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How Do Healthcare Fraud Investigations Usually Start?

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In these investigations, there are often informants who decide to give the government information about fraudulent billing. Sometimes these people are whistleblowers. They may work inside the company, believe something illegal is happening, want it to stop, and do not want to be involved in the wrongdoing.

They may secretly give this information to the government, which can start an investigation. A federal health care fraud case can be complex and stressful. If you receive a notice that you are under investigation, you should speak with an experienced federal health care fraud attorney as soon as possible.

How Do Healthcare Fraud Investigations Begin?

female police officer on laptop taking notes

Health care fraud investigations can start in different ways, but they almost always involve a large amount of paperwork and records. In many cases, the government may take computers, laptops, phones, and other devices. They may copy the data on those devices and review the files to look for evidence to support their case.

In many cases, the government carries out a search warrant. For example, the FBI may come to a doctor’s office and go through medical records. This is often a sign that a serious investigation is underway.

Letters of Notice

Another way someone may learn about the investigation is by receiving a target letter from the United States Attorney’s Office. This letter says that the person is a subject or target of a criminal investigation. It usually explains that a grand jury investigation has started and outlines some of the person’s legal rights.

These are common ways people learn they are under federal investigation for health care fraud, and what they might expect during the process. If these steps have happened, it is possible that the person may later be arrested and formally charged.

Will I Be Released Before Trial?

A judge may let someone stay out of jail while they wait for their trial in many cases of healthcare fraud and other financial crimes. The judge will look at a number of things, though, including how big the alleged scheme was, how much damage it did, how many people were affected, whether anyone died, and whether the person has a criminal record. All of these things can impact whether or not the person is let go and what rules will apply.

When someone is charged with a health care crime, there are many important decisions to make. It is very important to work with a strong federal health care fraud attorney who understands the system.

Mistakes Commonly Made at the Start of an Investigation

One of the biggest mistakes a person can make after being charged with health care fraud is thinking they can explain everything to a federal agent and make the problem go away. In many cases, federal agents may come to a person’s home or business with a search warrant to gather evidence.

Sometimes agents try to question a person during a search, when the person may feel confused or scared. They may ask the person to agree to an interview.

If agents are carrying out a search warrant at your home, you do not have to answer their questions. The safest choice is to stay calm, be polite, and say that you want to speak with a lawyer before answering anything.

Many people think that if they just tell the truth, the situation will work itself out. But by that point, agents are often trying to build a case. They may look for statements that can be used against the person. Sometimes interviews are not recorded, which can lead to disputes about what was said.

For that reason, it is usually best to stay quiet and ask to speak with a lawyer before answering any questions.

Another common mistake is thinking that if you have nothing to hide, you should go ahead and share information. In most cases, that does not help. Anything you say can be used against you, even if you believe you did nothing wrong.

The safest choice is to stay quiet and, as always, contact a lawyer right away.

Consult a Federal Healthcare Fraud Attorney

A federal health care fraud case can feel very overwhelming, especially if you don’t have a lawyer. If you have been charged, it is important to understand what may happen next and what steps you should take.

The most important step is to contact an experienced federal health care fraud attorney from Aaron L. Wiley Law, P.C.as soon as possible. To schedule a legal consultation, call us at (254) 566-3860 or fill out the short contact form on our website.

Ready to Talk?

Whether you’ve received a target letter, are under investigation, or just need answers—I’m here to help. Let’s talk through your next steps.