government to limit the number of counts, seek a deferred prosecution agreement where warranted, or present mitigating facts that support a lower offense level under the Sentencing Guidelines. If trial is necessary, the firm prepares to cross-examine government witnesses—auditors, agents, cooperating witnesses—and to present its own expert testimony on billing standards and medical necessity when appropriate. Throughout the process, the client is kept fully informed of the risks and strategic choices.
About Mr. Sris and the Firm’s Of Counsel Attorneys
Mr. Sris, Owner and Founder of Law Offices Of SRIS, P.C., has concentrated his practice on federal criminal defense since 1997. He is admitted in Virginia, Maryland, the District of Columbia, New Jersey, and New York. Mr. Sris testified before the Virginia House Courts of Justice Committee in support of 2019 HB 635 (chief patron Del. David Bulova). His background as a former prosecutor provides firsthand insight into how the U.S. Attorney’s Office builds and presents a federal fraud case.
The firm’s Of Counsel attorneys bring extensive combined legal experience in federal litigation. Support on health care fraud matters includes attorneys who are experienced in complex financial crimes, cross-border investigations, and evidence-intensive trials. Mr. Sris and the firm’s Of Counsel attorneys collaborate closely on every case, ensuring that the defense strategy draws on multiple perspectives while maintaining a single, coherent approach. Results may vary.
Frequently Asked Questions
What is health care fraud under federal law?
Federal health care fraud, codified at 18 U.S.C. § 1347, prohibits knowingly defrauding any health care benefit program or obtaining program funds through false pretenses. The statute covers a broad range of conduct, from billing for services never rendered to falsifying medical records to support a higher reimbursement level. It applies to Medicare, Medicaid, TRICARE, private insurers that receive federal funds, and any other health care benefit program. A conviction can result in a prison sentence of up to ten years, and up to life imprisonment if the fraud results in a patient’s death. The government must prove that the defendant acted with intent to defraud, not merely by mistake or billing error. For guidance on your specific situation, reach Law Offices Of SRIS, P.C. at (888) 437-7747.
What are the potential penalties for health care fraud in Virginia?
Under 18 U.S.C. § 1347, a health care fraud conviction can lead to a sentence of up to ten years of imprisonment, and a fine as provided by statute. If the fraud results in a patient’s death, the maximum sentence increases to life imprisonment. Federal sentencing is governed by the United States Sentencing Guidelines, which calculate a recommended range based on the amount of loss, the defendant’s role in the offense, and any prior criminal history. The court may also order restitution to the defrauded program and forfeiture of assets traceable to the fraud. Because there is no parole in the federal system, a defendant actually serves most of the sentence imposed. To discuss the details of your matter, contact Law Offices Of SRIS, P.C. at (888) 437-7747.
How do federal health care fraud investigations work?
A federal health care fraud investigation usually begins with a referral from a government audit, a qui tam whistleblower suit, or a cooperating witness. The FBI, HHS-OIG, or IRS-Criminal Investigation may issue subpoenas for billing records, interview employees and patients, and execute search warrants on business premises. The U.S. Attorney’s Office for the Eastern District of Virginia, with its proximity to Falls Church, often handles these investigations from an early stage. Targets and subjects of such an investigation are often contacted by agents; it is critical to have counsel present for any interview. The government may present the case to a grand jury, which returns an indictment if it finds probable cause. For a consultation, reach Mr. Sris and the firm’s Of Counsel attorneys at (888) 437-7747.
What defenses are available against health care fraud charges?
Defenses to health care fraud often focus on the absence of intent to defraud—showing that billing errors were mistakes, that medical-necessity judgments were made in good faith, or that the defendant reasonably relied on legal or billing advice. Other viable strategies include challenging the sufficiency of the government’s evidence on particular counts, demonstrating that the alleged scheme was not material to the program’s payment decision, or showing that the defendant was not the person responsible for the challenged conduct. Early factual investigation is crucial to identify documents and witnesses that support the defense narrative. Each case turns on its specific facts, so a detailed review of the government’s allegations is essential.
Should I speak to an attorney if I am under investigation for health care fraud?
Yes. If you are contacted by a federal agent or receive a target letter, you should contact an experienced federal criminal defense attorney before speaking with anyone about the investigation. Anything you say can be used against you in a criminal prosecution, even if you believe you are clarifying an innocent mistake. Agents are not required to tell you the full scope of their investigation, and they may already have evidence you are unaware of. Counsel can communicate with the government on your behalf, begin to preserve exculpatory evidence, and negotiate the terms of any meeting or interview. For guidance on your specific situation, reach Law Offices Of SRIS, P.C. at (888) 437-7747.
For further reading, see our related pages:
Federal Criminal Lawyer Fairfax County |
Federal Criminal Lawyer Fairfax City |
Federal Criminal Lawyer Prince William County
Primary sources:
18 U.S.C. § 1347 – Health care fraud
U.S. District Court for the Eastern District of Virginia
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