What Is the Statute of Limitations in Healthcare Cases

The statute of limitations in federal healthcare fraud cases is not a single deadline. It varies by offense, and several of the most significant statutes applicable to opioid fraud carry limitations periods considerably longer than the five-year general federal standard.

The practitioner who assumes that conduct from several years ago is beyond the government’s reach because the general federal limitations period has expired may find that the specific statute under which charges are filed carries a longer limitations period that encompasses the earlier conduct. Understanding which limitations period applies to which charge is a task that requires legal analysis of the specific offenses the investigation is likely to pursue.

The General Federal Limitations Period

The general federal statute of limitations, 18 U.S.C. 3282, provides that no person shall be prosecuted for any offense not capital unless the indictment is found or the information is instituted within five years after the offense was committed. For a practitioner whose allegedly improper prescribing concluded more than five years before any indictment, the general limitations period may bar prosecution for that conduct under statutes that do not have a specific limitations period.

The five-year period runs from the date of the offense, not from the date of discovery. For a prescribing offense under 21 U.S.C. 841, the offense is complete when the prescription is issued or the drug is distributed. Prescriptions issued more than five years before the date of any indictment are presumptively outside the limitations period.

Healthcare Fraud and the Extended Period

The healthcare fraud statute, 18 U.S.C. 1347, carries a specific ten-year limitations period under 18 U.S.C. 3293 for offenses affecting financial institutions. More significantly, healthcare fraud offenses involving federal healthcare programs are subject to an extended limitations period of ten years under the same provision where the offense affects a federally insured financial institution, and under separate provisions for False Claims Act purposes.

The False Claims Act itself provides a limitations period of six years from the date of the violation, or three years from the date the relevant government official knew or should have known about the facts material to the claim, but not more than ten years after the violation. In practice, the ten-year outside limit is the operative ceiling for False Claims Act liability, meaning that false claims submitted up to ten years before the filing of a qui tam complaint or government action may be within scope.

The Continuing Offense Doctrine

The continuing offense doctrine extends the statute of limitations for offenses that are ongoing rather than complete at a single moment. A drug distribution conspiracy under 21 U.S.C. 846 is a continuing offense; it begins when the agreement is formed and continues until the conspiracy ends or the defendant withdraws from it. The limitations period for a conspiracy charge runs from the date of the last overt act in furtherance of the conspiracy, not from the date the defendant joined.

A practitioner who participated in a prescribing conspiracy that was ongoing until recently may find that the statute of limitations does not bar prosecution for conduct that began years earlier, because the conspiracy continued until a date within the limitations period. The conspiracy charge’s limitations period encompasses all of the conduct within the conspiracy, including conduct that would be time-barred if charged as a standalone offense.

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The statute of limitations is a defense, not a safe harbor. It must be affirmatively raised and established through legal argument supported by evidence of when the alleged offense was complete. The government will argue for the interpretation of the limitations period that encompasses the most conduct. Counsel must identify the applicable period and assess whether the charged conduct falls within it, a task that requires careful analysis of the specific charges, the specific dates, and the specific legal standards applicable to each.

Tolling Provisions

Several provisions may toll, or suspend, the running of the statute of limitations. The fugitive tolling provision suspends the limitations period while the defendant is a fugitive from justice. The government’s sealing of an indictment, which is standard practice to permit warrant execution before the defendant learns of the charges, does not toll the limitations period for offenses in which the indictment was returned within the limitations period. The limitations period is satisfied by the return of the indictment, not by the defendant’s arrest or the unsealing of the charges.