Medicare Criminal Defense in Miami
A target letter is not an accusation you can answer later. It means federal prosecutors believe they have evidence linking you to a crime, and the decisions made in the following weeks often shape the rest of the case. If you are a physician, owner or manager of a healthcare business in South Florida and you have received a target letter, a grand jury subpoena or a visit from federal agents, you need Medicare criminal defense counsel before you speak with anyone about it.
The Health Law Offices of Anthony C. Vitale, now practicing as Vitale, Suarez & Associates, P.A., has defended healthcare providers in Florida from its office in Miami Lakes since 1982.
Federal Charges Medicare Providers Face
- Health care fraud (18 U.S.C. § 1347) and conspiracy to commit it (18 U.S.C. § 1349)
- Violations of the federal Anti-Kickback Statute (42 U.S.C. § 1320a-7b(b))
- False statements relating to health care matters (18 U.S.C. § 1035)
- Eliminating Kickbacks in Recovery Act (EKRA) violations involving laboratories and recovery homes (18 U.S.C. § 220)
- Related charges such as wire fraud, money laundering and aggravated identity theft
Florida Charges Involving Medicaid
When Medicaid claims are involved, the Florida Attorney General’s Medicaid Fraud Control Unit can bring state charges, including Medicaid provider fraud under section 409.920, Florida Statutes, and patient brokering under section 817.505. Florida law and federal law are not interchangeable, and the difference can decide which charges can stand.
How a Federal Healthcare Fraud Case Moves
- Investigation. Agents from HHS-OIG and the FBI review claims data, interview employees and collect records, often for months before anyone is told.
- Target letter or grand jury subpoena. The case becomes visible. This is the last stage where counsel can address prosecutors before a charging decision.
- Indictment and arraignment.
- Discovery. Healthcare cases often involve millions of claim lines and electronic records.
- 5. Motions, plea negotiations or trial.
- Sentencing, where the loss amount drives much of the guidelines calculation.
By the time an indictment is filed, the government has built its theory. The time to challenge it is before.
Strategic Legal Solutions for Healthcare Providers
Consequences Beyond the Criminal Case
A conviction for a program-related offense leads to mandatory exclusion from Medicare, Medicaid and other federal healthcare programs for at least five years (42 U.S.C. § 1320a-7). It can also trigger discipline against a professional license by the Florida Department of Health, action against a DEA registration and parallel civil liability under the False Claims Act. A criminal defense strategy has to account for all of them.
The Firm's Litigation Team
- Reynaldo T. Acosta heads the firm's litigation practice.
- Anthony C. Vitale, the firm's founder and now Of Counsel, served as an Assistant State Attorney in Miami-Dade County from 1978 to 1981 and as a Special Prosecutor in the same office from 1981 to 1982. He argued State v. Harden, in which the Florida Supreme Court in 2006 struck down the anti-kickback provision of Florida's Medicaid provider fraud statute. The charges were dismissed against all defendants, including three dentists.
- Louis V. Martinez served as Deputy Chief Assistant Attorney General for Florida's Medicaid Fraud Unit and as a Special Assistant United States Attorney for the Southern District of Florida.
- Peter Suarez, the firm's President, played an integral role in a three-week federal trial involving a physician charged with conspiracy to unlawfully dispense and distribute controlled substances.
- In-house IT and forensic investigations. The firm's own team works with electronic discovery and EHR data, which in healthcare cases is often where the defense is found.
The firm’s attorneys work with clients in English and Spanish.
Serving Clients in the Southern District of Florida
The firm’s office is in Miami Lakes, in Miami-Dade County. Federal healthcare fraud cases in Miami-Dade, Broward and Palm Beach counties are prosecuted by the U.S. Attorney’s Office for the Southern District of Florida.
Frequently Asked Questions
I received a target letter. Should I call the prosecutor?
Not yourself. Anything you say can be used in the case. Counsel can contact the prosecutor, learn what the government believes and decide whether a meeting serves you.
Can a Medicare billing problem become a criminal case?
Yes, when the government believes the false claims were submitted knowingly and willfully. The difference between an error and a crime is intent, and intent is argued from your documents.
Will a conviction affect my license and my ability to bill Medicare?
Usually, yes. Mandatory exclusion and licensing action often follow a conviction, which is why they have to be part of the strategy from the start.
Does the firm handle state Medicaid fraud charges?
Yes. The firm defends providers facing Medicare and Medicaid fraud charges in federal and Florida courts.
The owner of a Tampa, Florida-area medical marketing company was sentenced to 70 months in prison today for his role in a $2.2 million Medicare fraud scheme involving the payment of kickbacks and bribes to fraudulent medical clinics in Miami in exchange for the referral of Medicare beneficiaries for expensive genetic tests that were medically unnecessary, and for his role in the illegal structuring of cash withdrawal transactions.
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Maria Chapa Lopez of the Middle District of Florida, Special Agent in Charge Michael McPherson of the FBI’s Tampa Field Office and Assistant Inspector General Omar Perez of the U.S. Department of Health and Human Services Office of the Inspector General’s (HHS-OIG) Miami Regional Office made the announcement.