DOJ Won Six Healthcare Fraud Trials in Three Weeks: What That Means If You Are Under Investigation in Florida

If you bill Medicare or Medicaid and a federal agent has called your office, requested records, or left a business card with your front desk, you need to understand the climate you are operating in.

Between May 13 and June 1, 2026, the Justice Department's Health Care Fraud Unit won six federal jury trials in under three weeks, covering more than $1.1 billion in fraud losses across five federal districts, including a courtroom in Fort Lauderdale. The unit is now nine for nine at trial in 2026. That record should change how anyone facing a federal healthcare fraud investigation thinks about their next move.

Between May 13 and June 1, 2026, the DOJ's Health Care Fraud Unit secured six jury convictions across five federal districts. The largest involved a $1 billion telehealth billing scheme prosecuted in Fort Lauderdale.

Six Convictions, Five Districts, One Message

On June 4, 2026, the Justice Department announced that its Health Care Fraud Unit had secured jury convictions in six separate trials in under three weeks, tying the unit's own record. The verdicts came out of Fort Lauderdale, Los Angeles, Detroit, New York, and Nashville, covering six distinct categories of healthcare fraud: an industrial-scale telehealth platform, outlier physician billing, home health kickbacks, substance abuse clinic fraud, physical therapy kickbacks, and opioid overprescribing.

The Southern District of Florida case is the one that should get every Florida provider's attention. The founder of an internet platform was convicted of health care fraud conspiracy, kickback conspiracy, and conspiracy to defraud the United States after the government proved the platform connected foreign call centers, telemedicine companies, and durable medical equipment suppliers into a machine that generated more than $1 billion in false Medicare billings, of which Medicare paid more than $450 million. A co-defendant convicted at an earlier trial was sentenced to 15 years in prison.

In the California case, prosecutors did not start with a witness or a complaint. The Health Care Fraud Unit's data analytics team flagged a physician as the highest-paid Medicare biller for Botox injections in the country, more than $24 million over four years. The billing data showed claims submitted while the physician was out of the country, claims for a federally incarcerated patient, and more than $19 million in claims on days the clinic was closed. When a grand jury subpoena arrived, the physician fabricated and back-dated patient records and handed the altered documents to federal agents, converting a billing fraud case into a billing fraud and obstruction case with forfeiture of accounts and properties after the verdict.

The California prosecution started with billing data, not a complaint. A physician billed more than $24 million for Botox injections over four years and was flagged by CMS analytics as the highest-paid Medicare biller in that category in the country. Claims filed while the physician was abroad, billing for an incarcerated patient, and $19 million in claims on clinic-closed days built the government's case before a single subpoena was issued.

What the Government Is Actually Building

These six trials are not isolated wins. They are the output of a structure DOJ has spent two decades refining. On April 7, 2026, the Department created the National Fraud Enforcement Division, and healthcare fraud sits at the center of its docket. Since 2007, the Health Care Fraud Strike Force program, now nine strike forces nationwide, has charged more than 6,200 defendants who collectively billed federal programs and private insurers more than $45 billion. South Florida has been a strike force focus from the beginning, and the Assistant Attorney General singled out "a $1 billion fraud in South Florida" in announcing these verdicts.

The investigative model matters for anyone running a practice, a clinic, a lab, a pharmacy, or a med spa. The unit pairs trial prosecutors with data analysts from the opening of an investigation, screening CMS billing data for statistical outliers: providers whose volume, coding patterns, or per-patient billing sit far outside their peer group. If your billing profile is an outlier, you can become a federal target without a single employee, competitor, or patient ever making a call. By the time you receive a target letter, a grand jury subpoena, or a civil investigative demand, the government may have been studying your claims data for a year or more.

The Charges and the Real Exposure

The core statute in these cases is 18 U.S.C. § 1347, the federal healthcare fraud statute, which carries up to 10 years per count and up to 20 years where the offense results in serious bodily injury. Conspiracy charges under 18 U.S.C. § 1349 carry the same penalties as the underlying offense. Kickback conduct is charged under the Anti-Kickback Statute, 42 U.S.C. § 1320a-7b, with up to 10 years per violation, and conspiracies to defraud the United States under 18 U.S.C. § 371 frequently ride alongside. Altering or fabricating records after an investigation begins draws obstruction charges, including under 18 U.S.C. § 1519, which alone carries up to 20 years.

The statutory maximums are only half the story. Federal fraud sentences are driven by the loss table in the sentencing guidelines, and in healthcare cases the government routinely argues that intended loss is the full amount billed, not the amount paid. A provider who billed $10 million and collected $2 million can face a guideline range built on the larger number. Add enhancements for sophisticated means, vulnerable victims, and aggravating role, and exposure compounds quickly. Conviction also triggers mandatory exclusion from federal healthcare programs, forfeiture, and parallel civil liability under the False Claims Act, 31 U.S.C. § 3729.

What the government must prove is a knowing and willful scheme. Honest billing disputes, documentation lapses, and good-faith coding judgments are not federal crimes. But juries are shown patterns, and the patterns in these six trials, claims during vacations, billing for incarcerated patients, records created after the subpoena, made the government's intent case for it.

Conviction under 18 U.S.C. § 1347 carries up to 10 years per count. Where serious bodily injury results, up to 20 years. Kickback violations under the Anti-Kickback Statute add up to 10 years per violation. Obstruction under 18 U.S.C. § 1519 carries its own 20-year maximum. The sentencing guidelines then run the numbers on intended loss, not actual loss.

The Mistakes That Decide These Cases Early

Most healthcare fraud defendants damage their own cases before they ever retain a white collar defense attorney. The patterns repeat.

They sit for a "voluntary" interview with federal agents and make statements that later read as false exculpatory evidence. They produce records in response to a subpoena without a litigation hold, a privilege review, or a strategy. They treat an audit as a billing department problem rather than the opening move of a federal investigation defense. Worst of all, some try to clean up the file: amending charts, back-dating consents, supplementing documentation after the government has already imaged the originals.

The California Botox case shows how that ends. Fabricated records delivered after the grand jury subpoena gave prosecutors an obstruction narrative and additional counts. Nothing you add to a patient file after you learn of an investigation will save you, and everything you add can convict you.

What a Strategic Defense Looks Like Right Now

The window that matters in a federal healthcare fraud case is the pre-indictment window. Before charges are filed, a federal criminal defense attorney can engage the prosecution team, learn whether the client is a witness, a subject, or a target, and put facts in front of the government that its data analysts do not have: the clinical justification, the compliance program, the coding guidance the practice relied on. Charging decisions are fluid at this stage. Counts can be narrowed, loss theories challenged, and in the right case a declination or civil resolution is achievable.

Early defense work also means running your own analysis of the billing data before the government's version becomes the only version, deciding deliberately between cooperation and litigation, and preserving every argument on loss amount, since loss drives the guideline range more than any other factor.

"The pre-indictment window is where these cases are shaped. Before charges are filed, you can engage the prosecution, challenge the loss theory, and put facts in front of the government that its data analysts never see."— Aaron M. Cohen, AMC Defense Law

Why Timing Matters More After This Announcement

A nine-for-nine trial record changes the leverage math. Prosecutors who do not lose at trial have little reason to discount cases after indictment, and plea terms reflect that confidence. The point of maximum influence is before the charging decision, when the government is still deciding what its case is.

Providers in South Florida should assume the Fort Lauderdale and Miami strike force presence means faster investigations and lower tolerance for outlier billing. If you have received a target letter, a grand jury subpoena, or a visit from agents, the time to retain counsel is now, not after the indictment is returned.

Common Questions

Facing a Federal Healthcare Fraud Investigation in Florida?

AMC Defense Law represents physicians, practice owners, clinic operators, and healthcare executives in federal investigations and prosecutions in Florida and nationwide. If you have received a target letter, a grand jury subpoena, or a visit from federal agents, contact the firm for a confidential consultation. Early, discreet intervention is where these cases are shaped.

AMC Defense Law represents physicians, clinic operators, and healthcare executives in federal investigations and prosecutions. The pre-indictment window is when the defense can still shape the outcome.

If you or your loved ones are facing a federal healthcare fraud investigation in Florida, call Aaron M. Cohen, 24 hours a day to get help.

This article is provided for general informational purposes only and does not constitute legal advice. Reading it does not create an attorney-client relationship. Every case is different. If you are facing a criminal investigation or charges, consult a qualified attorney about your specific situation.

About the author: Aaron M. Cohen is the founder of AMC Defense Law, a federal and state criminal defense firm based in Florida, with more than 30 years of federal and state trial experience. The firm represents clients in federal investigations and prosecutions involving healthcare fraud, white-collar matters, peptide and compounded-drug enforcement, financial crimes, and complex federal litigation, in Florida and nationwide.