Federal Criminal Defense in the Middle District of Tennessee

By Elizabeth Franklin-Best, Esq., and Christopher Zoukis, JD, MBA

Nashville is the corporate heart of American healthcare, and the United States District Court for the Middle District of Tennessee sits squarely on the enforcement side of that economy: when HHS-OIG and the FBI investigate hospital chains, physician practices, labs, or billing companies based in Middle Tennessee, the resulting charges land at the Fred D. Thompson U.S. Courthouse on Church Street. The same court carries one of the country’s more firearms-heavy federal dockets — and, unusually for federal court, it still tries a meaningful share of its cases to juries.

Here you will find what defendants and their families need to know about this court: its judges and courthouses, the prosecutors and their priorities, the data on how cases actually resolve, and our firm’s role in defending them. Chambers USA 2026 ranks Elizabeth Franklin-Best, P.C. for Litigation: White-Collar Crime & Government Investigations — a practice fit for a district whose signature prosecutions are healthcare and financial — and The Best Lawyers in America 2026 names Elizabeth Franklin-Best a “Best Lawyer” in Appellate Practice. Across her career she has handled over 330 federal matters, including more than 100 appeals argued or briefed in all twelve federal circuits and cert petitions at the U.S. Supreme Court, to which she is also admitted. She represents federal defendants in the Middle District of Tennessee through admission pro hac vice; the page sits within our federal courts directory.

From a healthcare-fraud subpoena served on a Nashville practice to a § 922(g) indictment or a sentencing in Cookeville, our paid, one-hour initial consultation gives you a clear-eyed federal assessment of where the case stands and what can still be changed.

Quick Answer: Middle District of Tennessee

Question	Answer
What does the Middle District of Tennessee cover?	Thirty-two Middle Tennessee counties grouped by 28 U.S.C. § 123(b) into the Nashville, Northeastern (Cookeville), and Columbia divisions.
Who prosecutes federal cases there?	The U.S. Attorney’s Office for the Middle District of Tennessee, headed by U.S. Attorney Braden H. Boucek since his Senate confirmation on December 18, 2025.
What stands out about the docket?	Firearms cases led FY2024 sentencings at 32.1%, drug trafficking followed at 26.4%, and Nashville’s hospital economy drives a steady healthcare-fraud caseload.
Which circuit hears appeals?	The Sixth Circuit — the federal appellate court for Tennessee, Kentucky, Ohio, and Michigan.
Where are post-conviction motions filed?	Right here: a § 2255 motion contesting a Middle District conviction goes before this district court, usually the original sentencing judge.
Can the firm appear in this court?	Yes. We accept Middle District of Tennessee engagements through case-specific pro hac vice admission, from indictment through appeal and collateral review.

Key Takeaways

• Court sits in Nashville, Cookeville, and Columbia, but the clerk’s office and all filings run through Nashville — the divisional courthouses open only when court is in session.
• Firearms prosecutions were the district’s largest FY2024 category at 32.1 percent of sentencings, well above the 13.2 percent national share.
• The FY2024 trial rate was 8.1 percent — close to three times the 2.8 percent national rate — so trial readiness carries real negotiating weight here.
• Nashville’s healthcare industry makes the district a fixture in national healthcare-fraud enforcement, including the Justice Department’s 2025 takedown.
• Chief Judge William L. Campbell, Jr. leads the bench; the district holds four authorized judgeships under 28 U.S.C. § 133 plus three magistrate judges (as of mid-2026).
• U.S. Attorney Braden H. Boucek — once an AUSA in this very district — was confirmed by the Senate on December 18, 2025.
• After judgment enters, Rule 4(b) leaves roughly two weeks to notice an appeal to the Sixth Circuit; the deadline is unforgiving.
• Section 2255, sentence-reduction, and compassionate-release motions all return to this court — the heart of what our firm litigates.

The Middle District of Tennessee at a Glance

Under 28 U.S.C. § 123(b), the district’s thirty-two counties fall into three divisions: Nashville, the Northeastern Division seated at Cookeville on the Cumberland Plateau, and the Columbia Division to the southwest. Flanking it are the state’s two sister courts — the Eastern District of Tennessee toward the mountains and the Western District of Tennessee along the Mississippi.

Every indictment here is signed out of the United States Attorney’s Office for the Middle District of Tennessee in Nashville, and every judgment is reviewable by the Sixth Circuit — the court of appeals whose writ runs across Tennessee, Kentucky, Ohio, and Michigan — so circuit precedent frames each suppression fight and guideline argument from day one.

A practical quirk distinguishes this district: per the court’s website, the Columbia and Cookeville courthouses are occupied only while court is actually in session, and every document — even for divisional cases — must be filed in Nashville. The district’s local rules and standing orders layer onto the Federal Rules of Criminal Procedure, and counsel who miss those Nashville-centric mechanics start a case a step behind.

The Nashville Courthouse and the Bench

Criminal proceedings center on the Fred D. Thompson U.S. Courthouse and Federal Building at 719 Church Street in Nashville, named for the late senator and one-time federal prosecutor. The L. Clure Morton U.S. Post Office and Courthouse in Cookeville and the U.S. Courthouse & Post Office Building in Columbia host division sittings as the calendar requires.

As of mid-2026, the court’s public roster lists Chief Judge William L. Campbell, Jr. alongside District Judges Aleta A. Trauger, Waverly D. Crenshaw, Jr., and Eli J. Richardson — the district carries four authorized judgeships under 28 U.S.C. § 133 — supported by three magistrate judges — Barbara D. Holmes, Jeffery S. Frensley, and Luke A. Evans, who was invested in May 2026 — who handle initial appearances, detention, and pretrial management. Because the active judges all sit in Nashville, a defendant from Cookeville or Columbia should expect most hearings to happen in the capital.

Federal Criminal Cases in the District

The grand jury in Nashville returns indictments across the spectrum — firearms and drug conspiracies, healthcare and financial fraud, money laundering, and broader white-collar matters — and each follows the same procedural spine from investigation to judgment.

The opening move is usually investigative — a target letter, a civil investigative demand, or a grand jury subpoena — before charges arrive by indictment. Then come the initial appearance and arraignment, discovery and motions practice, resolution by negotiated plea or jury trial, and — on any conviction — Guidelines sentencing. Stage-by-stage detail lives in our federal criminal process hub.

What separates this district statistically is its appetite for trial. Of 333 individuals sentenced in FY2024, twenty-seven — 8.1 percent — were convicted at trial, nearly triple the national rate of 2.8 percent. Prosecutors here know defense counsel may actually try the case, and a defense team that prepares accordingly negotiates from strength.

Applied Insight: Healthcare investigations in this district rarely announce themselves with an arrest. They begin quietly — an audit letter, a civil investigative demand, employees interviewed at home — while prosecutors decide whether the matter stays civil under the False Claims Act or turns criminal. That window is the single best moment to shape the outcome, and it closes the day the indictment is returned. Get federal counsel into the room while the choice is still being made.

Healthcare Fraud Enforcement in the Healthcare Capital

Greater Nashville hosts hundreds of healthcare companies — hospital systems, physician-practice managers, behavioral-health networks, labs, and billing vendors — and federal enforcement follows the industry. HHS-OIG agents, FBI white-collar squads, and the U.S. Attorney’s Office work this docket continuously, and the district regularly appears in the Justice Department’s coordinated national actions. In the 2025 National Health Care Fraud Takedown — 324 defendants charged nationwide in connection with more than $14.6 billion in alleged intended losses — the Middle District’s charged cases included a Hendersonville physician and her office-manager husband. Those charges, like all indictments, are allegations only, and every defendant is presumed innocent.

Defending these cases means using the Supreme Court’s recent fraud decisions aggressively. Ciminelli v. United States, 598 U.S. 306 (2023), abolished the “right to control” theory, so depriving a payer of economic information alone is not federal fraud; Kousisis v. United States, 605 U.S. 114 (2025), confirmed that fraudulent-inducement theories survive but made materiality the real battleground. In billing-dispute prosecutions — where the government recasts coding judgments or medical-necessity disagreements as deception — those doctrines, along with the statutory safe harbors of the Anti-Kickback world, frequently mark the line between a civil overpayment case and a criminal one. Our federal fraud defense practice lives on that line.

A Firearms-Heavy Docket That Still Tries Cases

The U.S. Sentencing Commission’s FY2024 district packet shows firearms offenses as the Middle District’s single largest sentencing category — 107 of 333 cases, or 32.1 percent, against a 13.2 percent national share — with drug trafficking at 26.4 percent, money laundering at 7.8 percent, and robbery at 5.4 percent. Felon-in-possession and § 924(c) counts drive much of that volume out of Nashville’s violent-crime initiatives.

Firearms law is moving quickly, and the defense toolkit moves with it. Where an Armed Career Criminal Act enhancement looms, Erlinger v. United States, 602 U.S. 821 (2024), now requires a unanimous jury — not the judge — to find that prior offenses occurred on separate occasions before the fifteen-year ACCA floor applies. Combined with this district’s demonstrated willingness to put cases before juries, that kind of structural argument has practical bite here that it lacks in plea-mill districts.

Appeals and Post-Conviction Matters

Once judgment enters in Nashville, the clock that matters most is Rule 4(b)’s: roughly two weeks to file the notice that opens a direct appeal to the Sixth Circuit. On appeal, sentences are reviewed for reasonableness under Gall v. United States, 552 U.S. 38 (2007), and a defendant who argued for a lower sentence below has preserved that challenge — Holguin-Hernandez v. United States, 589 U.S. 169 (2020) — which is why the record we build at sentencing is constructed with the court of appeals in mind.

Collateral remedies stay in this courthouse too. A § 2255 motion attacking a Middle District conviction or sentence is filed in the Middle District, and compassionate release under § 3582(c)(1)(A) goes to the sentencing court as well. This is the firm’s deepest bench: post-conviction and appellate litigation is national work, and we bring it to Nashville without missing local procedural nuance. Compassionate-release practice here is thin by the numbers — U.S. Sentencing Commission data record no § 3582(c)(1)(A) motions decided in this district in fiscal year 2025, against a Sixth Circuit grant rate of 8.9 percent (24 of 271) and a national rate of 14.1 percent (394 of 2,795) — which makes the quality of the extraordinary-and-compelling showing, and the choice between § 3582 and § 2255, all the more decisive.

How the Firm Practices in This Court

When we take a Middle District of Tennessee case, we move for pro hac vice admission under the court’s local rules — the standard mechanism that lets a federal practitioner admitted in other courts appear in a specific Nashville case. The motion is routine; what the client is actually buying is the substance behind it.

That substance is federal-specific experience. Title 18 and Title 21, the Federal Rules, the Sentencing Guidelines, and Sixth Circuit precedent do not change at the Davidson County line — they are the same body of law we litigate in district courts across the country, and Elizabeth Franklin-Best holds bar admissions in the U.S. Supreme Court and every one of the twelve federal circuits. Her practice pairs white-collar and healthcare-fraud defense with a nationwide appellate and post-conviction docket — dozens of § 2255 and habeas matters, First Step Act resentencings, and compassionate-release litigation — the layered capability a Nashville fraud or firearms case tends to need before it is over.

In a healthcare-enforcement hub, the right question for any prospective lawyer is whether they have defended professionals and executives against fraud theories, fought guideline loss tables, and carried a case up on appeal when the district court got it wrong. That combination — white-collar defense married to appellate depth — is precisely the firm’s profile.

Frequently Asked Questions

Plan Your Defense in Nashville’s Federal Court

An investigation letter from HHS-OIG, a sealed indictment, an unsatisfying sentence, a conviction worth appealing — wherever your Middle District of Tennessee matter stands, our paid, one-hour initial consultation maps the legal terrain and the realistic paths through it, candidly and without sales talk.