Healthcare fraud allegations are extremely serious. Whether you are a physician, nurse, billing professional, clinic owner, or business executive, accusations of healthcare fraud can destroy your career, your reputation, and your financial future.
Federal prosecutors treat these cases aggressively—and the penalties are severe.
If you are being investigated or have been charged with healthcare fraud in Fort Lauderdale, you need strong legal representation immediately. At Rossen Law Firm, we understand the complexities of healthcare regulations and criminal law.
We are ready to help you protect your rights, your professional license, and your future.
Call (754) 206-6200 today to schedule a confidential consultation with a Fort Lauderdale healthcare fraud attorney you can trust to take your defense seriously.
Why Choose Rossen Law Firm for Healthcare Fraud Defense
Healthcare fraud cases are unlike ordinary criminal cases. They involve detailed billing practices, complex healthcare regulations, administrative rules, and aggressive federal agencies like the Department of Justice and the Office of Inspector General.
At Rossen Law Firm, we have extensive experience dealing with complex white-collar and federal criminal charges. We understand the high stakes involved, including the risk to your professional license, your financial stability, and your freedom.
When you work with us, we take immediate action to:
- Analyze the government's evidence
- Identify weaknesses in the prosecution’s case
- Protect you during investigations and audits
- Negotiate with federal authorities when appropriate
- Prepare a strong and strategic defense for trial if necessary
You need a legal team that understands both the criminal law side and the regulatory landscape of healthcare fraud allegations. We are prepared to guide you through this difficult time and fight for the best possible outcome.
The Serious Consequences of Healthcare Fraud Convictions
Healthcare fraud is prosecuted harshly under both state and federal law.
The penalties for a conviction can be devastating and reach far beyond fines or jail time.
Consequences may include:
- Federal prison sentences of several years or longer
- Criminal fines reaching hundreds of thousands—or millions—of dollars
- Mandatory restitution payments
- Permanent loss of professional licenses or certifications
- Exclusion from participation in Medicare, Medicaid, and other federal programs
- Loss of hospital privileges and employment opportunities
- Severe reputational harm that can follow you permanently
At Rossen Law Firm, we fight to protect not just your freedom, but your livelihood, your career, and your ability to move forward after the case is resolved.
Healthcare Fraud Cases Are Different From Other Criminal Cases
Healthcare fraud cases often involve parallel civil and criminal investigations. You may be facing not only criminal charges but also civil penalties under laws like the False Claims Act.
In some situations, you could be sued by whistleblowers (also known as qui tam relators) who bring claims on behalf of the government.
Government agencies that may be involved include:
- The U.S. Department of Justice (DOJ)
- The Federal Bureau of Investigation (FBI)
- The Office of Inspector General (OIG) for the Department of Health and Human Services
- Centers for Medicare & Medicaid Services (CMS)
These agencies work aggressively to build healthcare fraud cases—and they often conduct lengthy investigations before you even know you are a target.
At Rossen Law Firm, we understand how healthcare fraud cases are built and prosecuted. We know how to intervene early, protect your rights during audits and investigations, and aggressively defend you in court if necessary.
What Is Healthcare Fraud? Common Allegations You May Face
Healthcare fraud covers a wide range of alleged activities where someone is accused of improperly billing government programs or private insurers.
Many cases arise from complex billing errors that prosecutors interpret as intentional fraud.
Some of the most common healthcare fraud allegations include:
- Billing for Services Not Provided: Charging for medical procedures, tests, or services that never actually occurred.
- Upcoding: Billing for more expensive services than were actually provided.
- Unbundling: Separately billing procedures that should be combined at a lower cost.
- Kickbacks: Paying or receiving payments in exchange for patient referrals or the use of specific products and services.
- Prescription Fraud: Overprescribing or fraudulently distributing controlled substances.
- False Cost Reporting: Misrepresenting costs in programs like Medicare or Medicaid.
Healthcare billing systems are incredibly complex, and not every mistake amounts to criminal fraud. We work to distinguish honest errors from intentional misconduct and build a defense based on the specific facts of your case.
Federal vs. State Healthcare Fraud Investigations
Not all healthcare fraud cases are handled the same way.
Depending on the circumstances, you may be facing state charges, federal charges, or both.
State healthcare fraud cases typically involve smaller claims or local billing issues.
Federal healthcare fraud cases often involve:
- Allegations of fraud against federal programs like Medicare, Medicaid, Tricare, or the VA
- Larger financial amounts at issue
- Interstate activities or multiple clinics across different states
- Involvement of federal agencies like the DOJ, FBI, or HHS-OIG
Federal charges bring much harsher penalties, including mandatory prison sentences, higher fines, and more aggressive prosecution strategies.
At Rossen Law Firm, we are prepared to defend you whether your case is being handled by state prosecutors, federal authorities, or both. We build defense strategies tailored to the specific system you are facing.
How Healthcare Fraud Investigations Begin
Healthcare fraud investigations often start long before formal charges are filed.
In many cases, you may not even know you are under investigation until agents show up at your door or you receive a subpoena.
Common triggers for healthcare fraud investigations include:
- Whistleblower lawsuits: Former employees, patients, or business partners file claims under the False Claims Act.
- Insurance company audits: Insurers report suspected fraud to government agencies.
- Government data analytics: Agencies use software to identify unusual billing patterns.
- Patient complaints: Patients who notice unusual billing may report providers to authorities.
- Random compliance audits: Regular government reviews of billing practices uncover potential issues.
Once an investigation starts, prosecutors work quickly to gather documents, interview witnesses, and build a case.
If you are contacted by investigators or receive a subpoena, you should not attempt to handle the situation alone. We can step in immediately to protect your rights and manage your exposure.
Potential Penalties for Healthcare Fraud Convictions
Healthcare fraud penalties are designed to be severe—to deter others from similar conduct. Both criminal and civil penalties can apply, and the consequences can be long-lasting.
Criminal penalties may include:
- Prison time ranging from months to decades, depending on the amount of loss
- Substantial fines, sometimes reaching millions of dollars
- Restitution payments to the government or insurers
- Probation with restrictive conditions
Civil penalties can include:
- Fines under the False Claims Act (up to three times the government’s losses)
- Civil monetary penalties for kickbacks or Stark Law violations
- Permanent exclusion from Medicare and Medicaid programs
- Professional license suspension or revocation
- Loss of hospital privileges and insurance contracts
The financial and professional damage from a healthcare fraud conviction can be greater than the criminal sentence itself. That is why it is essential to act early and build the strongest defense possible.
Common Defense Strategies in Healthcare Fraud Cases
Being accused of healthcare fraud does not mean you are guilty. There are many defenses that can be used to challenge the government’s claims, depending on the facts of your case.
At Rossen Law Firm, we explore every possible strategy to protect your rights, including:
- Lack of Intent: Prosecutors must prove that you intended to defraud. Honest billing mistakes or clerical errors are not criminal acts.
- Insufficient Evidence: We challenge whether the evidence truly shows a pattern of fraud rather than isolated mistakes.
- Compliance Efforts: Demonstrating that you had strong compliance programs in place can help defend against accusations of intentional wrongdoing.
- Witness Credibility Attacks: Many cases rely heavily on testimony from disgruntled former employees or whistleblowers with financial motives. We aggressively cross-examine these witnesses.
- Unconstitutional Investigations: If investigators violated your constitutional rights—such as through unlawful searches or seizures—we move to suppress the resulting evidence.
Every healthcare fraud case is different. We tailor your defense based on the specifics of your billing practices, documentation, communications, and business operations.
False Claims Act Cases and Whistleblower Involvement
Many healthcare fraud cases in South Florida are triggered by whistleblower complaints under the False Claims Act (FCA). The FCA allows private individuals, known as relators, to file lawsuits on behalf of the government and share in any recovery.
If a whistleblower files a complaint and the government decides to intervene, the case can quickly escalate into a major civil—and sometimes criminal—investigation.
Key risks in False Claims Act cases include:
- Treble Damages: The government can seek three times the amount of alleged losses.
- Civil Fines: Additional fines are added for every allegedly false claim submitted.
- Reputational Damage: Even allegations of fraud can hurt your business relationships and standing in the healthcare community.
If you learn that a whistleblower complaint has been filed against you, contacting Rossen Law Firm immediately can help you respond strategically, preserve your rights, and limit your exposure.
The Importance of Early Intervention in Healthcare Fraud Defense
Time matters in healthcare fraud cases. The sooner you involve a defense attorney, the more opportunities you have to shape the outcome of the investigation.
Early intervention allows us to:
- Communicate directly with prosecutors and investigators on your behalf
- Correct misunderstandings before formal charges are filed
- Negotiate for civil resolutions when appropriate, avoiding criminal prosecution
- Protect your professional licenses during administrative investigations
- Prevent costly mistakes that could damage your defense later
If you receive a subpoena, civil investigative demand, target letter, or audit notification, you should not attempt to respond without legal advice. We are ready to guide you through every step of the process and take immediate action to protect you.
How Rossen Law Firm Builds a Strategic Defense Against Healthcare Fraud Allegations
At Rossen Law Firm, we know that healthcare fraud cases require detailed preparation and a proactive defense strategy. We do not wait for the prosecution to dictate the narrative—we take control early.
When you work with us, we:
- Conduct a thorough, independent review of billing practices, claims, and patient records
- Consult with billing experts and forensic accountants when necessary
- Challenge the government’s interpretation of billing codes and regulations
- Identify and attack weaknesses in the evidence
- File strategic pretrial motions to suppress unlawfully obtained evidence
- Negotiate with federal and state prosecutors when appropriate
- Prepare for trial to aggressively defend your innocence when necessary
Healthcare fraud cases are document-intensive and complex. We bring the experience, resources, and strategic thinking necessary to fight for the best outcome possible.
Healthcare Licensing Consequences After Fraud Allegations
Even if you are never convicted of a crime, healthcare fraud allegations alone can trigger devastating consequences for your professional license. State licensing boards, hospital credentialing committees, and insurance providers all take fraud accusations extremely seriously.
Possible licensing consequences include:
- License suspension or revocation by the Florida Department of Health
- Loss of DEA registration needed to prescribe medications
- Termination of hospital privileges
- Being banned from participation in Medicare, Medicaid, and other federal healthcare programs
- Negative reporting to the National Practitioner Data Bank (NPDB)
Licensing investigations often move faster than criminal cases—and the standards of proof are much lower. You can lose your ability to practice even without a criminal conviction.
At Rossen Law Firm, we work not just to defend you in court but also to protect your professional license and livelihood. We coordinate your criminal defense with your administrative defense to give you the best chance of preserving your career.
Protect Your Career, Your Freedom, and Your Reputation
Healthcare fraud allegations strike at every part of your life. Your career, your financial future, and your personal reputation are all at risk. Without a strong legal defense, even an investigation—without a conviction—can cause irreversible damage.
At Rossen Law Firm, we understand the high stakes you are facing. We are ready to step in immediately, defend your rights, protect your professional standing, and fight to resolve your case as favorably as possible.
You have worked too hard to build your career and reputation to let an accusation destroy everything. Taking action now can make all the difference.
Call Rossen Law Firm Today for a Confidential Consultation
If you are being investigated for healthcare fraud—or have already been charged—there is no time to waste. You need a legal team that understands the complexities of healthcare fraud cases and knows how to protect your future.
Call (754) 206-6200 today to schedule a confidential consultation with a Fort Lauderdale healthcare fraud attorney at Rossen Law Firm. We are ready to listen, advise you on your rights, and build a defense strategy designed to protect everything you have worked so hard to achieve.