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Health Care Fraud

We have a proven track record of success in handling over 15,000 criminal cases and consistently awarded as one of Ohio’s top criminal defense firms. We are highly experienced health care fraud lawyers. Experience matters when dealing with these cases, which prosecutors and judges handle differently on a case by case basis. We know what to expect and what to do to get the best result possible.

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Columbus Health Care Fraud Attorney

Health Care Fraud Lawyers in Columbus Assisting Health Providers and Practices Facing Criminal Charges

The State of Ohio is made up of a large number of individuals who depend on government programs for federal health care benefits. Given this group of dependent individuals, the Medicare Fraud Strike Force directly monitors the State of Ohio. The Strike Force is composed of various components, including teams of investigators and prosecutors who represent several federal agencies. Those agencies include the Department of Health and Human Services, the Department of Justice, the Federal Bureau of Investigation, and the Office of the Inspector General.

Due to the people who regularly depend on public programs for health care, the Strike Force carefully watches the claims that individuals file in the Columbus area to ensure that false claims are not being paid out. The Strike Force then has the authority to investigate these claims and to prosecute individuals, companies, and other entities that allegedly commit health care fraud.

If you, your organization, or your company has been charged with committing health care fraud, it is essential that you have an experienced legal team on your side during your entire criminal case. The Columbus health care fraud attorneys at Joslyn Law Firm are ready to represent you throughout every stage of your criminal case and help you pursue the best result available in your circumstances. Please give us a call today at 614-444-1900 or contact us online to learn more about how we could assist you with defending against your criminal health care fraud charge.

Overview of Health Care Fraud in OH


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What is Health Care Fraud in Columbus?

Health care fraud occurs when an individual or company intentionally provides false information to wrongfully receive healthcare benefits. Medicaid fraud is a state offense, while federal law covers fraud against Tricare, Medicare, federal workers compensation, or some other health care program that is administered by and through the federal government. In order to be charged with and/or convicted of federal health care fraud in Ohio, you must have done one or more of the following:

  • Violated the Stark Law The Stark Law is also sometimes called the Self-Referral Law. This federal statute prevents doctors (as well as individuals who are immediate family members of a doctor) from sending one or more of their patients, via referral, to a health care service, in cases where the doctor has an investment interest – or an ownership interest – in that entity. The same holds true if the doctor and the entity have some sort of compensation arrangement in place.
  • Violated the Anti-Kickback Statute Under federal law, healthcare providers are strictly prohibited from obtaining some sort of financial kickback, stipend, or fee, in exchange for a patient referral. This law applies not only to doctors, but also to business owners and marketing representatives.
  • Engaged in Prescription Fraud When a doctor and/or a health care practice issues an unusually high number of narcotic prescriptions (i.e., running a “pill mill”), the federal government can begin to investigate the doctor and his or her medical practice for insurance fraud.
  • Violated the Medicare False Claims Act Submitting a false or inaccurate claim to a health care program that is run by the federal government, such as Medicare, can cause the government to begin a formal investigation into a medical office’s billing practices.
  • Engaged in Billing Fraud The federal government is especially vigilant when it comes to investigating billing practices that involve “upcoding” – or utilizing a code that is billed higher than the code for the service that was actually performed. The government also regularly investigates practices that bill for ghost patients – or patients who do not actually exist – as well as instances of phantom billing (or billing for one or more services that were not actually provided). The government also investigates instances in which a medical provider or practice bills for medical services or equipment that were not actually necessary to provide the patient with medical treatment.
  • Errors in Certification The federal government has the authority to investigate instances of fraudulent certification for home hospice care and other types of home health services.

No matter what law you are accused of violating, you should speak with a Columbus health care fraud lawyer as soon as possible.


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Will I Go to Jail for a Health Care Fraud Conviction?

Health care fraud can result in serious penalties, including possible jail time, depending largely on the circumstances that are involved. If you are charged under Ohio law, you could face the following charges and jail time:

  • If the fraud is worth $1,000 to $7,500 = Fifth-degree felony charges and up to 12 months in jail
  • If the fraud is worth $7,500 to $150,000 = Fourth-degree felony charges and up to 18 months in prison
  • If the fraud is worth more than $150,000 = Third-degree felony charges and up to five years in prison

Federal charges can result in more severe penalties according to the federal sentencing guidelines, which includes possible time in federal prison.

If you are sued civilly and a civil penalty is imposed, you might have to repay the claim, or a federal health care program could elect to exclude you or your business. The Ohio Medical Board can also call you to testify, and as a result, you may lose your license to practice medicine or your hospital privileges at one or more medical facilities. 


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Our Columbus Health Care Fraud Attorneys Can Defend Against Your Charges

In order for the federal government to obtain a criminal conviction against you for federal health care fraud, it has a high legal burden to overcome. Specifically, the government has the burden of demonstrating beyond a reasonable doubt that you intended to commit health care fraud. With the constantly changing health care laws in the industry, mistakes and human error – rather than a specific intent to defraud the federal government – can account for many instances of alleged health care fraud.

Even though mistakes need to be corrected promptly, mistakes are not criminal in nature and should not be deemed as such. If you or your business are facing health care fraud charges, an experienced Columbus health care fraud attorney can review your circumstances and help you come up with one or more legal defenses that you could argue in court.


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Speak with a Columbus Health Care Fraud Lawyer Today

If you or your practice is facing a criminal charge for health care fraud, the experienced white collar legal team at Joslyn Law Firm is ready to help in all Central Ohio Counties including, Union County, Delaware County, Licking County, Fairfield County, Pickaway County, Madison County, and Franklin County Ohio. To schedule a free case evaluation and legal consultation with a Columbus health care fraud attorney, please call us at 614-444-1900 to learn more about how we could assist you with your legal defense.


  • Brian Joslyn was named Best Lawyer in 2019 by Birdeye.
  • Columbus CEO magazine has yearly selections for the best attorneys in Columbus Ohio. Brian Joslyn has been identified as one of the most highly skilled attorneys across central Ohio.
  • Brian Joslyn has earned recognition for community leadership by Lawyer LegionLawyer Legion
  • Preeminent Attorney Award. Peer rated for highest level of professional exellence.
  • The Better Business Bureau (BBB), founded in 1912, is a private, nonprofit organization whose self-described mission is to focus on advancing marketplace trust.

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