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Health Care Fraud

The federal government concentrates on detecting and prosecuting health care fraud, mainly Medicare and Medicaid fraud.

The statutory and regulatory scheme creates both civil and criminal sanctions for any person or entity that provides health care goods or services in a fraudulent or abusive manner.

The Medicaid False Claims Statute criminalizes false statements or representations in connection with applying for a claim or benefit under a federal health care program.

The Medicaid Anti-Kickback Statute prohibits knowingly and willfully paying or receiving any form of payment or reward in exchange for prescribing, purchasing, or recommending any service, treatment, or item for which payment will be made by any federally funded health care program.

Health Care Fraud is also prosecuted under the False Claims Act, the False Statements Act, the Social Security Act, and other criminal fraud statutes.