Houston Health Care Fraud Defense Attorney
Health care fraud charges can endanger everything you’ve worked so hard to build. Stand up to such charges with proven health care fraud defense attorneys at your side. Our trial team, led by respected lawyer Dan Cogdell, is here to protect your rights and your future.
At the Cogdell Law Firm, we put our over 40 years of experience toward tenaciously defending health care executives, pharmacists, physicians, surgeons and other medical professionals. When you are facing serious allegations in Houston, East Texas, North Texas or other parts of the state, turn to us for strong, goal-focused health care fraud defense representation.
Facing health care fraud accusations or charges in Texas? Contact Cogdell Law Firm today. Call 713-426-2244 or send a message through our online contact form.
Health Care Professionals We Defend
Health care fraud investigations often involve professionals across many areas of the medical field. At Cogdell Law Firm, our defense team represents individuals whose careers and reputations are threatened by fraud allegations. These cases frequently involve complicated billing rules, regulatory compliance issues and federal program requirements.
Our firm defends a wide range of health care professionals, including:
- Physicians and surgeons accused of improper billing or documentation
- Pharmacists and pharmacy owners facing prescription fraud allegations
- Hospital administrators and health care executives under investigation for financial misconduct
- Medical practice owners accused of referral or billing violations
- Nurses, physician assistants and other providers involved in patient care or recordkeeping
Each profession has different regulatory obligations, and investigators often examine billing records, communications and financial transactions when building a case. Our legal team analyzes these records closely while preparing a strategic defense for the professionals we represent.
When Should You Contact A Health Care Fraud Defense Lawyer?
If you believe you may be under investigation for health care fraud, it is important to seek legal representation as early as possible. Investigations frequently begin long before formal charges are filed, and government agencies may gather evidence quietly through audits, data analysis or subpoenas.
Common warning signs may include audit notices, record requests or contact from investigators. Even informal inquiries can indicate that authorities are examining your professional activities.
Early involvement of a defense attorney allows for careful review of the situation and helps protect your rights during the investigation. A lawyer can also guide how records should be handled, respond to government inquiries and begin developing a defense strategy before charges are filed. Taking action early can make a meaningful difference in the direction of your case.
What Are Some Common Types Of Health Care Fraud?
Health care fraud encompasses a wide range of illegal activities. Common types include:
- Defrauding Medicare or Medicaid
- Overbilling and other fraudulent billing practices
- Taking or offering kickbacks
- Improper referrals
- Laundering unlawfully obtained money
- Improperly filling or prescribing medications
- Misusing telehealth services for fraudulent purposes
If you’re facing allegations of such conduct, our health care money laundering defense lawyers can help.
What Are The Laws Against Health Care Fraud?
Various federal laws cover health care fraud, including:
- The Health Care Fraud Statute (18 U.S.C. § 1347): Prohibits defrauding health care programs.
- The criminal False Claims Act (18 U.S.C. § 287): Addresses fraudulent claims to the federal government
- The Anti-Kickback Statute (42 U.S.C. § 1320a-7b(b)): Prohibits kickbacks
- The Stark Law (42 U.S.C. § 1395nn): Addresses physician self-referrals
State laws, such as Chapter 35A of the Texas Penal Code, also address health care fraud. What specific statute(s) you are facing charges under has a huge impact on what your case will look like case. Our Medicaid fraud defense attorneys can provide you with honest explanations of what you can expect given what specific charges you are facing and the other specifics of your case.
What Consequences Can Health Care Professionals Expect?
The health care fraud accusations can have severe repercussions. A conviction could expose you to:
- Substantial prison time
- Significant fines
- Loss of your physician license
- Loss of your pharmacy license
- Major damage to your professional reputation
Your career and life as you know it can be at risk. This is why it is so important to not delay in addressing medical fraud investigations and allegations. Our health care fraud defense lawyers can help you understand the potential penalties you could face and take proactive steps to safeguard your future.
What Defenses Can Be Brought In Health Care Fraud Cases?
There are many different routes for trying to fight health care fraud charges. Defenses you might be able to pursue include:
- Lack of intent: Asserting that what happened was an honest mistake and that you weren’t intending to defraud anyone
- Legitimate conduct: Arguing that your actions did not actually violate any laws and were above board
- Exception: Claiming that what you did falls under a valid legal exception, such as the safe harbor provisions of the Anti-Kickback Statute
- Insufficient evidence: Arguing that the available evidence does not rise to the level of proving that you were in violation of the law
- Improperly obtained evidence: Asserting that authorities came to possess evidence through misconduct, such as an illegal search, and that thus the evidence should be thrown out
What medical fraud defense strategy would be best-suited for your case can hinge on a wide range of factors. We are here to provide you with the clear explanations and thorough analysis you need to understand your options. Let us help you find the right path forward for your health care fraud defense.
How Common Is Health Care Fraud In Texas?
Health care fraud is a serious concern in Texas, especially within federal programs like Medicare. The Medicare Fraud Strike Force, established in 2007, is a multi-agency team that utilizes data analysis and community policing to combat Medicare fraud. Operating in several U.S. cities, including Houston and Dallas, the Strike Force has charged physicians, pharmacists and other health care professionals for false billings amounting to billions of dollars.
Recent enforcement activities highlight the ongoing efforts to combat health care fraud in Texas. In 2024, the Department of Justice’s Health Care Fraud Unit charged over 147 individuals linked to $3.26 billion in fraudulent claims. They utilize advanced data analytics to identify fraud.
The state’s susceptibility to health care fraud has led to increased scrutiny and enforcement efforts. The Department of Health and Human Services’ Office of Inspector General collaborates with the Department of Justice and other agencies through the Medicare Fraud Strike Force to prevent and combat fraud, waste and abuse in health care programs.
Health Care Fraud Defense Lawyers Serving Clients Across Texas
Based in Houston, Cogdell Law Firm represents clients statewide, with a particular focus on North and East Texas. The firm has established a presence in several key locations:
- Houston: Our physical office location is located in Houston, serving as the central hub for the firm’s operations.
- Dallas and Fort Worth: Cogdell Law Firm extends its services to clients in the Dallas-Fort Worth metroplex, addressing legal needs in this urban area.
- Sherman: Our firm offers legal representation in Sherman, catering to clients in this region.
- Beaumont: Clients in Beaumont and surrounding areas can also access our firm’s legal services.
This statewide reach helps ensure clients across Texas, especially in North and East Texas, have access to our legal guidance.
What Should You Do If You Are Under Investigation For Health Care Fraud?
If you are under investigation for health care fraud, consider the following steps:
- Engage an attorney experienced in health care fraud defense to guide you through the legal process and protect your rights.
- Maintain comprehensive records of billing, communications and other pertinent documents.
- Limit conversations about the investigation to your attorney to prevent unintentional disclosures.
- Respond promptly to subpoenas or requests for information as advised by your attorney.
Taking these steps can help protect your interests during a health care fraud investigation.
The Talented Advocates You Deserve For Your Health Care Fraud Defense
In addition to having very high stakes, health care fraud cases can be incredibly high profile. You need a health care fraud defense team with the experience, skill and tenacity to successfully navigate the challenges that come with this. Dan Cogdell, our firm’s founder, has a well-earned reputation for having what it takes to prevail in tough cases. Over his decades of practicing law, he has achieved results in a wide range of famous and noteworthy legal matters. He and the rest of our team are here to be your voice and pursue the real, meaningful solutions you need to get through this difficult time.
Frequently Asked Questions About Texas Health Care Fraud
This FAQ section addresses common questions faced by people addressing health care fraud matters in Texas.
What is considered health care fraud under Texas and federal law?
Health care fraud involves any intentional act to deceive a provider or a government program like Medicare or Medicaid to receive unauthorized payments. In Texas, the law looks for an intent to defraud through various actions, including:
- Billing for medical services or office visits that never actually occurred.
- Misrepresenting the medical necessity of a specific procedure to secure payment.
- Charging for a more expensive treatment than what was provided to the patient.
- Participating in kickback schemes involving the referral of patients or services.
Federal authorities also prosecute these offenses under statutes like the False Claims Act. It allows for civil penalties of up to three times the amount fraudulently obtained. Texas state law mirrors many federal provisions but adds its own penalties, including potential imprisonment for up to 10 years for serious violations.
Both systems work together. This means a single fraudulent act can trigger investigations at multiple levels simultaneously. As such, working with an experienced attorney is important to build an effective defense early in the process.
Can a health care fraud conviction affect my medical or professional license?
Yes. In Texas, professional boards monitor these cases closely and often initiate their own disciplinary actions. A health care fraud conviction can impact your professional standing in multiple ways, including:
- Administrative proceedings separate from criminal cases: Licensing boards can pursue disciplinary action even before a criminal conviction is finalized.
- Mandatory nationwide reporting requirements: A Texas conviction triggers reporting systems that follow you across state lines and affect licensure everywhere.
- Immediate loss of hospital privileges: Medical facilities often revoke staff privileges as soon as fraud charges become public knowledge.
- Malpractice insurance complications: Insurance carriers may cancel your coverage or refuse to renew policies after fraud allegations surface.
Because the state treats these matters with such severity, the path forward requires strategic moves to protect your livelihood and your reputation.
Reach Out To Our Experienced Health Care Fraud Defense Lawyers Today
Health care fraud allegations have the potential to ruin your career and reputation and take away your very freedom. You can’t afford to wait to protect your rights. Take steps today to put your defense in trusted hands. Our skilled and proven health care fraud defense attorneys are here for you. Get in touch with us now by completing our contact form or calling 713-426-2244.