Health Law Alert

2012: Issue 3

Understanding the Use of Misdemeanors in Healthcare Enforcement

By: Virginia B. Evans* and John S. Linehan

As reflected in recent headlines and statistics, the federal government has made the fight against healthcare fraud an enforcement priority. Equipped with a barrage of legal tools and resources, and buoyed by broad popular and political support, healthcare prosecutions have reached an unprecedented scale and frequency. For fiscal year 2011, the number of healthcare prosecutions was projected to reach 1,355, an increase of 85.4% over fiscal year 2010 and 157% over five years ago.1

A notable feature of the government's new prosecution strategy is its increased reliance upon criminal misdemeanor convictions to further enforcement goals. While a misdemeanor plea may be an ideal resolution in many white collar scenarios, such a result could lead to devastating consequences in the healthcare context. This article describes the use of misdemeanor prosecutions in federal healthcare enforcement, surveys collateral consequences, and provides suggestions for waging an optimal defense.