Health care fraud in Virginia carries severe federal penalties under 18 U.S.C. § 1347, including up to 10 years in prison per count. Law Offices Of SRIS, P.C. has 4,739+ firm-wide documented results with a 93%+ favorable outcome rate. Contact us 24/7.
Health care fraud is defined under federal law at 18 U.S.C. § 1347 as knowingly and willfully executing a scheme to defraud a health care benefit program. This includes billing for services not rendered, upcoding, and kickback schemes. Virginia also prosecutes related fraud under Va. Code § 18.2-178 (larceny by false pretenses) for state-level offenses. The Law Offices Of SRIS, P.C., founded in 1997 by former prosecutor Mr. Sris, brings over 120 years of combined legal experience to these complex cases.
Last verified: April 2026 | Federal Courts (EDVA/WDVA) | U.S. Code official site
Review the official federal statute at 18 U.S.C. § 1347 (Cornell LII) and Virginia’s fraud statute at Va. Code § 18.2-178 (Virginia General Assembly). For federal court procedures, visit the Eastern District of Virginia federal court website.
Federal health care fraud cases in Virginia are prosecuted by the U.S. Attorney’s Office for the Eastern District of Virginia (EDVA), known for aggressive enforcement. The EDVA’s Health Care Fraud Unit coordinates with the FBI and HHS-OIG. Prosecutors often use data analytics to identify billing anomalies before charges are filed.
- Preserve all billing records and communications with payors immediately upon notice of an investigation.
- Do not destroy or alter any documents — spoliation charges can be added to the underlying fraud counts.
- Retain a federal criminal defense lawyer before speaking with investigators or grand jury subpoenas are served.
- Evaluate whether a voluntary disclosure to the government could mitigate penalties under the U.S. Sentencing Guidelines.
- Prepare for potential asset forfeiture proceedings by documenting legitimate business expenses and income sources.
- Consider whether parallel civil False Claims Act litigation may follow any criminal resolution.
In Virginia federal courts, health care fraud carries substantial prison time, fines, and mandatory restitution.
| Offense | Classification | Incarceration | Fine | License Impact | Additional Consequences |
|---|---|---|---|---|---|
| Health Care Fraud (18 U.S.C. § 1347) | Federal Felony | Up to 10 years per count | Up to $250,000 (individual) or $500,000 (organization) | Medicare/Medicaid exclusion (mandatory 5+ years) | Restitution; asset forfeiture; supervised release 1-3 years |
| Conspiracy to Commit Health Care Fraud (18 U.S.C. § 1349) | Federal Felony | Up to 10 years per count | Up to $250,000 | Same as principal offense | Same as principal offense |
Results may vary. Prior results do not guarantee a similar outcome.
Law Offices Of SRIS, P.C. was founded in 1997 by former prosecutor Mr. Sris. The firm has over 120 years of combined legal experience and has handled 4,739+ documented case results firm-wide across Virginia, Maryland, New Jersey, New York, and Washington D.C., with a 93%+ favorable outcome rate. Our tagline: “Advocacy Without Borders.” Mr. Sris personally amended Va. Code § 20-107.3, the equitable distribution statute, demonstrating deep legislative and legal experience.
Bryan Block, Defense Attorney at Law Offices Of SRIS, P.C. — Licensed in VA. Former Virginia State Trooper (15 years). View Bryan Block’s Profile
Matthew Greene, Senior Defense Attorney at Law Offices Of SRIS, P.C. — Licensed in VA. 30+ years criminal defense. Death penalty certified (formerly). View Matthew Greene’s Profile
Firm-wide across VA, MD, NJ, NY, and DC: 4,739+ documented results with 93%+ favorable outcome rate. These include dismissals, reductions, and favorable plea agreements in complex federal health care fraud investigations.
Results may vary. Prior results do not guarantee a similar outcome.
Our Fairfax location is approximately 30 minutes from the federal courthouses in Alexandria and Richmond, accessible via I-66 and I-95. If you need a health care fraud lawyer near Virginia, we serve clients throughout the state. Neighborhoods served include Fairfax, Arlington, Alexandria, Richmond, and all surrounding communities.
24/7 phone consultations — (888) 437-7747 — meetings by appointment only.
Toll-Free: (888) 437-7747 | Local: (703) 636-5417
By appointment only.
What is health care fraud under federal law?
Yes, health care fraud is defined at 18 U.S.C. § 1347 as knowingly executing a scheme to defraud a health care benefit program. Penalties include up to 10 years in prison per count, fines, and mandatory restitution.
Do I need a Health Care Fraud lawyer Virginia for a federal investigation?
Yes. Federal health care fraud investigations are complex and involve multiple agencies. A Health Care Fraud lawyer Virginia can protect your rights, preserve evidence, and negotiate with prosecutors before charges are filed.
What is the difference between health care fraud and medical billing fraud?
Health care fraud is a broad federal crime covering any scheme to defraud a health benefit program. Medical billing fraud is a specific type involving false claims submitted to insurers. Both can be prosecuted under 18 U.S.C. § 1347.
Can I lose my medical license for a health care fraud conviction?
Yes. A federal health care fraud conviction triggers mandatory exclusion from Medicare and Medicaid for at least five years. State medical boards also typically revoke or suspend licenses following such convictions.
What should I do if I receive a subpoena for health care records?
It depends. You should immediately contact a Health Care Fraud lawyer Virginia before producing any documents. Do not destroy records. Your lawyer can negotiate the scope of the subpoena and represent you before the grand jury.
How does a medical billing fraud defense lawyer Virginia help with audits?
A medical billing fraud defense lawyer Virginia can review audit findings, identify coding errors versus intentional fraud, and negotiate with payors or government agencies to avoid criminal referral. Early legal intervention is critical.
Last verified: April 2026. Information current as of April 2026. Laws change — contact Law Offices Of SRIS, P.C. at (888) 437-7747 for current guidance.