The Champion

September/October 2009 , Page 36 

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Anatomy of a Federal Health Care Fraud Prosecution

By Alexandra C. Gaugler and Marc S. Raspanti

Read more White-Collar Crime columns.

Unfortunately, every year health care providers across the United States become the targets of a federal health care fraud investigation. Prosecuting health care fraud has been one of the government’s top law enforcement priorities for well over a decade. It remains a priority under the current administration. Indeed, prosecutions are on the rise. The Federal Bureau of Investigation recently reported that health care fraud investigations are among the highest priority investigations within the FBI’s White Collar Crime Program, ranking behind only public corruption and corporate fraud.1 Through fiscal year 2007, the FBI alone investigated 2,493 cases of suspected health care fraud, resulting in 839 indictments and 635 convictions of individuals.2  

Those medical providers who become the target of a criminal health care fraud prosecution must prepare for the literal fight of their professional lives. Their world will be turned upside down. They will face a grueling legal battle, with the

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