Tampa Medicare Fraud Defense: Federal Criminal Cases
A federal healthcare fraud case is three cases at once. The criminal case decides your liberty. The civil and administrative cases decide whether your business, your license and your ability to bill Medicare survive it. If you are a physician, nurse practitioner, pharmacist or healthcare business owner in Tampa Bay facing a target letter or federal charges, you need Tampa Medicare fraud defense that plans for all three.
The Health Law Offices of Anthony C. Vitale, now practicing as Vitale, Suarez & Associates, P.A., is a Florida healthcare law firm founded in 1982. Its office is in Miami Lakes, and it represents clients throughout Florida, including the Tampa Bay area.
The Charges
Federal healthcare fraud cases in the Tampa Bay area are prosecuted by the U.S. Attorney’s Office for the Middle District of Florida. The most common charges are health care fraud (18 U.S.C. § 1347), conspiracy (18 U.S.C. § 1349), violations of the Anti-Kickback Statute (42 U.S.C. § 1320a-7b(b)), false statements relating to health care matters (18 U.S.C. § 1035) and, for laboratories and recovery businesses, EKRA (18 U.S.C. § 220). Many indictments add wire fraud or money laundering counts.
Decisions That Shape the Case
- Whether to speak with agents. An interview without counsel is rarely in your interest, even when you believe you did nothing wrong.
- Whether to meet with prosecutors before an indictment. A proffer agreement limits, but does not eliminate, how your statements can be used. It is a strategic decision, not a courtesy.
- Whether to cooperate. Cooperation can change the outcome. It also has costs, and it cannot be undone.
- Whether to plead or go to trial. The loss amount drives much of the sentencing guidelines calculation, and how that amount is measured is often contested.
Each of these decisions closes some options and opens others. By the time an indictment is filed, several have already been made.
Parallel Proceedings
The criminal case rarely moves alone:
- Payment suspension. Medicare can suspend payments on a credible allegation of fraud before any conviction (42 C.F.R. § 405.371).
- Civil False Claims Act liability, with damages and per-claim penalties.
- Exclusion from federal healthcare programs, which is mandatory after a conviction for a program-related offense (42 U.S.C. § 1320a-7).
- Licensure. Florida law requires the Department of Health to act quickly against the license of a practitioner convicted of, or who pleads to, certain healthcare fraud offenses (section 456.074, Florida Statutes).
- Forfeiture of property traceable to a federal healthcare offense (18 U.S.C. § 982(a)(7)).
A plea that resolves the criminal case can trigger several of these at once. The defense strategy has to see them coming.
Protecting the Business During the Case
- Preserve documents and stop routine deletion
- Understand that employees who receive subpoenas may need their own counsel, and never tell an employee what to say
- Decide, with counsel, whether and how the business continues to bill
- Correct compliance problems going forward, since remediation may be considered later
30+ Years of Expertise in Healthcare Law and Compliance
Strategic Legal Solutions for Healthcare Providers
The Firm's Litigation Team
Reynaldo T. Acosta heads the firm’s litigation practice. Founder Anthony C. Vitale, now Of Counsel, served as an Assistant State Attorney and Special Prosecutor in Miami-Dade County. Louis V. Martinez served as a Special Assistant United States Attorney and as Deputy Chief Assistant Attorney General for Florida’s Medicaid Fraud Unit. The firm’s in-house IT and forensic investigations team works with the electronic discovery that healthcare cases produce. The firm’s attorneys work with clients in English and Spanish.
Frequently Asked Questions
What is a proffer?
A meeting with prosecutors, under a written agreement, in which you answer questions about the case. The agreement limits how your statements can be used, but it does not make the meeting risk-free.
Can Medicare suspend my payments before I am convicted?
Yes. A payment suspension can be based on a credible allegation of fraud and does not require charges or a conviction.
An employee received a grand jury subpoena. What should I do?
Preserve the documents, speak with counsel and do not discuss the employee’s testimony with them. The employee may need separate counsel.
Does the firm have an office in Tampa?
The firm’s office is in Miami Lakes. It represents clients throughout Florida, including the Tampa Bay area.
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.