What Counts as Fraud? 6 Federal Offenses You Should Know About

By Barry Wax

  |  

Criminal Defense

  |  

Dec 18, 2025

Executive Summary: Fraud charges cover a broad range of conduct, including Medicare fraud, securities fraud, tax fraud, mail and wire fraud, mortgage fraud, and private insurance fraud (EKRA). These cases are often prosecuted at the federal level and can involve severe penalties. Professionals and business owners may be at risk even when mistakes seem minor. Understanding the types of fraud and how they’re charged is essential for protecting your rights and your future.

If you’re a professional who manages money, owns a business, or works in healthcare, you may not think of yourself as a target for criminal charges. But fraud charges don’t always look like what you’d expect. Many are built on paper trails, billing audits, and vague allegations of misrepresentation. In the federal system, these cases often begin with investigators who assume the worst.

Fraud cases account for a significant portion of white-collar prosecutions in the U.S. Once you’re accused, the consequences can impact everything from your finances to your freedom. Here are six types of fraud the federal government is watching closely.

1. Medicare Fraud

Medicare operates largely on an honor system when it comes to billing, which makes it vulnerable to abuse. Fraud happens when a healthcare provider submits claims for services that weren’t performed, weren’t necessary, aren’t reimburseable, or were misrepresented to increase reimbursement.

This type of fraud is heavily prosecuted pursuant to Title 18 of the United States Code, and civilly under the False Claims Act. Even small practices can be targeted.

2. Securities Fraud

Securities fraud covers a wide range of illegal conduct tied to investments, stocks, or financial markets. That includes insider trading, misrepresenting a company’s financials, running a Ponzi scheme, or artificially inflating stock prices through false or misleading statements (commonly called “pump and dump” schemes).

These cases often involve federal agencies like the SEC and DOJ. In 2023, the SEC filed 784 enforcement actions and secured $5 billion in financial remedies, representing a 3% increase from the previous year.

3. Tax Fraud

Tax fraud is one of the most common types of financial crime. It happens when a person or business willfully avoids paying taxes by underreporting income, overstating deductions, hiding assets, or failing to file returns altogether.

While audits by the IRS have declined over the past decade, high-income earners and business owners continue to be regularly scrutinized. If the IRS believes the conduct was intentional, it can quickly escalate into a criminal referral.

4. Mail and Wire Fraud

Mail and wire fraud are catch-all charges often used when fraud involves communication across state lines. This includes sending anything fraudulent through U.S. mail, email, phone, fax, or internet.

What’s important to understand is that these charges don’t require the scheme to be successful, just that someone tried to execute it using mail or electronic communication. That makes them extremely common in federal indictments.

5. Mortgage Fraud

Mortgage fraud is on the rise, particularly in periods of high interest rates and housing market volatility. The most common example is misstating income, employment, or assets in order to qualify for a loan or to help someone else qualify.

Lying on a loan application, even with the best intentions, can trigger a federal investigation. Lenders are under pressure to report suspicious activity, and even minor misstatements can be used to build a case.

6. Insurance and Private Payer Fraud (EKRA)

The Eliminating Kickbacks in Recovery Act (EKRA) [LINK TO EKRA BLOG FROM SEPTEMBER] is a newer law targeting fraud in addiction treatment, clinical labs, and recovery homes, especially when private insurance is involved.

EKRA makes it a crime to pay or receive money for patient referrals, even if the insurance is not government-funded. Violations can lead to prison time and are often charged alongside healthcare or wire fraud.

Why Fraud Charges Are So Dangerous

Fraud cases often result in:

• Federal indictments
• Asset seizures
• Parallel civil and criminal investigations
• Damaging media coverage
• Significant prison time 

Worse, many people facing fraud charges didn’t think they were doing anything wrong. But under federal law, intent can be inferred from patterns, documents, or third-party statements regardless of what your actual intentions were.

Barry Wax gives people in trouble the ability to make the right choices and regain control of their lives. If you’re facing a fraud investigation or worried you could be, call Barry. He’ll take the time to understand your business, your background, and your concerns, and provide you with a realistic plan moving forward.