Receiving a criminal subpoena can be one of the most alarming experiences for healthcare providers, signaling potential legal trouble that could threaten your practice, license, and freedom. Understanding how to respond properly is crucial for protecting your interests and avoiding inadvertent self-incrimination.

What is a Criminal Subpoenas in Healthcare?

Criminal subpoenas in healthcare investigations typically arise from allegations of billing fraud, kickback schemes, prescription drug violations, or other federal healthcare crimes. Unlike civil subpoenas, criminal subpoenas indicate that law enforcement agencies are actively investigating potential criminal conduct. These documents carry the full weight of federal authority and must be taken seriously from the moment they arrive.

The timing of your response can significantly impact the outcome of your case. Federal prosecutors and investigators use subpoenas to gather evidence that may later be used against you in criminal proceedings. Every document you produce and every statement you make during this process could potentially become evidence in a criminal trial.

What Are The Three Types Of Subpoenas?

The three main types of subpoenas are:

1. Subpoena ad testificandum - This compels a person to appear and provide testimony, either at a deposition, trial, or other legal proceeding. The person must physically appear to answer questions under oath.
2. Subpoena duces tecum - This requires a person or organization to produce specific documents, records, or other physical evidence. The focus is on obtaining tangible materials rather than testimony.
3. Subpoena ad testificandum et duces tecum - This is a combination subpoena that requires both testimony and the production of documents. The person must appear to testify and also bring specified documents or records with them.

In the context of healthcare investigations that we've been discussing, providers most commonly receive subpoenas duces tecum (for medical records, billing documents, etc.) or the combination type where they must both produce documents and potentially provide testimony about their practices.

There are also distinctions between civil subpoenas (issued in civil litigation) and criminal subpoenas (issued by grand juries or in criminal investigations), but these relate more to the legal context rather than the fundamental types based on what they require.

How to Respond to a Criminal Subpoena as a Healthcare Provider

Receiving a criminal subpoena as a healthcare provider requires immediate, strategic action to protect your practice, license, and freedom. At Vargehese & Associates, P.C., we guide healthcare professionals through this critical process with proven defense strategies.

• Contact a Healthcare Fraud Defense Lawyer: Immediately retain experienced criminal defense counsel who understands healthcare law and federal investigations before taking any other action.
• Stop All Document Destruction: Cease routine document destruction policies and notify all staff to preserve materials, as destroying documents after receiving a subpoena can result in obstruction charges.
• Review Subpoena Scope Carefully: Examine the specific documents requested, compliance deadlines, and investigating agency with your attorney to understand the full extent of your obligations.
• Implement Litigation Hold: Issue formal notices to all employees instructing them to preserve documents, emails, billing records, and communications related to the investigation.
• Assess Patient Privacy Requirements: Work with your attorney to navigate HIPAA compliance while meeting subpoena obligations, as patient privacy laws typically don't prevent criminal subpoena compliance.
• Identify Privileged Materials: Review all documents with counsel to protect attorney-client privilege and other legally protected communications from disclosure.
• Document Collection Process: Develop systematic procedures for gathering responsive materials while ensuring completeness and avoiding inadvertent omissions that could create credibility issues.
• Electronic Data Preservation: Secure electronic records, including emails, databases, and system backups, working with forensic professionals when necessary for proper collection.
• Evaluate Privilege Claims: Assert appropriate privilege protections for confidential communications while ensuring compliance with valid subpoena requirements.
• Coordinate Production Timeline: Work with prosecutors to establish reasonable production schedules, seeking extensions when necessary for thorough document review.
• Limit Voluntary Disclosure: Provide only specifically requested materials and avoid offering additional documents that could expand the investigation scope.
• Maintain Communication Protocols: Direct all investigator contact through your attorney to prevent inadvertent statements that could be used in criminal proceedings.
• Prepare for Potential Interviews: Develop strategies for responding to interview requests, including preparation procedures and decisions about participation levels.
• Address Parallel Proceedings: Consider potential state medical board investigations and professional licensing implications that may arise from federal criminal matters.
• Review Insurance Coverage: Examine professional liability policies to determine available coverage for criminal defense costs and related expenses.
• Strengthen Compliance Programs: Use the investigation as an opportunity to review and enhance internal compliance measures demonstrating good faith efforts.
• Coordinate Multi-Agency Responses: Manage simultaneous investigations by different agencies while maintaining consistency in your legal positions and factual presentations.
• Plan Long-Term Strategy: Develop comprehensive defense approaches that address immediate subpoena compliance while positioning for favorable investigation outcomes.

Reasons You May Receive a Criminal Subpoena as a Healthcare Provider

Criminal subpoenas in healthcare investigations can arise from various federal enforcement priorities, often targeting billing practices, prescription patterns, and business relationships. At Vargehese & Associates, P.C., we help healthcare providers understand the common triggers for criminal investigations and develop effective defense strategies.

• Medicare and Medicaid Billing Fraud: Federal investigators target healthcare providers suspected of submitting false claims, upcoding procedures, or billing for services not rendered to government programs.
• Prescription Drug Violations: DEA investigations focus on providers who allegedly prescribe controlled substances outside legitimate medical practice or operate pill mills distributing opioids illegally.
• Kickback and Referral Schemes: Anti-kickback statute violations involving improper financial relationships between providers, laboratories, medical device companies, or pharmaceutical manufacturers.
• False Claims Act Violations: Investigations targeting providers who allegedly submitted fraudulent claims to federal healthcare programs, often triggered by whistleblower complaints from employees or competitors.
• Healthcare Fraud Task Force Operations: Multi-agency investigations by Medicare Fraud Strike Forces targeting organized healthcare fraud schemes across multiple providers and locations.
• Telemedicine Fraud Allegations: Federal scrutiny of telemedicine providers suspected of prescribing medications without proper patient examinations or operating fraudulent online consultation services.
• DME and Medical Equipment Fraud: Investigations targeting durable medical equipment providers, testing facilities, or physicians involved in unnecessary medical device schemes.
• Laboratory Billing Violations: Federal investigations of clinical laboratories suspected of paying kickbacks for referrals or billing for unnecessary or fraudulent testing services.
• Home Healthcare Fraud: Investigations targeting home health agencies and certifying physicians suspected of billing for services not provided or medically unnecessary care.
• Physical Therapy and Rehabilitation Fraud: Federal scrutiny of therapy providers suspected of billing for services not rendered or providing unnecessary treatments to maximize reimbursement.
• Ambulance and Transportation Fraud: Investigations targeting emergency medical services providers suspected of billing for unnecessary transports or fraudulent mileage claims.
• Hospice Care Violations: Federal investigations of hospice providers suspected of enrolling ineligible patients or billing for services not provided to terminally ill patients.
• Mental Health Services Fraud: Investigations targeting behavioral health providers suspected of billing fraud, inadequate services, or violations of patient care standards.
• Dental Practice Violations: Federal scrutiny of dental providers suspected of unnecessary procedures, Medicaid fraud, or billing irregularities in government program participation.
• Chiropractic Care Investigations: Investigations targeting chiropractors suspected of billing for excessive treatments, unnecessary services, or fraudulent insurance claims.
• Compounding Pharmacy Violations: Federal investigations of specialty pharmacies suspected of kickback schemes, adulterated medications, or fraudulent billing practices.
• Clinical Trial Fraud: Investigations targeting research facilities or physicians suspected of falsifying clinical trial data, billing irregularities, or FDA compliance violations.
• HIPAA Violations and Data Breaches: Criminal investigations arising from significant patient privacy violations, data breaches, or willful neglect of electronic health record security requirements.
• Tax Evasion and Financial Crimes: IRS investigations targeting healthcare providers suspected of underreporting income, payroll tax violations, or other financial crimes.
• State Medicaid Fraud Referrals: State investigations that escalate to federal criminal matters when Medicaid fraud crosses state lines or involves federal healthcare programs.

What Not To Do When You Have Received a Subpoena

Receiving a criminal subpoena can trigger panic and lead to costly mistakes that may worsen your legal situation or result in additional criminal charges. At Vargehese & Associates, P.C., we help healthcare providers avoid common pitfalls that can damage their defense and complicate their cases.

• Don't Destroy Any Documents: Never delete files, shred papers, or dispose of records after receiving a subpoena, as document destruction can result in separate obstruction of justice charges.
• Don't Ignore the Subpoena: Failing to respond to a criminal subpoena by the specified deadline can lead to contempt of court charges and additional legal complications.
• Don't Handle It Yourself: Attempting to respond to a criminal subpoena without experienced legal counsel puts you at serious risk of self-incrimination and procedural violations.
• Don't Talk to Investigators Alone: Speaking with federal agents, prosecutors, or investigators without your attorney present can result in statements being used against you in criminal proceedings.
• Don't Discuss the Case with Staff: Talking about the investigation with employees, colleagues, or business partners can compromise your defense and create additional witnesses for prosecutors.
• Don't Continue Routine Document Destruction: Maintaining normal document retention policies after receiving a subpoena can be interpreted as obstruction, even if the destruction is routine business practice.
• Don't Provide More Than Requested: Volunteering additional documents or information beyond what the subpoena specifically requests can expand the investigation and create new areas of legal exposure.
• Don't Alter or Modify Records: Making any changes to existing documents, even corrections or clarifications, can be viewed as evidence tampering and result in additional criminal charges.
• Don't Miss Critical Deadlines: Failing to meet subpoena compliance deadlines without proper legal justification can result in contempt proceedings and damage your credibility with prosecutors.
• Don't Panic and Make Hasty Decisions: Rushing to respond without careful planning and legal guidance often leads to mistakes that can be used against you later.
• Don't Assume You're Just a Witness: Many healthcare providers receive subpoenas thinking they're merely witnesses, only to discover they're actually targets of the criminal investigation.
• Don't Rely on General Counsel: Using attorneys without criminal defense experience or healthcare fraud knowledge can result in inadequate representation during this critical phase.
• Don't Post on Social Media: Discussing the investigation, expressing opinions about the case, or posting related content on social platforms can be used as evidence against you.
• Don't Trust Verbal Assurances: Believing verbal promises from investigators about immunity, cooperation benefits, or case outcomes without written agreements can lead to serious disappointment.
• Don't Delegate Response Duties: Allowing staff members, administrators, or non-legal personnel to handle subpoena responses can result in compliance failures and strategic mistakes.
• Don't Assume Privilege Protections: Believing that all communications with attorneys, accountants, or consultants are protected can lead to inadvertent disclosure of sensitive information.
• Don't Contact Other Subpoena Recipients: Reaching out to colleagues, business partners, or other providers who received subpoenas can be viewed as witness tampering or obstruction.
• Don't Make Financial Moves: Transferring assets, making large purchases, or changing financial arrangements after receiving a subpoena can appear suspicious to investigators and prosecutors.
• Don't Continue Questionable Practices: Maintaining billing patterns, business relationships, or operational procedures that triggered the investigation demonstrates lack of good faith cooperation.
• Don't Assume Insurance Will Cover Everything: Relying on professional liability insurance without understanding coverage limitations can leave you personally responsible for substantial legal costs and damages.

Who Sends Healthcare Providers Criminal Subpoenas?

Multiple federal and state agencies have authority to issue criminal subpoenas to healthcare providers during fraud investigations, each with specific jurisdictional focuses and enforcement priorities. At Vargehese & Associates, P.C., we help healthcare professionals understand which agencies are investigating them and develop appropriate response strategies.

• U.S. Attorney's Office: Federal prosecutors issue grand jury subpoenas for criminal healthcare fraud investigations, often coordinating with other agencies to build comprehensive cases against providers.
• FBI Healthcare Fraud Unit: The Federal Bureau of Investigation conducts criminal investigations of healthcare fraud schemes and issues subpoenas for documents and testimony related to billing violations.
• HHS Office of Inspector General: The Department of Health and Human Services OIG investigates Medicare and Medicaid fraud, issuing subpoenas for provider records and conducting criminal referrals to prosecutors.
• DEA Diversion Control Division: The Drug Enforcement Administration issues subpoenas to healthcare providers suspected of illegal prescription practices, controlled substance violations, or operating pill mills.
• Medicare Fraud Strike Force: Multi-agency task forces in major cities coordinate criminal investigations and issue subpoenas targeting organized healthcare fraud schemes affecting federal programs.
• CMS Center for Program Integrity: The Centers for Medicare and Medicaid Services investigates billing irregularities and refers criminal matters to law enforcement agencies for subpoena issuance.
• State Attorney General Offices: State prosecutors issue criminal subpoenas for Medicaid fraud investigations and coordinate with federal agencies on cases involving state healthcare programs.
• State Medicaid Fraud Control Units: Specialized state units investigate provider fraud in Medicaid programs and issue subpoenas for records related to billing violations and patient abuse.
• IRS Criminal Investigation Division: The Internal Revenue Service investigates healthcare providers for tax evasion, unreported income, and financial crimes related to medical practice operations.
• FDA Office of Criminal Investigations: The Food and Drug Administration investigates healthcare providers involved in drug approval fraud, clinical trial violations, or pharmaceutical-related criminal schemes.
• U.S. Postal Inspection Service: Postal inspectors investigate healthcare providers who use mail services for fraudulent billing schemes or prescription drug distribution violations.
• State Medical Board Investigators: Professional licensing boards conduct criminal investigations of providers and coordinate with law enforcement agencies on cases involving professional misconduct.
• Workers' Compensation Fraud Units: State agencies investigate healthcare providers suspected of workers' compensation fraud and issue subpoenas for treatment records and billing documentation.
• Insurance Fraud Bureaus: State insurance departments investigate providers suspected of private insurance fraud and coordinate criminal referrals with prosecutorial agencies.
• Local District Attorney Offices: County prosecutors investigate healthcare providers for criminal violations within their jurisdiction and issue subpoenas for local healthcare fraud cases.
• Multi-Agency Task Forces: Collaborative investigations involving federal, state, and local agencies that combine resources to target complex healthcare fraud schemes affecting multiple jurisdictions.
• Congressional Oversight Committees: House and Senate committees investigating healthcare fraud may issue subpoenas to providers as part of legislative oversight and criminal referral processes.
• State Department of Health: Health departments investigate providers for criminal violations of public health laws and coordinate with law enforcement on cases involving patient safety.
• Office of the Inspector General (Various Agencies): Multiple federal agencies have OIG units that investigate healthcare-related criminal violations within their specific regulatory areas.
• Joint Federal-State Investigations: Coordinated efforts between federal and state agencies that result in subpoenas from multiple jurisdictions targeting the same healthcare fraud investigation.

Potential Criminal Charges Healthcare Providers Face During Federal Investigations

Federal prosecutors have numerous criminal statutes at their disposal when investigating healthcare providers, each carrying severe penalties including substantial fines and imprisonment. At Vargehese & Associates, P.C., we help healthcare professionals understand the potential charges they may face and develop strategic defenses against federal prosecution.

• Healthcare Fraud (18 U.S.C. § 1347): Federal prosecutors charge providers who knowingly execute schemes to defraud healthcare benefit programs or obtain money through false pretenses, carrying up to 10 years imprisonment per violation.
• Wire Fraud (18 U.S.C. § 1343): Charges apply when providers use electronic communications to further fraudulent billing schemes, with each transmission constituting a separate offense punishable by up to 20 years imprisonment.
• Mail Fraud (18 U.S.C. § 1341): Federal prosecutors pursue these charges when providers use postal services to submit false claims or further fraudulent schemes, carrying penalties up to 20 years per count.
• False Claims Act Violations (31 U.S.C. § 3729): Civil and criminal penalties apply to providers who knowingly submit false claims to government healthcare programs, including treble damages and substantial monetary penalties.
• Anti-Kickback Statute Violations (42 U.S.C. § 1320a-7b): Criminal charges target providers who offer, pay, solicit, or receive illegal remuneration for healthcare referrals, carrying up to 10 years imprisonment and significant fines.
• Stark Law Violations (42 U.S.C. § 1395nn): While primarily civil, certain physician self-referral violations can trigger criminal prosecution when combined with other fraudulent conduct affecting federal healthcare programs.
• Controlled Substances Act Violations (21 U.S.C. § 841): DEA prosecutes healthcare providers for illegal prescription practices, operating pill mills, or distributing controlled substances outside legitimate medical practice.
• Money Laundering (18 U.S.C. § 1956): Charges apply when providers attempt to conceal the proceeds of healthcare fraud through financial transactions designed to hide the illegal source of funds.
• RICO Violations (18 U.S.C. § 1961): Racketeering charges target providers involved in organized healthcare fraud enterprises, carrying enhanced penalties including asset forfeiture and extended prison sentences.
• Conspiracy Charges (18 U.S.C. § 371): Federal prosecutors charge providers who agree with others to commit healthcare fraud, even if the underlying fraud is not completed successfully.
• Tax Evasion (26 U.S.C. § 7201): IRS criminal investigations target healthcare providers who fail to report income from fraudulent schemes or underreport legitimate medical practice revenue.
• Obstruction of Justice (18 U.S.C. § 1503): Charges apply when providers interfere with federal investigations by destroying documents, intimidating witnesses, or providing false information to investigators.
• Perjury (18 U.S.C. § 1621): Federal prosecutors charge providers who make false statements under oath during grand jury proceedings, depositions, or other official proceedings.
• False Statements (18 U.S.C. § 1001): Charges target providers who make material false statements to federal investigators or agencies, regardless of whether the statements were made under oath.
• Aggravated Identity Theft (18 U.S.C. § 1028A): Enhanced penalties apply when healthcare fraud schemes involve unauthorized use of patient identities or provider identification numbers.
• Computer Fraud (18 U.S.C. § 1030): Charges apply to providers who illegally access healthcare databases, manipulate electronic health records, or use computers to further fraudulent billing schemes.
• Honest Services Fraud (18 U.S.C. § 1346): Federal prosecutors use this statute to charge providers who breach fiduciary duties to patients, employers, or healthcare organizations through fraudulent conduct.
• Forfeiture Proceedings (18 U.S.C. § 981): Civil and criminal asset forfeiture allows government seizure of property derived from or used to facilitate healthcare fraud schemes.
• Program Exclusion Violations (42 U.S.C. § 1320a-7): Criminal charges may apply to excluded providers who continue participating in federal healthcare programs or attempt to circumvent exclusion requirements.
• HIPAA Criminal Violations (42 U.S.C. § 1320d-6): Willful disclosure of protected health information or wrongful conduct involving electronic health records can result in criminal prosecution.

Don't Face Federal Charges Alone

Time is critical when federal prosecutors are building a case against you. The attorneys at Vargehese & Associates, P.C. understand the complexities of healthcare criminal defense and fight aggressively to protect your practice and freedom. Contact us today for immediate legal protection.