Businesses and professionals operating in highly regulated industries such as healthcare, government contracting, and public programs face a complex web of compliance requirements. While many violations of these rules are civil, there is a growing trend toward criminal prosecution when the government believes fraud, waste, or abuse has occurred.
The line between regulatory noncompliance and criminal conduct is not always clear. When federal agencies pursue charges related to healthcare fraud, procurement abuse, or misuse of federal funds, the consequences can be severe.
At Trombley & Hanes, our Tampa criminal defense attorneys represent individuals, executives, and companies accused of violating federal statutes governing public healthcare programs, contract procurement, and program integrity. These investigations are often aggressive, involve multiple agencies, and require a strategic legal response from the outset.
The Escalation from Civil Enforcement to Criminal Prosecution
Federal regulatory agencies such as the Department of Health and Human Services (HHS), the Centers for Medicare and Medicaid Services (CMS), and the Department of Defense Inspector General are tasked with enforcing rules to protect taxpayer-funded programs.
In many cases, initial enforcement actions begin as audits, administrative reviews, or civil investigative demands. However, if investigators uncover evidence suggesting intentional deception or financial misconduct, the case may be referred for criminal prosecution.
The Department of Justice, often working in conjunction with federal agents from the FBI or the Office of the Inspector General, may bring charges under statutes such as the False Claims Act, the Anti-Kickback Statute, and federal wire fraud laws. These laws carry the potential for significant prison time, forfeiture of assets, and substantial fines.
Common Allegations in Healthcare and Procurement Fraud Cases
Healthcare providers, suppliers, and administrators are often accused of fraud involving Medicare, Medicaid, TRICARE, or other federal healthcare programs.
Common allegations include:
- Submitting false or inflated claims for reimbursement.
- Billing for services that were not medically necessary or never provided.
- Engaging in kickback arrangements or unlawful referral schemes.
- Upcoding procedures to obtain higher payments.
- Misrepresenting patient eligibility or provider credentials.
In federal procurement and grant programs, the government frequently investigates:
- Falsified bids or cost reports during the contract procurement process.
- Failure to perform according to contract terms or specifications.
- Double-billing or misuse of government property.
- Concealing conflicts of interest or related-party transactions.
- Misuse of funds in research grants, disaster relief, or public benefit programs.
These allegations often arise from whistleblower complaints, audits, or data-mining programs designed to identify anomalies in billing or reporting patterns.
Crafting a Strategic Defense Against Federal Charges
When a regulatory inquiry shifts to a criminal investigation, the stakes change dramatically. At Trombley & Hanes, we provide early, proactive counsel designed to protect our clients during all phases of the investigation. Our team includes former federal prosecutors who understand how these cases are built, how evidence is gathered, and where enforcement actions may overstep their bounds.
Our defense strategies may include challenging the sufficiency of the evidence, demonstrating a lack of intent to defraud, or negotiating favorable outcomes, such as civil settlements, rather than prosecution. We also assist clients in preparing for interviews, responding to subpoenas, and safeguarding privileged information throughout the process.
Experienced Counsel in High-Stakes Federal Investigations
If you or your company is facing a federal investigation for healthcare fraud, procurement abuse, or program misuse, the time to act is now. These cases move quickly and carry significant reputational and legal consequences.
Contact Trombley & Hanes at 813-229-7918 or online for a confidential consultation. We provide experienced, strategic defense for clients caught in the crosshairs of complex federal investigations.
