Los Angeles Healthcare Fraud Defense Lawyers

Are You in Need of a Healthcare Fraud Defense Attorney in Los Angeles?

A healthcare fraud allegation is a direct threat to your freedom, career, and reputation. Whether you’re a physician, pharmacist, medical administrator, or billing professional, being charged with healthcare fraud means you’re probably facing a complex federal investigation with potentially devastating consequences.

At Werksman Jackson & Quinn LLP, we understand the gravity of these charges. When you hire our firm, you're getting an elite team of trial-tested criminal defense attorneys with decades of experience in white-collar defense, including healthcare fraud.

Why Choose Us Over Other Los Angeles Healthcare Fraud Defense Lawyers?

With the full force of our firm behind your case, we are ready to take on federal prosecutors, government investigators, and regulatory agencies to protect your freedom and future. Here’s why so many healthcare professionals in Los Angeles have come to trust our firm.

• Founded in 1994 with a proven legacy in high-stakes criminal defense, the firm is trusted by professionals, public figures, and individuals facing serious criminal allegations.
• Mark J. Werksman, former Deputy District Attorney and former Assistant U.S. Attorney, brings nearly four decades of legal experience, allowing him to anticipate and counter prosecutorial tactics with precision.
• Alan Jackson, former Assistant Head Deputy in the LA County DA’s Major Crimes Division, known for his high-profile trial work, brings courtroom authority and media-savvy strategy to every case.
• Kelly Quinn is a certified specialist in writs and appeals who brings a meticulous, strategic approach to addressing government cases and protecting your future.
• Rated AV by Martindale-Hubbell – the highest distinction for legal ability and ethics, reflecting the firm’s unwavering reputation among judges and peers.
• Selected by Super Lawyers multiple times based on peer reviews and independent research.
• Comprehensive team approach – you gain the power of multiple strategists, litigators, and appellate specialists backing your defense.

Your Career Is on the Line

Call (213) 688-0460 to get a proven legal team behind you.

Reasons to Contact a Lawyer Right Away

If you’ve been contacted by investigators, received a subpoena, or suspect you’re under investigation, you must act immediately. Time is critical for several reasons:

• Early intervention may prevent charges from being filed.
• Your statements to investigators can be used against you.
• Delays allow the government more time to build a case while you fall behind.
• A proactive defense can involve forensic accounting, expert witnesses, and immediate compliance reviews to mitigate exposure.

Do not wait for formal charges. Contact Werksman Jackson & Quinn LLP the moment healthcare fraud is on your radar.

What Is Healthcare Fraud?

Healthcare fraud involves deliberately deceiving a healthcare benefit program for unlawful financial gain. These cases often fall under federal jurisdiction, including violations of the False Claims Act, Anti-Kickback Statute, and Health Care Fraud Statute.

Prescription Drug Fraud

Prescription fraud includes:

• Writing prescriptions for non-existent patients
• Falsifying diagnoses to justify controlled substances
• Doctor shopping and identity theft
• Pharmacies dispensing medication without proper documentation

This form of fraud is closely monitored by the DEA, Medicare/Medicaid authorities, and state licensing boards.

Health Insurance Fraud

Health insurance fraud may include:

• Submitting false claims for services not rendered
• Upcoding or billing for higher-cost services
• Performing unnecessary procedures
• Double billing
• Billing under another provider’s name or number

Private insurers and federal agencies like CMS (Centers for Medicare & Medicaid Services) often cooperate in joint investigations, which can lead to serious criminal charges.

Medical Fraud

Broadly speaking, medical fraud covers:

• Fraudulent billing for services not provided
• Falsifying patient charts
• Ghost patients or fictitious treatment plans
• Violations related to Durable Medical Equipment (DME)
• Kickbacks or self-referrals under Stark Law

Whether you’re a physician, chiropractor, clinic owner, or administrator, you could face criminal, civil, and administrative penalties if convicted.

What to Do If You Are Arrested

If you're arrested or contacted by federal agents or law enforcement:

1. Do not speak without your attorney present.
2. Do not attempt to explain or justify documents or billing.
3. Do not delete or alter records; this could result in obstruction of justice charges.
4. Contact our office immediately. We will intervene, protect your rights, and begin crafting a strong defense.

Law enforcement is not on your side. Let your Los Angeles white-collar crime defense attorney shield you from self-incrimination and overreach.

What Are the Penalties for Healthcare Fraud?

Penalties depend on the nature and scope of the fraud but may include:

• Federal imprisonment: Up to 10 years per offense, and up to 20 years if serious injury resulted from the fraud
• Massive fines: Often hundreds of thousands or even millions in restitution and penalties
• Asset forfeiture: The government may seize your property, bank accounts, or business
• Probation and supervised release
• License suspension or permanent revocation

Many healthcare fraud charges result in multiple felony counts, dramatically increasing the probability of prison time.

Additional Consequences of a Conviction

In addition to incarceration and financial penalties, a conviction can bring:

• Loss of professional licenses
• Being barred from participating in Medicare/Medicaid
• Ineligibility for future medical employment
• Reputational destruction in your community
• Civil lawsuits and qui tam whistleblower actions
• Immigration consequences, including deportation for non-citizens

Under Federal Investigation for Healthcare Fraud?

Let us step in. Call (213) 688-0460 to learn more today.

Effective Legal Defenses for Healthcare Fraud?

There are a number of effective legal defense strategies that Werksman Jackson & Quinn LLP has used to successfully defend clients in healthcare fraud cases.

Lack of Intent

Healthcare fraud charges require specific intent to defraud. You cannot be convicted if the government cannot prove intent beyond a reasonable doubt.

Lack of Awareness

You may have signed off on documents, billing, or practices without fully understanding their implications. In large practices or billing operations, not every action is under your direct control.

Medical Necessity

Medical decisions can be subjective. What the government calls “unnecessary” might have been medically justified based on your judgment and patient care history.

Honest Mistake

Mistakes happen, including coding errors, billing missteps, and miscommunications. These are not crimes. Without fraudulent intent, these are compliance issues, not criminal violations.

Good Faith Reliance on Billing Experts or Staff

You may have relied on accountants, billing companies, or compliance officers to handle complex billing systems. A strong defense may argue you acted in good faith and did not knowingly engage in fraud.

Regulatory Compliance

Many alleged violations stem from complex and evolving healthcare regulations. We can argue your practices were aligned with, or at least not in violation of, the current regulations, or that guidance was unclear or misapplied.

How a Lawyer Can Help

At Werksman Jackson & Quinn LLP, our defense begins long before trial. Here’s how we help:

• Early intervention: We contact investigators and prosecutors to protect you and potentially head off charges.
• Internal investigations: Our team will conduct confidential audits of your business and billing practices.
• Challenging evidence: We analyze and challenge the prosecution’s financial records, digital evidence, and witness credibility.
• Expert witness strategy: Our network includes healthcare professionals, coding specialists, and regulatory consultants.
• Case dismissal or charge reduction: We negotiate aggressively and pursue all avenues to eliminate or lessen the charges.
• Jury trial defense: If your case goes to court, our attorneys are seasoned litigators ready to dismantle the prosecution’s case and present a compelling defense.

Constitutional Violations Made by Law Enforcement Officials

In healthcare fraud cases, government agencies may cross the line. We will closely examine:

• Unlawful searches and seizures under the Fourth Amendment
• Improper or coerced statements violating the Fifth Amendment
• Right to counsel violations under the Sixth Amendment
• Entrapment by undercover agents or cooperating witnesses
• Overbroad subpoenas or unjustified raids

If your constitutional rights were violated during an investigation or arrest, we will move swiftly to suppress evidence and have charges dismissed.

Case Result

No Convictions in Workers’ Fraud Case

Mark Werksman the LA District Attorney's Office in their tracks by preventing them from convicting their client in a four week workers' compensation insurance fraud trial. Their client, a successful payroll service provider in the Inland Empire was accused of a $3 million fraud against her business clients for allegedly failing to acquire workers' compensation insurance for them. After three days of deliberations, a Los Angeles Superior Court jury deadlocked, causing a mistrial. Werksman's tenacious defense and creative rebuttal of the prosecution's 37-witness case caused the jury to deadlock which prevents the District Attorney's Office from obtaining a conviction against their 63-year-old client. "While a hung jury is not an ideal outcome," Werksman said, "our job is to prevent our client from being convicted and we accomplished that critical goal." The key to success was in the Firm's ability to absorb, digest, and rebut hundreds of thousands of pages of discovery in a complex financial crimes case and to present a coherent and persuasive defense to the jury.

What Clients Are Saying About Us

A phenomenal attorney! -Jenna Jepson (5-Star Google Review)

Alan Jackson is a phenomenal attorney! He is so quick on his feet, detail oriented, and will zealously represent his clients.

I cannot thank him enough- Allen T. (5-Star Yelp Review)

Mark Werksman is a professional, educated, and articulate lawyer. He goes above and beyond to successfully represent his clients. He is full of wit and quick on his feet. Before I came to Mark, my mind was full of doubt with previous lawyers. One of them even told me there was nothing they could do to help me. Mark managed to settle my case beyond my expectations. He kept me updated with constant positive follow-ups. He stays on top of things and he strives to achieve nothing but the best results for all of his clients. I felt this every time I spoke with him. Thanks to Mark, the stress and worries are out the window. I cannot thank him enough. There are many lawyers out there. However, rationale, quick thinking, and intellect are rare. Mark meets the criteria for a top-notch lawyer.

Speak With a Trusted Los Angeles Healthcare Fraud Defense Attorney Today

A healthcare fraud investigation is a threat to everything you’ve built. You need a law firm that doesn’t flinch under pressure. We are a legal team with experience in both federal courtrooms and state criminal proceedings; a firm that sees the whole board and knows how to win.

Call a Los Angeles federal crime lawyer at Werksman Jackson & Quinn LLP at (213) 688-0460 for a confidential consultation. Your defense starts now.

Frequently Asked Questions

What is considered healthcare fraud?

Healthcare fraud involves intentionally deceiving a health benefit program such as Medicare, Medicaid, or private insurers to receive unauthorized payments. This includes false billing, upcoding, kickbacks, unnecessary procedures, or misrepresentation of services.

Who can be charged with healthcare fraud?

Anyone involved in the healthcare system can be charged, including doctors, nurses, chiropractors, billing managers, pharmacists, clinic owners, and even administrative staff. If your name appears on billing records or treatment plans, you're potentially at risk.

Is healthcare fraud a federal or state crime?

Healthcare fraud can be prosecuted at both the federal and state levels. Federal charges are common when Medicare or Medicaid is involved, and these cases often carry more severe penalties and are investigated by agencies like the FBI, HHS, or DOJ.

What are the penalties for healthcare fraud?

Penalties can include up to 10–20 years in federal prison per count, massive fines, asset forfeiture, loss of professional licenses, exclusion from federal healthcare programs, and lasting damage to your reputation and career.

What should I do if I’m under investigation but haven’t been charged yet?

Call Werksman Jackson & Quinn LLP immediately at (213) 688-0460. Early legal intervention is often your best opportunity to avoid formal charges. Do not speak to investigators, comply with subpoenas, or hand over documents without your attorney present.

What agencies investigate healthcare fraud?

Common agencies include the Department of Justice (DOJ), Department of Health and Human Services (HHS), the Office of Inspector General (OIG), the FBI, and state licensing boards. These investigations are often extensive and well-funded and your defense needs to be stronger.

What legal defenses can be used in a healthcare fraud case?

Possible defenses include lack of intent, honest mistake, medical necessity, lack of knowledge, good faith reliance on staff or billing professionals, and regulatory ambiguity. We tailor our strategy to the facts and aggressively challenge the prosecution's narrative.

Will I lose my medical license if I’m convicted?

A conviction, or even an investigation, can trigger disciplinary action from your licensing board. While outcomes vary, many professionals face license suspension or permanent revocation. Protecting your license is a top priority in our defense strategy.

Meet Our Attorneys

Mark J. Werksman

Mark J. Werksman is one of California’s most respected criminal defense attorneys, with nearly four decades of experience handling the most complex and high stakes criminal matters. A former Deputy District Attorney and Assistant United States Attorney, Mark has been practicing criminal law since 1986, bringing an insider’s understanding of how prosecutors build cases.

Throughout his career, Mark has successfully represented clients facing serious criminal exposure at both the state and federal levels. His clients include high profile individuals from the entertainment and professional sports industries, senior executives, business leaders, and major multi national corporations. When a case carries severe legal, financial, and reputational consequences, Mark is widely regarded as the attorney others turn to.

Alan Jackson

Alan Jackson is one of the most accomplished and respected criminal defense attorneys in the United States, known for winning high-profile, high-stakes cases that other attorneys won’t touch. A former Assistant Head Deputy of the Major Crimes Division in the Los Angeles County District Attorney’s Office, Alan brings rare courtroom experience, sharp strategic insight, and a reputation for delivering results when the stakes are highest.

During his time as a prosecutor, Alan secured the murder conviction of legendary music producer Phil Spector, one of the most watched criminal trials in California history. Since entering private practice, he has built a formidable record defending public figures, celebrities, corporate leaders, and international clients, often resolving complex cases without ever going to trial. Recently, he served as lead counsel in the internationally watched Karen Read murder retrial, securing a not guilty verdict.

Kelly Quinn

Kelly Quinn is a highly respected appellate attorney and a Certified Specialist in Criminal Law Writs and Appeals, a designation awarded by the California State Bar to attorneys with exceptional expertise and experience in post-conviction and appellate matters. With more than 20 years of experience, Kelly has built a reputation as one of California’s foremost authorities in challenging criminal convictions and resolving complex legal issues at the highest levels of the judiciary.

Kelly has successfully represented clients before the California Courts of Appeal, the California Supreme Court, and the United States Court of Appeals for the Ninth Circuit. Her ability to craft precise legal arguments, identify constitutional violations, and leverage nuanced areas of criminal and surveillance law makes her an essential asset to the firm’s clients, especially in high-stakes felony and white-collar cases.

Additional Information

• You’ve Been Contacted by a Federal Agent for Healthcare Fraud—Now What?
• What Should I Do If I’ve Been Accused of Healthcare Fraud?
• The Ins and Outs of California Healthcare Fraud
• Penal Code 550