18 USC 1349 — Conspiracy and Attempt to Commit Health Care Fraud

18 USC 1349 is the federal statute that lets prosecutors charge attempt or conspiracy to commit health care fraud. Its most important feature is that an attempt or conspiracy is punished just as severely as the completed crime — so a conspiracy to commit health care fraud carries the same up-to-10-year exposure as the fraud itself. And unlike the general federal conspiracy statute, 18 USC 1349 does not require the government to prove an overt act; the agreement alone, joined knowingly, can be enough.

This page explains how 18 USC 1349 works, what the government must prove, the penalties, and how conspiracy charges are defended. It is a plain-English legal reference for anyone facing a health care fraud conspiracy allegation in California. To see how we defend these cases, visit our federal health care fraud defense page.

Summary of the Statute

18 USC 1349 applies to the fraud offenses in Chapter 63 of Title 18 — including health care fraud, mail fraud, wire fraud, and bank fraud. It provides simply that any person who attempts or conspires to commit one of those offenses is subject to the same penalties as those prescribed for the offense itself.

That single sentence carries enormous weight in health care fraud prosecutions. Because most large health care fraud cases involve multiple people — owners, physicians, billers, marketers, patient recruiters — the government frequently builds its case around a 18 USC 1347 conspiracy, allowing it to hold every alleged participant responsible for the whole scheme. The conspiracy charge becomes the umbrella under which the entire prosecution is organized.

What the Government Must Prove

The elements depend on whether the charge is conspiracy or attempt.

For a Conspiracy

The government must prove that two or more people agreed to commit health care fraud, and that the defendant knowingly and voluntarily joined that agreement with the intent to further it. Notably, it does not have to prove an overt act in furtherance of the conspiracy — a key difference from the general conspiracy statute, 18 USC 371. The defense often focuses on whether a genuine agreement existed and whether the defendant actually knew of and intended to join an unlawful scheme, as opposed to simply doing a job or associating with others.

For an Attempt

The government must prove that the defendant intended to commit health care fraud and took a substantial step toward completing it — more than mere preparation. The defense can challenge whether the defendant’s conduct crossed the line from preparation to a true attempt, and whether the required intent existed.

Why Conspiracy Charges Are So Powerful

Conspiracy law gives prosecutors several advantages, which is why 18 USC 1349 appears in so many health care fraud indictments. Statements made by one alleged co-conspirator can sometimes be used against the others. A defendant can be held responsible for the reasonably foreseeable acts of co-conspirators, even acts the defendant did not personally carry out. And the lack of an overt-act requirement lowers the government’s burden compared with general conspiracy charges.

These same features are why defense strategy matters so much. People on the periphery of a scheme — employees following instructions, vendors providing ordinary services — can find themselves charged as conspirators. Separating lawful conduct and mere association from a knowing agreement to defraud is frequently the heart of the defense.

Penalties Under 18 USC 1349

18 USC 1349 has no separate penalty of its own. Instead, it borrows the penalty of the underlying offense — so the exposure depends entirely on the target crime.

Because the conspiracy carries the same maximum as the completed crime — and because sentencing is then driven by the Sentencing Guidelines loss amount attributed to the whole scheme — a defendant convicted of conspiracy can face exposure far beyond their individual role. Restitution, forfeiture, and program exclusion typically follow as well, just as with a substantive fraud conviction.

Related Federal Statutes

• 18 USC 1347 (health care fraud) — the most common object of a health care fraud conspiracy.
• 42 USC 1320a-7b (Anti-Kickback Statute) — kickback schemes are frequently charged as conspiracies.
• 18 USC 1035 (false statements) — false statement counts often accompany a conspiracy charge.
• 18 USC 1028A (aggravated identity theft) — may be added where patient identities are misused within the scheme.

How Conspiracy Charges Are Defended

The strongest defenses usually attack the existence of an agreement or the defendant’s knowing participation in it. Demonstrating that the defendant performed legitimate work, did not know of any fraudulent purpose, or withdrew from the alleged conspiracy can be decisive. Where the government relies heavily on cooperating witnesses, challenging their credibility and motives is often central. In multi-defendant cases, separating one client’s conduct from the group is critical to avoid guilt by association.

For more on how these large, multi-party cases are built and investigated, see our explainer on OIG health care investigations. The right defense depends on the specific evidence of agreement and intent.

Facing a Conspiracy Charge? Contact Us

A health care fraud conspiracy charge can carry the same penalties as the underlying fraud — even for someone on the edges of a scheme. The earlier you involve experienced counsel, the better. KN Law Firm, APLC defends these cases in the U.S. District Court for the Central District of California and before the Ninth Circuit. Call (888) 950-0011 for a free, confidential consultation with attorney Chris Nalchadjian.