Chicago Healthcare Fraud Federal Criminal Defense Lawyer

| by Max Soni

Last Updated on: 30th September 2025, 09:48 pm

Chicago Healthcare Fraud Federal Lawyer

If you’re on our website, it’s because you’re either under investigation or already charged with federal healthcare fraud – and you know you need serious legal firepower. At Spodek Law Group, we handle federal cases nationwide, and Chicago (Northern District of Illinois) is one of the hottest battlegrounds for this type of prosecution. This isn’t a small mistake on some billing codes, it’s not something you can brush off. It is a federal indictment, with FBI, HHS-OIG, DEA, and even the USPIS building cases that take months, sometimes years, before they even surface in public. And when they do surface, they hit like a hammer.

I’ll be straight with you: federal healthcare fraud charges aren’t academic. They’re not hypotheticals. Just in 2024, two suburban physicians were slammed with 6–10 year prison terms out of the Dirksen Federal Courthouse right here in Chicago. That’s not rare. That’s the playbook. The government doesn’t mind ruining someone’s career, family, future if it means padding conviction rates and writing another DOJ press release. That’s the environment we fight in every single day.

What Is Federal Healthcare Fraud Exactly?

Federal healthcare fraud is not a single clean-cut crime. It’s an umbrella term. It covers multiple overlapping federal statutes, and prosecutors love stacking them together. Here’s just a sample of what they throw in the charging documents when you walk into federal court in downtown Chicago:

• 18 U.S.C. § 1347 – the main federal healthcare fraud statute itself; “scheme to defraud” Medicare or Medicaid
• 18 U.S.C. § 1341 & 1343 – mail and wire fraud, always tacked on for maximum leverage
• 18 U.S.C. § 371 – conspiracy to commit healthcare fraud, and conspiracy charges multiply risk quickly
• 42 U.S.C. § 1320a-7b – Anti-Kickback Statute, criminalizes kickbacks, referral fees, arrangements
• 31 U.S.C. §§ 3729–3733 – the False Claims Act, massive civil penalties stacked onto criminal counts
• 18 U.S.C. § 1035 – false statements relating to healthcare matters

When someone asks me: what are healthcare fraud charges, legally? The answer is complicated, but the short version is: they’re felonies that carry serious prison exposure, financial penalties that could drain everything, and loss of your medical career. And in Chicago, the AUSA’s assigned to the Northern District of Illinois healthcare fraud strike force, they pursue these cases with a vengence. They’re not overburdened with thousands of street crimes like state prosecutors, they have specialized desks focused purely on healthcare fraud. That’s what makes your fight that much harder.

Federal vs State Charges in Illinois

People confuse this a lot. State-level insurance fraud in Illinois is serious, but it does not even compare to federal prosecutions. At state level, maybe you negotiate something, maybe probation, maybe a lighter outcome. In federal court – very different universe. In Chicago, these cases are fed through the Northern District, you’ve got assistant U.S. attorneys backed by the Health Care Fraud Unit, working with the FBI, DEA diversion investigators, HHS-OIG auditors with forensic accounting backgrounds. You’re dealing with seasoned professionals who’ve made this their career. Even the whistleblower bar in Chicago is aggressive – qui tam relators file lawsuits under the False Claims Act and the DOJ jumps in. Cases like Stop Illinois Health Care Fraud, LLC v. Asif Sayeed show that watchdogs line up to fuel these indictments. That’s the climate you’re dealing with every single day here.

Chicago specifically is on the DOJ’s radar because of its mix of urban and suburban healthcare facilities, dozens of hospitals, and the high billing volume to Medicare/Medicaid. The government loves picking Chicago as example zone. So even before you think about fighting, you’ve got to accept you’re in one of the most aggressive healthcare fraud jurisdictions in the country.

How Federal Healthcare Fraud Cases Work in Chicago

Here’s basically how this plays out. It begins long before you get subpoenaed. The FBI or HHS-OIG is monitoring billing patterns through CMS data. They flag “outliers.” DEA kicks in on controlled substance cases – especially opioid prescribing. Then, sealed subpoenas go out, grand juries meet in secret, and an investigation runs silently. You have no idea it’s happening until your practice gets raided early in the morning, agents with jackets that say FBI or DEA show up, seize your computers, take patient files, and start asking questions. Or you get a target letter from the U.S. Attorney’s Office downtown Chicago.

At that point, indictment is coming. And it’s coming in the federal courthouse at 219 S. Dearborn (Dirksen). Federal judges here are not soft. Judge Leinenweber. Judge Kendall. Judge Alonso. They have seen hundreds of these cases, and they run tight courtrooms. They know this playbook, they’re skeptical of defendants, and they listen very closely to guideline enhancements requested by prosecutors. We know this because we appear before them, we fight these cases, we see the sentences being handed down.

Trial? That’s rare. Because the feds stack so many charges under 18 U.S.C. §§ 1347, 1341, 1343, plus 31 U.S.C. penalties, that the sentencing exposure is immense. Most cases go into plea negotiations. But if you go to sentencing, the Guidelines are brutal, enhancements for loss amounts, number of victims, leadership role, abuse of trust – the the list goes on. And look, we’ve handled healthcare fraud cases that… look, the point is we win complicated federal trials when it matters, but you need realistic perspective about how these cases actually flow in the system.

Penalties in Federal Healthcare Fraud Convictions

Statutes tell the story. Under 18 U.S.C. § 1347, there’s 10 years per count. If injury to a patient is proven, it goes to 20. If death, it goes life. That’s straight statutory language. Add fines – $250,000 per count – or twice the gross gain or loss, whichever is higher. Add massive restitution amounts mandated by the Mandatory Victims Restitution Act. Add loss of license, loss of DEA registration, total exclusion from federal health programs under 42 U.S.C. § 1320a-7. That’s end-of-your-career. And Chicago judges have imposed these sanctions without hesitation. We’ve seen doctors with zero criminal history pulled out of suburban practices sentenced to 6 years, 9 years, even 10 years in federal prison. Huge restitution orders layered on top. This is real life, not theoretical.

Why You Need a Specialized Chicago Federal Healthcare Fraud Lawyer

Let me be blunt: these aren’t DUIs, they’re not bar fights, they’re not retail theft cases. They are document-heavy, statute-heavy, expert-driven criminal prosecutions. You need a law firm that knows both federal trial practice and healthcare regulation. That combination is rare. That’s our lane. We know how CMS billing systems work. We know audit trails. We know how whistleblower complaints under the False Claims Act work. And we know how the Northern District AUSAs structure indictments. That’s the edge Spodek Law Group brings.

We have a rock star team with 50+ years of combined experience. National media recognition (yes, Todd Spodek defended Anna Delvey – you’ve seen the Netflix show about it). That case wasn’t healthcare fraud, but it was federal-level complex fraud and the exposure was massive, and we brought credibility in the highest public pressure environment possible. That matters. It shows we deliver in big cases. Healthcare fraud in Chicago may not be on Netflix but it sure as hell is high-stakes. Same skillset, same mindset, same relentless defense. This is why clients hire us, and why we tell people plainly: hire a law firm that gets it.

The Costs of Hiring Us

This part nobody likes: what will it cost? There’s no flat fee answer. It depends if we can intervene pre-indictment – sometimes we stop cases before charges are filed. Sometimes we fight indictments head-on, pretrial motions, evidentiary hearings, trial. Sometimes we resolve at plea or sentencing. Every stage has a different level of intensity. Bottom line: you don’t measure this cost against pocket change, you measure it against the cost of losing your career, getting 10 years in prison, being financially destroyed. Hiring the cheapest lawyer you can find is almost always the costliest decision when you’re in federal court. Our clients recognize this, and they make the decision to invest intelligently in their future, their family, and their freedom.

Our Strategy in Federal Healthcare Fraud Cases

We fight early. Intervention during the investigative stage is everything. HHS-OIG and FBI agents don’t expect defense counsel to push back before indictment – but we do. We demand case material, challenge subpoenas, negotiate with AUSAs pre-charge. Our litigation is aggressive. Motions to dismiss certain counts, suppression challenges, Daubert motions to weaken government experts, we do it all. At sentencing, we build mitigation packages that humanize our clients in ways guidelines never account for. We understand Chicago’s district court culture and we use our national experience to bring perspective AUSAs rarely see from local attorneys. Our defense strategy is relentless, and here’s the part clients remember: our loyalty is only to you. Not the government, not public pressure, not prosecutors who want headlines. Solely you. Always you.

Local Chicago Cases Show the Pattern

We don’t need hypotheticals. DOJ press releases keep coming. In 2023, suburban physician sentenced to 10 years – barred permanently from practice. Another doctor sentenced to almost 6 years just early 2024. Restitution amounts stacked, professional exclusion ordered, careers ended. Nationwide, hundreds of providers charged – 600+ doctors, nurses, managers swept up in fraud takedowns. Chicago is always on that list. AUSAs here openly say they want to make Chicago a national example. They target volume, they target physicians with billing “anomalies.” They win convictions and sentence enhancements. And every new indictment fuels the next. Make no mistake: they want headlines, they want deterrence, they want long prison terms. Your case is not just a case, it’s their chance to move the needle. We take their agenda and turn it into your defense strategy.

Act Now – Don’t Wait

Here’s reality. Federal cases don’t start when you hear from them – they start months, often years earlier. If you got a subpoena, a target letter, or saw your colleagues raided, that means the government is already deep into building their case. You’re late to the party already. Waiting longer just hands them more advantage. You need defense now, not later. If you’re a healthcare professional in Chicago under investigation or charged with federal healthcare fraud, don’t wait until it’s too late. Contact us now. Every day matters. Every decision matters. Every mistake gets magnified ten times in federal court.

Spodek Law Group owes loyalty to only YOU. We bring over 50 years of combined federal criminal defense experience, and we’ve handled some of the most complex fraud cases in the nation. Now, we bring that same fight directly into your case here in Chicago. Confidential consultations. Straight answers. Aggressive strategy. Don’t take chances with your freedom, your career, your family. Reach out, and we’ll build the defense you need when absolutely everything is on the line.