What is Federal Program Fraud? - Medicare RAC Audits & Appeals Services
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What is Federal Program Fraud?

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  • Federal program fraud is a federal offense and refers to the theft of funds from a federal program.
  • The federal government aggressively prosecutes cases of federal program fraud because the fraud involved is against the United States and its federally funded programs.
  • Charges could result in significant fines, imprisonment, or both.
  • Section 666 of the U.S. Code prohibits the theft or bribery of programs receiving federal funds by criminalizing the embezzlement or theft of property that is valued at $5,000 or more and is owned or under control of a government, organization, or entity and prohibits the corrupt solicitation, demand, or acceptance of anything of value from a person influenced for a business transaction involving anything valued at $5,000 or more.
  • There are many statutes used to prosecute federal program fraud including conspiracy to defraud the United States, false statements or documents to a federal agency, false claims to the U.S. government, and mail and wire fraud.
  • Consider placing a qualified attorney on your side to explain the process, implications, and defense strategies involved with these charges.

Put our highly experienced team on your side

Dr. Nick Oberheiden
Dr. Nick Oberheiden



Lynette S. Byrd
Lynette S. Byrd

Former DOJ Trial Attorney


Brian J. Kuester
Brian J. Kuester

Former U.S. Attorney

Amanda Marshall
Amanda Marshall

Former U.S. Attorney

Local Counsel

Joe Brown
Joe Brown

Former U.S. Attorney

Local Counsel

John W. Sellers
John W. Sellers

Former Senior DOJ Trial Attorney

Linda Julin McNamara
Linda Julin McNamara

Federal Appeals Attorney

Aaron L. Wiley
Aaron L. Wiley

Former DOJ attorney

Local Counsel

Roger Bach
Roger Bach

Former Special Agent (DOJ)

Chris Quick
Chris J. Quick

Former Special Agent (FBI & IRS-CI)

Michael S. Koslow
Michael S. Koslow

Former Supervisory Special Agent (DOD-OIG)

Ray Yuen
Ray Yuen

Former Supervisory Special Agent (FBI)

Experienced Defense Team

If you need advice regarding charges or an impending investigation in connection to federal program fraud, do not hesitate to contact one of our defense attorneys.

The federal government is especially eager to aggressively prosecute individuals suspected of federal program fraud because the fraud concerns the integrity of the U.S. government and transforms the United States into a victim.

Individuals charged with federal program fraud face the possibility of significant fines, imprisonment, and reputational losses.

It is important to understand that you have rights and are entitled to due process protections under the law.

The key is to retain a qualified defense team that not only has the experience in defending its clients against charges of federal program fraud, but also has the dedication and deeply cares about the wellbeing of its clients.

At Oberheiden, P.C., our team of defense attorneys can help you develop a personalized defense strategy, negotiate a deal with the prosecutor, and explore all your legal options in response to these allegations.

Do not wait to get in touch with a qualified attorney today.

Put Oberheiden, P.C. on your side to advise you on these legal issues and protect your reputation and liberty.

Introduction and Definition

Federal program fraud refers to the theft, or other tactic of obtaining by fraud, of a federally funded program or entity. The objective is to obtain money from the government or to misdirect or misapply services or make the agency take a certain course of action that it would not otherwise have done because of the deception or fraud.

Federal program fraud requires an intent to defraud, meaning that the person must act with the specific intent and knowledge to defraud someone or some entity in order to receive some financial benefit for themselves.

The term “federally funded” is broad and can refer to an entitlement, grant, loan, guaranteed program, etc.

Because fraud of federal programs can result in significant monetary loss, there are administrative procedures designed to regulate and protect the federal programs. When such procedures fail to detect or stop fraud, the federal government is empowered to seek administrative, civil, and criminal remedies to hold the perpetrators liable.

Federal Program Fraud Legislation – Section 666

The Department of Justice deals with federal program fraud and bribery though U.S. Code Section 666 (18 U.S.C. § 666). Section 666 deals with the investigation and prosecution of these offenses.

Its purpose is to provide a means of enforcement against persons who steal, embezzle, or otherwise commit a theft of money or misapply property from the government or organization that receives federal funds.

Briefly, Section 666 makes it a federal crime to engage in the theft of federal funds that are distributed through a federal program and to misapply property that is under the care, custody, or control of a government or federal agency.

A summary of the full section is presented below:

§ 666. Theft or bribery concerning programs receiving Federal funds


1. embezzles, steals, obtains by fraud, or knowingly converts to the another person other than the rightful owner or intentionally misapplies, property that is valued at $5,000 or more and is owned by or under the control of an organization, government, or agency, or

2. corruptly solicits or demands for the benefit of any person or accepts anything of value from any person intending to be influenced or rewarded for any business transaction of the organization, government, or agency involving anything valued at $5,000 or more

… shall be fined, imprisoned not more than 10 years, or both.

The organization, government, or agency under this section must receive an excess of $10,000 in any one year under a federal program involving a grant, contract, subsidy, loan, guarantee, insurance, or other type of federal assistance.

Examples of Federal Program Fraud

Federal program fraud can be perpetrated in many ways, some simple and some complicated. Below we offer a few examples of federal program fraud:

  • forging a false signature on the back of a check that pertained to some government entitlement
  • supplying unnecessary medical equipment to Medicare recipients
  • using medical doctors to give medical services that are unnecessary

The more complicated schemes are especially problematic for federal enforcement efforts because they use sophisticated technologies that make detection difficult.

If you are concerned about a possible allegation of impropriety hinging on federal program fraud, contact our office today.

Statutes Used to Prosecute Federal Program Fraud

The main statutes used to prosecute federal program fraud include:

  • conspiracy to defraud the United States (18 U.S.C. § 371)
  • false statements or false documents presented to a federal agency (18 U.S.C. § 1001)
  • false, fictitious claims to the U.S. government (18 U.S.C. § 287)
  • mail and wire fraud statutes (18 U.S.C. § 1341, 18 U.S.C. § 1343)

Federal law enforcement agencies that are charged with the protection of federal programs and the enforcement of its violations include the Federal Bureau of Investigation, the Department of Justice, the Inspector General Offices, and law enforcement agencies in other federal departments.

In addition to the imposition of penalties and jail time, a conviction has many dangerous collateral consequences. For instance, because the individuals charged with federal program fraud usually do a lot of business with the government, that individual may now be barred from doing business with the government in the future.

Also, medical professionals charged with this offense may be barred or suspended from participating in federal programs regarding medical care such as Medicare and Medicaid.

Because these possibilities can be devasting, it is critical that you act immediately to mitigate or eliminate these consequences with the counsel of an experienced defense attorney.

Need Advice Regarding Federal Program Fraud?

Allegations of federal program fraud can be a worrisome time and can result in imprisonment, significant fines, and reputational losses.

The attorneys at Oberheiden, P.C. have the experience and knowledge needed to advise you of federal program fraud defenses, mitigate or eliminate the stages of the prosecution, and litigate or settle your case quickly with terms favorable for you.

We can provide a diligent defense strategy that gives you the best chance of success whether you are in New York, California, Texas, D.C., Florida, or any other U.S. state.

Call us today or contact our office for a free consultation to help resolve these allegations and fight for your reputation and freedom.

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