FEDERAL FRAUD CRIMES
Federal law defines fraud as any intentional deception or misrepresentation used to benefit yourself or someone else. The United States Attorney's; Office penalizes various kinds of fraud specifically identified under federal laws. These laws identify specific types of fraud crimes, each of which has specific penalties associated with them. The following crimes is by no means exhaustive. Common Federal Fraud Crimes include:
Health Care (Medicare) Fraud
Securities Fraud & Ponzi Schemes
Mail & Wire Fraud
Health care fraud
It's not ''take an aspirin and call me in the morning & anymore Federal Healthcare Fraud involves many entities such as medical offices, hospitals, diagnostic facilities (IDTF’s), laboratories, medical supply companies, pharmacies, home health care agencies and adult day care facilities.
These violations involve performing medical procedures that are not medically necessary for that particular patient, not performing certain procedures ― but actually billing for them as if they were performed (commonly known as phantom billing), overcharging for certain medical care, providing medical supplies to patients that do not need them, paying kickbacks to entities that refer each other business in the medical field, submitting false claims to the Medicare program and to private insurance carriers, paying patients to undergo unnecessary procedures, pretending to, but not actually offering proper medical care, ownership by non-doctors of medical facilities such as medical offices, well as
many other such violations.
Here are some present-day examples:
In January 2017, a neurosurgeon in Michigan named Aria Sabit was sentenced to nearly 20 years in prison for giving patients unnecessary spinal surgeries solely to boost his own profits. He defrauded $2.8 million from healthcare programs, including Medicare and Medicaid.
Healthcare companies sometimes develop an excessive focus on boosting profits and end up breaking the law. Though all hospitals need patients in order to continue operating, it is illegal to pay for patient referrals while enrolled while enrolled with public healthcare programs. In 2016, for example, Tenet Healthcare paid over $500 million to settle allegations that it bribed prenatal clinics to refer Medicaid patients to Tenet hospitals ― even if the nearest branch was very far from where the expectant mothers lived. Tenet raked in over $145 million from Federal healthcare programs from this kickback scheme.
Compounded medicines are an important option for patients with unique treatment needs or difficulty taking standard forms of medication. Many pharmacies that offer these types of prescriptions have been known, however, to orchestrate large-scale fraud schemes. A California pharmacy was recently accused of a compounding scheme, after bribing doctors to write $3,000
prescriptions for pain creams, when the patients’ needs could have been met with $20 prescriptions. Since Medicare and Medicaid are publicly funded, it is illegal to deliberately overcharge the Government for any treatment, including pharmaceutical products.
The Sentencing Guidelines and Health Care Fraud
In Federal Medicare cases, a defendant's prospective sentence is determined, for the most part, by the alleged dollar value of the false or fraudulent claims ― what we refer to as amount of loss. That amount of loss is used in calculating an advisory, sentencing Guideline range. The Guidelines are advisory ― Courts have to calculate them, but
don't necessarily have to follow them. For example, a defendant with no prior criminal history indicted for health care fraud will start with a base offense level of 6, which translates to 0 ― 6 months of imprisonment. If the amount of alleged loss is more than $1.5 million dollars, an additional 16 levels are added to the base, increasing the defendant's offense level to 22 and commensurate prison time to anywhere between 41 and 51 months.
It's not just about inflating your income on an loan application anymore Mortgage Fraud can take many different forms from lying on your loan application, to overstating one’s income, to failure to disclose liabilities and, even, inflating an
appraisal. In South Florida, for example, mortgage fraud has become very intricate. These crimes
often involve broad conspiracies involving real estate brokers, mortgage brokers, “straw buyers” and real estate appraisers.
The Fraud Enforcement and Recovery Act
In the aftermath of the housing crash in 2008, Congress enacted the Fraud Enforcement and Recovery Act (FERA), and the FBI formed the Financial Institution Fraud Unit. This unit of the FBI investigates all types of mortgage and real estate fraud. Specifically, the FBI has been investigating real estate and mortgage insiders for overstating values of real properties and issuing loans based on false figures, predatory lending, and misrepresentation of income, assets, and employment history in order to qualify for a loan by mortgage brokers and consumers.
Securities fraud & ponzi schemes
''Greed is Good''
Securities Fraud can occur in a variety of ways, for example, insider trading, stock manipulations, failure to disclose material information in investment schemes, corporate fraud, Internet fraud, ''boiler room'' operations, ''micro-cap''
fraud, accountant fraud,mutual fund fraud, Ponzi schemes and ''pump and dumps.''
Often, these types of cases involve lengthy investigations by the Securities and Exchange Commission (SEC) and Government prosecutors. Therefore, it's important to have competent legal counsel representing your interests at the onset of any investigation and in connection with any subpoenas issued by the Feds for business
records or testimony.
A ''Ponzi scheme'' is a description of an investment operation where unusually high profits are paid to investors out of the money paid into the investment plan by new investors — as opposed to legitimate profits generated by business activity. In a Ponzi scheme, investors are usually offered high returns on their investment in order to persuade new investors to join into the investment scheme. These high investor profits demand that the flow of money from newly acquired investors increase in order to keep scheme going. Rather, the ''investment plan'' starts falling apart due to bad investments or declining market conditions and investors begin to voice their dissatisfaction. Once complaints
are made to local law enforcement, FBI, SEC, FTC, or CFTC, the investigatory period
And, once that happens, it makes good sense to contact a good criminal defense lawyer.
It's critically important to hire an experienced Federal criminal defense attorney to develop an effective defense strategy and hold the Government to their burden of proving the crime of securities fraud beyond and to the exclusion of any reasonable doubt. Simply put, you’ll need a lawyer who can differentiate between a lie to
prospective investors and a ''forward looking statement''.
MAIL & WIRE FRAUD
Did you check the mail?
Any criminal activity that involved the United States mail or electronic/digital communications, or both, is considered Mail or Wire Fraud. Many charged crimes that fall under this definition actually use mail, television, radio, or the Internet in order to transmit false or fraudulent promises or advertisements to the unsuspecting public.
What the Feds have to prove
To prove mail or wire fraud under 18 U.S.C. §§ 1341, 1343, the United States Attorney must prove the following:
There was a scheme to defraud by materially false and fraudulent representations
The defendant(s) knowingly and willfully participated in the scheme to defraud, with knowledge of its fraudulent nature and with specific intent to defraud;
In execution of that scheme, the defendant used or caused the use of the mailsor wires.
In essence, whenever a person engages in criminal activity which requires the use of mail or wire communications (Internet or telephone), the Government can, and usually does, charge the crime of Mail and Wire Fraud.
There are viable defenses to Mail and Wire Fraud charges. Successful defenses will negate one or more of the elements of the crime, all of which the Government is required to prove beyond a reasonable doubt. Most commonly attacked is the Government’s claim that the defendant possessed specific intent to deprive another of money, property, or the intangible right to their
honest services. In addition, a defendant might argue that the “in furtherance” requirement has not been satisfied since the wire transmission occurred after the scheme had reached fruition. Another example of a successful defense to wire and mail
fraud is the argument that an employee of a defendant lacked the authority to write a letter on the defendant’s behalf, thus negating the “causes the mails to be used” requirement.
Tax fraud is the act of avoiding paying taxes or limiting paying taxes through illegal ways. Usually, this involves filing a false tax return, tax evasion, filing false supporting documents, failure to collect employment or sales taxes, failure to pay taxes, and failing
to file a tax return. Federal Tax Crimes Indeed, the Internal Revenue Service (or IRS) has classified as criminal offenses (IRS
Code Sections 7201 through 7217) has classified the following as Federal tax crimes:
Attempting to evade tax obligations;
Willfully failing to pay or collect taxes;
Willfully choosing not to file a required income tax return.
Failing to provide tax statements to employees as required by law Providing false tax statements to employees; Incorrectly completing new hire paperwork when brought in as a new employee, resulting in improper tax withholding due to willful false statements or intentional withholding of information
Filing a fraudulent tax return and Failing to obey a summons to provide information or testimony to the Internal Revenue Service.
If your actions were found to have been a willful violation of the Internal Revenue Code, you could be charged with Federal tax fraud.
It's critically important to hire an experienced Federal criminal defense attorney to
develop an effective defense strategy and hold the Government to their burden of
proving the crime of Federal tax fraud beyond and to the exclusion of any reasonable
doubt. Remember: the IRS has to prove that your failure to pay taxes, or your under-
payment was willful and knowing.
There is hope
If you or a loved one is arrested and charged with
Health Care (Medicare) Fraud
Securities Fraud & Ponzi Schemes
Mail & Wire Fraud
please call our 24-hour telephone number 305-461-1066 to set up an appointment
and free consultation so we can assess your particular case and provide you with the
best legal advice on how to proceed.
Stop worrying. I can help. I want to hear your side of the story.