Defending Against Health Care Fraud Allegations in Mississippi

Marisol Quijano Buckley
3 days ago
2 min read

Health care fraud allegations can devastate a professional’s career and reputation. From risking medical licenses to facing federal criminal charges, the stakes couldn’t be higher. If you are a physician, nurse, pharmacist, or health care provider accused of fraud, you need to understand what lies ahead—and how to protect yourself.

What Is Health Care Fraud?

Health care fraud is a broad term that covers many types of alleged misconduct. Common accusations include:

Falsifying health care claims
Double billing for services
Prescribing or billing for unnecessary medications or procedures
Kickback arrangements or improper referrals

Each type of allegation requires a tailored legal defense strategy based on the facts of the case and the governing federal statutes.

Federal Laws Governing Health Care Fraud

Health care fraud cases are heavily regulated by federal law. Some of the most common statutes used by prosecutors include:

The False Claims Act (FCA): Targets false billing and fraudulent claims submitted to federal health care programs.
The Anti-Kickback Statute (AKS): Prohibits offering, paying, or receiving compensation in exchange for patient referrals or services.

Penalties are severe, ranging from criminal prosecution and prison time to massive fines, restitution orders, and professional license suspension or revocation.

The Investigation Process

Health care fraud investigations are rarely simple. They typically involve multiple federal agencies, including the:

Department of Justice (DOJ)
Federal Bureau of Investigation (FBI)
Office of Inspector General (OIG)

Providers usually receive formal notice of an investigation before teams of auditors and investigators begin reviewing billing records, patient files, and compliance procedures.

What to Expect

Document reviews and audits
Subpoenas for records
Formal interviews by investigators

⚠️ Warning: Speaking to investigators without legal counsel can create serious risks. Even innocent statements can be misinterpreted and used against you later.

Defending and Appealing Health Care Fraud Allegations

A strong defense strategy can make the difference between protecting your career—or losing everything you’ve worked for. Possible defenses include:

Challenging the accuracy of billing audits
Demonstrating lack of intent to defraud
Proving compliance with federal and state regulations
Negotiating settlements or reduced penalties

If an adverse decision is made, appeals are possible, though the process depends on the specific agency or court involved.

Why You Need an Experienced Federal Criminal Defense Attorney

When your livelihood and freedom are on the line, you need a lawyer who understands both federal law and health care investigations.

Federal defense Attorney Sean Buckley brings over 25 years of courtroom and trial experience defending professionals accused of federal crimes, including health care fraud, money laundering, conspiracy, and white-collar offenses.

📍 Based in Gulfport, Mississippi, Sean represents clients across Gulfport, Hattiesburg, South Mississippi, statewide, and nationwide. His reputation for aggressive defense strategies and deep knowledge of federal criminal law has earned him national recognition.