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.
What Is Health Care Fraud Under Federal Law?
Health care fraud is defined under 18 U.S.C. § 1347 as knowingly and willfully executing a scheme to defraud any health care benefit program. This includes private insurance plans, Medicare, and Medicaid. The statute prohibits false billing, upcoding, billing for services not rendered, and kickback schemes. A conviction requires proof of intent to defraud. The government must show you acted with specific intent to deceive a health care program for financial gain. Federal prosecutors in Virginia, particularly in the Eastern District of Virginia (EDVA), aggressively pursue these cases.
Last verified: April 2026 | Federal Courts (EDVA/WDVA) | 18 U.S.C. § 1347 (official U.S. Code)
For more information, review the 18 U.S.C. § 1347 health care fraud statute (official U.S. Code) and the U.S. District Court for the Eastern District of Virginia (official court website).
Insider Procedural Edge: How Federal Health Care Fraud Cases Move in Virginia
Federal health care fraud cases in Virginia typically begin with a grand jury subpoena or a search warrant. The government often uses data analytics to identify billing patterns. You may not know you are under investigation until agents arrive.
- Step 1: Receive a subpoena, search warrant, or target letter from federal agents (FBI, HHS-OIG, or DCIS).
- Step 2: Do not speak to agents without counsel. Assert your right to remain silent and request a lawyer.
- Step 3: Contact a Health Care Fraud lawyer Virginia immediately to preserve documents and respond strategically.
- Step 4: Your attorney will conduct a parallel investigation, identify defenses, and negotiate with the U.S. Attorney’s Office.
- Step 5: If charges are filed, your case proceeds in U.S. District Court (EDVA or WDVA) with arraignment, discovery, motions, and trial.
In Virginia, health care fraud carries substantial federal penalties including prison time, fines, and exclusion from federal health programs.
| 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 (or twice the loss/gain) | Medicare/Medicaid exclusion (mandatory 5+ years) | Restitution, forfeiture, supervised release up to 3 years |
| False Claims (31 U.S.C. § 3729) | Federal Civil/Qui Tam | N/A (civil) | $5,500-$11,000 per claim + treble damages | Program exclusion | Whistleblower lawsuits, reputational harm |
| Kickbacks (42 U.S.C. § 1320a-7b) | Federal Felony | Up to 5 years per count | Up to $25,000 per violation | Mandatory exclusion | Civil monetary penalties up to $50,000 per violation |
Results may vary. Prior results do not guarantee a similar outcome.
Why Choose Law Offices Of SRIS, P.C. for Your Health Care Fraud Defense?
Founded in 1997 by former prosecutor Mr. Sris, Law Offices Of SRIS, P.C. brings over 120 years of combined legal experience to every case. Our firm has handled 4,739+ documented case results with a 93%+ favorable outcome rate firm-wide across Virginia, Maryland, New Jersey, New York, and Washington D.C. Mr. Sris personally amended Va. Code § 20-107.3 (equitable distribution statute), demonstrating his deep understanding of complex statutory schemes. Our team includes former prosecutors who understand how the government builds health care fraud cases.
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
Case Results
Law Offices Of SRIS, P.C. has achieved 4,739+ documented case results firm-wide across VA, MD, NJ, NY, and DC with a 93%+ favorable outcome rate. Our team has experience defending health care professionals, providers, and organizations against federal fraud allegations.
Results may vary. Prior results do not guarantee a similar outcome.
Our Virginia Location Serving Health Care Fraud Clients
Our Fairfax location is centrally located near the U.S. District Court for the Eastern District of Virginia, accessible via I-66 and the Capital Beltway (I-495).
Looking for a Health Care Fraud lawyer Virginia near Fairfax, Arlington, or Alexandria? We serve clients throughout Northern Virginia and the entire state.
Neighborhoods served: Fairfax, Arlington, Reston, Herndon, McLean, Vienna, Tysons, Centreville, Chantilly, Burke, Springfield, Annandale, Falls Church, Manassas, Woodbridge, Leesburg, Ashburn, Warrenton, Stafford, Fredericksburg.
24/7 phone consultations — (888) 437-7747 — meetings by appointment only.
Toll-Free: (888) 437-7747 | Local: (804)201-9009
By appointment only.
Frequently Asked Questions About Health Care Fraud in Virginia
Do I need a Health Care Fraud lawyer Virginia if I receive a subpoena?
Yes. A subpoena often means you are a target. Contact a Health Care Fraud lawyer Virginia immediately before speaking to agents or producing documents.
Can I go to prison for health care fraud in Virginia?
Yes. Health care fraud under 18 U.S.C. § 1347 carries up to 10 years in federal prison per count. Sentences often run consecutively, skilled to decades of incarceration.
What is the difference between civil and criminal health care fraud?
Civil fraud (False Claims Act) involves financial penalties and exclusion from federal programs. Criminal fraud requires proof of intent beyond a reasonable doubt and carries prison time. Both can arise from the same conduct.
How do federal prosecutors build health care fraud cases in Virginia?
Prosecutors use data analytics to identify billing anomalies, patient complaints, whistleblower tips, and undercover operations. The FBI, HHS-OIG, and DCIS frequently collaborate on investigations in EDVA.
Can I lose my medical license for a health care fraud conviction?
Yes. A federal health care fraud conviction typically results in mandatory exclusion from Medicare/Medicaid for at least five years. State medical boards also impose license suspension or revocation.
What should I do if federal agents show up at my practice?
Remain calm. Do not consent to a search without a warrant. Do not answer questions without your attorney present. Ask for their business cards and contact a Health Care Fraud lawyer Virginia immediately.
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.