Medicaid and Medicare Fraud Defense in Las Vegas, Nevada

Medicare and Medicaid Fraud Investigations in Nevada

Healthcare fraud investigations may begin with an audit, unusual billing activity, a whistleblower complaint, a subpoena, or contact from state or federal investigators.

Possible investigating agencies include the U.S. Department of Justice, FBI, U.S. Department of Health and Human Services Office of Inspector General, Centers for Medicare & Medicaid Services, and the Nevada Attorney General’s Medicaid Fraud Control Unit.

Recent Nevada cases show that healthcare billing remains an active enforcement priority. In August 2026, federal prosecutors announced charges against a Henderson physician accused of participating in an alleged $95 million Medicare fraud scheme involving wound-care products and allegedly medically unnecessary treatments. In July 2025, a Las Vegas nurse practitioner pleaded guilty in a Medicare wound-care case involving approximately $14.3 million in submitted claims and roughly $9.1 million in Medicare payments.

An indictment or criminal charge is only an allegation, and every defendant is presumed innocent unless proven guilty.

Potential consequences of a conviction can include prison, fines, restitution, forfeiture, exclusion from Medicare or Medicaid, and professional licensing consequences.

If you receive a subpoena, target letter, audit notice, or request to speak with investigators, consider speaking with a criminal defense attorney before responding. Pariente Law Firm represents individuals facing serious criminal investigations and charges in Las Vegas and throughout Nevada.

Medicaid and Medicare Fraud FAQs

What is considered Medicaid fraud in Nevada?
Medicaid fraud may involve knowingly submitting false claims, billing for services that were not provided, falsifying documentation, misrepresenting provider information, or otherwise attempting to improperly obtain Medicaid funds.

What is considered Medicare fraud?
Medicare fraud generally involves knowingly and willfully attempting to defraud Medicare or obtain program funds through false or fraudulent claims or representations.

Is an incorrect Medicare or Medicaid claim automatically fraud?
No. Billing mistakes and administrative errors can occur without criminal intent. Investigators may look at knowledge, intent, billing patterns, documentation, and the person’s responsibilities.

Can I be charged if an employee or billing company submitted the claim?
Possibly. Investigators may examine whether you knew about the conduct, supervised the billing process, had authority over claims, or had reason to know inaccurate claims were being submitted.

What is upcoding?
Upcoding occurs when a provider bills for a more expensive service, procedure, or level of care than was actually provided.

Who investigates Medicaid fraud in Nevada?
The Nevada Attorney General’s Medicaid Fraud Control Unit investigates certain cases involving fraud against Nevada Medicaid. Federal agencies may also become involved depending on the allegations.

What should I do if I receive a subpoena related to Medicare or Medicaid billing?
Consider speaking with a criminal defense attorney before responding. A subpoena may mean the government is gathering evidence in an investigation even if no charges have been filed. Call us (702-466-1871) or contact us here to schedule your free consultation today (we’re available 24/7).