What is the statute of limitations for federal health care fraud charges?

The health care fraud statute, 18 U.S.C. Section 1347, does not set its own limitation period, so the general federal rule in 18 U.S.C. Section 3282 applies: prosecution is barred unless an indictment is returned or an information filed within five years of the offense. The same five-year default governs charges under the Anti-Kickback Statute and the health care fraud conspiracy statute, 18 U.S.C. Section 1349, because neither sets a separate period either.

Does a ten-year statute of limitations apply to health care fraud cases?

The ten-year extension in 18 U.S.C. Section 3293 does not reach health care fraud charges. That extension names a specific list of offenses tied to financial institutions, such as bank fraud, and reaches mail or wire fraud only when a financial institution is affected; the health care fraud statute is not among them. Absent an actual financial institution connection, the five-year default in Section 3282 controls a health care fraud or kickback charge.

Can a conspiracy charge reach conduct from years before an indictment?

Yes, within limits. Under Grunewald v. United States, the limitation period on a conspiracy charge runs from the last overt act a member took to advance the agreement, not from when the agreement began, so an active conspiracy can reach back further than a stand-alone fraud count. The Supreme Court also held that acts taken only to cover up a completed scheme, after its central goals were already met, do not extend the conspiracy.

Statute of Limitations and Continuing Schemes in Criminal Healthcare Fraud

Federal prosecutors do not have forever to bring a criminal healthcare fraud, kickback, or conspiracy case, but the clock on a multi-year billing scheme rarely starts where a provider expects. The general federal limitation period for most non-capital offenses, including the health care fraud statute and the Anti-Kickback Statute, is five years from the date the offense was committed, under 18 U.S.C. Section 3282. A continuing scheme or an active conspiracy can keep that clock running well past the first fraudulent claim. This explainer covers how that period runs for the charges that anchor most healthcare fraud defense matters, and how a continuing scheme or conspiracy keeps old conduct alive.

The Default Five-Year Period

Three charges anchor most criminal healthcare fraud cases: the health care fraud statute at 18 U.S.C. Section 1347, the Anti-Kickback Statute at 42 U.S.C. Section 1320a-7b(b), and the general federal conspiracy statute at 18 U.S.C. Section 371. None of the three sets its own limitation period. Each falls under the default rule in Section 3282, which bars prosecution unless an indictment is returned or an information is filed within five years of the offense. The companion health care fraud conspiracy statute, 18 U.S.C. Section 1349, borrows the underlying offense's penalties and contains no separate limitation clause, so the same five-year default applies.

No Special Extension for Health Care Fraud

Federal law does extend the limitation period to ten years for a defined list of offenses under 18 U.S.C. Section 3293, and providers sometimes assume it reaches their matter because it involves a federal health care program. That extension is written narrowly. It names specific statutes tied to financial institutions, including bank fraud, and reaches mail or wire fraud only when the offense affects a financial institution. The health care fraud statute is not on that list, so the five-year default in Section 3282 governs a health care fraud or kickback charge absent an actual financial institution connection.

How a Continuing Scheme Is Evaluated

Prosecutors sometimes frame a years-long billing scheme as one continuous offense, which would let the clock run from the scheme's last act rather than its first. The Supreme Court limited how far that argument reaches in Toussie v. United States, holding that an offense should be treated as continuing only when the explicit language of the statute compels that result, or when the nature of the crime is such that Congress must have intended continuing treatment. Statutes of limitations are to be interpreted liberally in favor of repose, which makes the continuing-offense label the exception, not the rule. Whether billing conduct years into the past belongs in a current indictment often turns on the line between a billing error and a scheme to defraud, a distinction covered in Billing Error or Fraud: Where Enforcement Draws the Line.

Conspiracy Runs From the Last Overt Act

Conspiracy charges run on a different clock than the underlying fraud count. Section 371 requires proof that at least one conspirator took an overt act to carry out the agreement, and the Supreme Court held in Grunewald v. United States that the limitation period runs from that last overt act, not from when the agreement was formed, so a conspiracy that stayed active, with members still taking steps toward its goal, can reach years into the past. The Court drew a sharp line around concealment: acts taken only to cover up a crime after its central objectives were already accomplished do not extend the conspiracy, even where the conspirators understood the need for secrecy.

A conspiracy charge does not freeze at the moment it began. Under Grunewald, the limitation period runs from the last overt act taken to advance the agreement, not the act that started it.

It is critical that healthcare providers promptly retain experienced healthcare defense counsel upon receiving a grand jury subpoena, a civil investigative demand, or any other sign of a federal investigation into billing conduct. Early legal intervention can map which years of conduct fall inside the limitation period, preserve records exactly as they exist rather than risk a correction resembling the backdating and late chart edits discussed in Backdating and Late Chart Edits in a Federal Investigation, and allow counsel to communicate with investigators on the provider's behalf. Delaying representation narrows the defenses available once the government has fixed its own theory of when the scheme began and ended.

Health Law Alliance defends physicians, pharmacies, and healthcare companies through every stage of a criminal healthcare fraud investigation, from the first subpoena through indictment and trial.

Health Law Alliance's attorneys have overseen 2,000+ audits and handled 5,000+ matters, with 25+ years of experience.

Contact Health Law Alliance's criminal healthcare fraud defense team for a free, confidential consultation to review the specific charges a matter carries and the years of conduct they actually reach.