Massachusetts federal healthcare fraud lawyer

Federal health care fraud can take many forms, including submitting false or inaccurate Medicare claims, billing for services that were never provided, billing for nonexistent patients, upcoding services to receive higher reimbursements, billing for medically unnecessary services or equipment, prescription fraud, improper physician self-referrals, and paying or receiving kickbacks for patient referrals. Federal investigations may therefore focus heavily on billing practices, medical records, financial records, claims, emails, text messages, tax documents, and other communications that could show whether fraudulent activity occurred.

Federal health care fraud charges in Massachusetts can carry serious criminal, financial, and professional consequences, including federal prison time, substantial fines, repayment obligations, exclusion from federal health care programs, and potential effects on a provider’s medical license or hospital privileges. An important element in a criminal federal health care fraud case is intent: the government must prove beyond a reasonable doubt that the defendant intended to commit fraud. As a result, defenses discussed on the page include lack of intent, insufficient evidence, entrapment, consent, and mistaken identity, with mistakes or human error potentially distinguished from intentional fraudulent conduct.

Where federal health care fraud charges are prosecuted in Massachusetts

Federal healthcare fraud crimes in Massachusetts are prosecuted in the federal court system through the U.S. District Court for the District of Massachusetts. Boston is a major court location for the District of Massachusetts, which has jurisdiction over federal cases arising throughout the state. The District of Massachusetts falls within the jurisdiction of the U.S. Court of Appeals for the First Circuit. The specific court location where a federal healthcare fraud case is prosecuted generally depends on where the alleged criminal conduct occurred and the division responsible for that area.