Under Sec 1347 of Title 18, if a person knowingly and willfully executes to defraud the Health Care benefit program shall be fined and imprisonment of not more than 10 years. However the term may not more than 20 years in case the violation results serious bodily injury. It is also possible for the fine or imprisonment for a term of life if such violation results death of the person. It should be noted that the attempt to defraud the health care benefit program is enough for the prosecution under Health Care Fraud.
The False Claims Act is a remedy for Health Care Fraud. The law enforcement considers the False Claims Act is most powerful weapon to the government. Particularly The False Claims Act prohibits the submission of known false claims to obtain federal funds. In such case, the United States may sue the persons who violated the Act by imposing fine of three times on the financial loss with $5,000 to 10,000 as additional fine.
Many types of frauds in Health Care, yet the top three areas are over-billing, unnecessary tests/surgeries and scams in pharmaceutical industry. In order to investigate the white collar crimes, the FBI established branches in all over the country and work the local health clinics, pharmacies, medical equipment retailers etc. besides the FBI has partnership with the Food and Drub Administration, Drug Enforcement Agency and other local government as well law enforcement agencies in order to stop healthcare fraud schemes.