Federal Medicare and Medicaid Fraud Charges in Florida: What You Need to Know

Florida has long been one of the most scrutinized states in the country for healthcare fraud, and that pressure just intensified significantly. In March 2026, the Trump administration formally identified Florida as a “hotspot” for Medicaid fraud, with Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz sending a letter to Governor DeSantis and other state officials demanding detailed information on how Florida identifies, prevents, and addresses fraudulent activity in its Medicaid program.

That letter came just one day after President Trump signed an executive order creating a new anti-fraud task force targeting federal benefit programs, led by Vice President JD Vance, as part of a broader, administration-wide push to crack down on fraud, waste, and abuse. Florida is now at the center of that initiative.

If you work in healthcare, medical billing, or any related field in Florida, here is what that means for you.

Why Is Florida Under a Federal Microscope Right Now?

Florida has historically had some of the highest rates of Medicare and Medicaid fraud in the nation. Federal authorities have prosecuted dozens of large-scale schemes in the state over the years, including fraudulent billing for home health services, unnecessary prescriptions, and false claims by durable medical equipment suppliers.

The Trump administration’s current crackdown takes that scrutiny to a new level. CMS has not only demanded answers from Florida officials but has also announced a six-month freeze on all new Medicare enrollments for suppliers of durable medical equipment, prosthetics, orthotics, and supplies used to treat chronic conditions or assist in injury recovery, citing widespread suspected improper billing.

This means federal investigators are already actively working cases across Florida. Investigations that began quietly months ago may now be moving toward indictments.

What Counts as Medicare or Medicaid Fraud Under Federal Law?

Federal fraud charges in the healthcare context can stem from a wide range of conduct. Many providers who face prosecution were unaware they were doing anything wrong, or believed their billing practices were standard in their industry.

Common allegations that lead to federal charges include:

• Billing for services that were never provided
• Upcoding, which means billing for a higher level of service than what was actually delivered
• Unbundling, or billing separately for services that should be combined under a single billing code
• Billing for medically unnecessary services or equipment
• Kickback arrangements for referrals
• Identity theft of patient or provider information for fraudulent claims
• False certification of patient eligibility

Federal prosecutors often charge these cases under the False Claims Act, the Anti-Kickback Statute, or under general federal wire fraud and conspiracy statutes. The penalties are serious: prison time, substantial fines, exclusion from federal programs, and the loss of professional licenses.

You May Be Under Investigation Without Knowing It

One of the most important things to understand about federal healthcare fraud investigations is that they are typically built over months or even years before anyone is charged. By the time federal agents contact you, the investigation is often already well advanced.

Warning signs that you may be under investigation include:

• Receiving a subpoena or civil investigative demand from the Department of Justice or HHS Office of Inspector General
• Being contacted by agents from the FBI, HHS-OIG, or CMS
• Hearing from colleagues or employees that they have been interviewed by federal investigators
• Unusual audits or requests from Medicare or Medicaid contractors
• A Medicare or Medicaid payment hold on your account

If any of these things have happened, you should speak with a criminal defense attorney immediately, before responding to investigators or producing any documents.

What Should You Do If You Are Being Investigated?

The single most important thing you can do if you believe you are under federal investigation is to stop talking to investigators without an attorney present. Federal agents are trained interrogators, and statements made without counsel, even innocent, well-intentioned explanations, can be used against you or others.

You should:

• Contact an experienced criminal defense attorney as soon as possible
• Preserve all records and communications related to your billing practices, patients, and business operations
• Do not destroy or delete any documents, even if you believe they are damaging
• Do not contact anyone else who may be part of the investigation

Destruction of records after an investigation begins can result in additional federal obstruction charges on top of any underlying fraud allegations.

Federal Cases Require Federal Defense Experience

Healthcare fraud cases prosecuted in federal court are among the most complex criminal matters in the legal system. Federal prosecutors typically spend years building their case, work with multiple agencies, and have significant resources at their disposal. The charging documents alone can span hundreds of pages. The stakes, both in terms of prison time and financial penalties, are severe.

Attorney James Amarosa and the Amarosa Law Firm, P.A. have experience representing clients in Florida’s federal district courts, including in white collar and fraud matters. Every case is approached with the same aggressive, detail-oriented defense strategy that Jim Amarosa has applied throughout his career, reviewing every piece of evidence, challenging every assumption, and fighting to protect your rights from the moment you engage the firm.

Talk to Amarosa Law Firm Before It Is Too Late

With the federal government now treating Florida as a top priority for healthcare fraud enforcement, the pace of investigations and prosecutions in the state is likely to accelerate. If you have any reason to believe you are a target, or even if you simply want to understand your risk, do not wait.

Contact our firm today for a free, confidential consultation, or call us directly. We are available 24 hours a day.