What Is Health Care Fraud

Federal Heathcare Fraud Statute 18 USC § 1347

Health Care Fraud

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Healthcare Fraud Charges

The focus of the provisions of 18 USC § 1347 is to provide safeguards in the health care sector. The law provides that any act of fraud involving the health care benefit program shall be punishable. What constitutes a crime under this provision is the commission of the following acts:

  • The use a scheme or acts to defraud the health care sector
  • To obtain any money or property within the custody of the health care benefit program using a false representation or promises, relative to the receipt or delivery of payments of any item, services or benefits.
  • Actual knowledge or specific intent in the commission of the above-mentioned acts need not be proved to constitute as a violation of the law.

Healthcare Fraud Investigations

The primary investigating body involved in the health care fraud investigation is the Federal Bureau of Investigation (FBI). Its jurisdiction in investigating the crime extends to both the federal and private insurance companies. The Internal Revenue Service (IRS) has a criminal investigation department that mainly investigates fraud committed against the federal and state government health insurance programs and may also extend in investigating private insurance companies. The main focus of the IRS investigation, however, is more concerned about health care fraud under 18 USC 1347 in connection to tax fraud and money laundering. The US Attorney’s Office under the Department of Justice may also work in coordination with the FBI in the investigation of health care fraud. In many instances, the Office of the Inspector General (OIG) of the Department of Health and Human Service may also get involved.

Healthcare Fraud Penalties

The provision of the 18 USC § 1347 provides both the civil and criminal penalties for health care fraud as follows:

  • Fine
  • Imprisonment of not more than 10 years
  • Both fine and imprisonment
  • In case bodily injury is involved, the penalty is imprisonment of not more than 20 years
  • In case death results from the commission of the crime, the prison term will be a life sentence

Long-term prison sentence can sometimes be avoided in white collar crimes, such as a health care fraud pursuant to 18 USC § 1347. Wall Street Prison Consultants specializes in helping federal and state offenders to obtain sentence reductions through programs that can help provide alternative solutions to long term incarceration. Our consultation services employ investigative and research processes to assist inmates and their lawyers in finding the best solution and alternatives available to reduce prison terms of an inmate. Discuss possible solutions to your issues today.

Contact Wall Street Prison Consultants at 855-577-4766. We’re here to help!

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