18 U.S.C. § 1347 – Health care fraud
This law makes it a federal crime to defraud a health care program or to try to get money from one through false claims or promises.
Section 1347 applies to any scheme to cheat a health care benefit program, including Medicare, Medicaid, or private insurance. A person can be charged even if the fraud does not succeed or even if they did not know the exact statute they were violating.
What the law prohibits.
A person violates this statute if they knowingly do any of the following:
- Carry out or attempt a plan to defraud any health care benefit program.
- Use lies or false promises to obtain money or property from a health care program.
- Submit or help submit false claims connected to medical care, services, or payments.
- Try to obtain reimbursement for services not actually provided or falsely described.
Penalties.
Violations of § 1347 are federal felonies. Punishments can include:
- up to 10 years in federal prison,
- up to 20 years if the fraud causes serious bodily injury,
- up to life in prison if the fraud results in death,
- fines and restitution, and
- other sanctions such as exclusion from federal health programs.
No special intent required.
A person does not need to know this exact law or intend to violate this specific statute to be convicted. It is enough that they knowingly carried out the fraudulent conduct.
If you’re being investigated for federal health care fraud, call (314) 900-HELP or contact our criminal defense attorneys for legal support.
