We are a team of
former federal prosecutors


Most of our cases have ended in
No Criminal Charges

Meet the Team
Oberheiden Attorneys

Medicare Fraud Defense Lawyers Serving Ada and all of Southeastern Oklahoma

If you’re in Ada, Oklahoma or the surrounding area and you’re being investigated for Medicare fraud, contact the Oberheiden Law Group, PLLC. We provide legal representation for people, health care systems, and health care businesses that are being investigated by the federal government, involved in an audit, need asset protection plans, and for federal compliance programs, qui tam defense, assistance with grand jury or OIG subpoenas, federal criminal defense, and internal investigations. The Oberheiden Law Group is comprised of attorneys with top legal education and former involvement as federal prosecutorial and senior trial attorneys. Our team is managed by a former Chief Health Care Fraud Coordinator from the U.S. Attorney’s Office.

Medicare Fraud Is a Federal Violation

Medicare fraud is a federal violation with both civil and criminal penalties. It involves filing one or more false claims for reimbursement from a federal health care program. Medicare fraud includes Medicare, Medicaid, Tricare, and federal workers’ compensation. If you’re being investigated for Medicare fraud by the federal government, you’re being accused of violating at least one of the following:

  • Violating the Anti-Kickback Statute;
  • Violating the False Claims Act
  • Violating Stark Law (the Physician Self-Referral Law)
  • Violating the Social Security Act
  • Violating U.S. Criminal Code

Physicians, nursing professionals, pharmacists, health care businesses, clinics, and hospitals in Ada, Oklahoma are investigated for Medicare fraud more often than similarly sized cities in the United States. Ada is one of nine regions in the United States with a large number of residents who are beneficiaries of a federal health care program. This causes an increase in the number of claims for the area. The increase in claims means that the federal government will constantly monitor it for instances of Medicare fraud.

Medicare fraud is monitored, investigated, and prosecuted by the Medicare Fraud Strike Force. This is a federal team of investigations and prosecutors from various federal agencies including the DOJ, DEA, DOD, Department of Human Services, the Office of Inspector General, the FBI, and the IRS. However, other federal agencies can be involved. If you’re being investigated by the Medicare Fraud Strike Force or if you’re contacted by a member from a federal agency, contact Oberheiden Law Group right away. Initial consultations are free.

Ada, Oklahoma Medicare Fraud Investigations

Medicare fraud investigations in Ada, Oklahoma and the surrounding areas generally begin because a claim with a mistake is filed with a federal health care program. The federal government notices the mistake and decides to investigate because they believe you intentionally filed a fraudulent claim. These claims usually have an unauthorized medical service or use of medical equipment, include an incorrect charge, or lists an excessive charge. The most common billing errors in Ada, Oklahoma include:

  • Phantom billing – billing for services that were never performed;
  • Double billing for medical equipment or services;
  • Submitting a claim for medically unnecessary medical services or equipment;
  • Submitting a claim for medically unnecessary medical supplies;
  • Submitting a claim for a medically unnecessary certification (including a claim for hospice or home health care );
  • Inflating charges;
  • Up-coding;
  • The overuse of medical equipment of services;
  • Providing or accepting kickbacks.

Physicians, nursing professionals, pharmacists, physician-owned businesses, DME providers, and nursing homes in Ada, Oklahoma are some of the most common targets of Medicare fraud investigations.

Civil and Criminal Penalties of Medicare Fraud

Medicare fraud allegations in Ada, Oklahoma can result in both civil and criminal penalties. The civil penalties include:

  • Repayment of claims in questions;
  • Future claims aren’t paid;
  • A fine of up to $11,000 per false claim;
  • Exclusion from federal health care programs;
  • Assignment of treble damages;
  • Attorney fees

You could also be summoned by the disciplinary or licensing board. You could lose your license to practice or your hospital privileges.

Criminal consequences often include:

  • Fines that cost you hundreds of thousands of dollars, even for a misdemeanor;
  • A criminal record;
  • A federal prison sentence of up to 10 years for each count of Medicare fraud for which you are convicted;
  • Federal prison sentence of up to 20 years for each count of Medicare fraud that resulted in serious bodily harm to the patient or patients;
  • A life sentence in federal prison for Medicare fraud that results in the death of a patient.

Hiring a Medicare Fraud Defense Attorney in Ada, Oklahoma

Allegations of Medicare fraud can ruin your business. It is a serious matter that often includes federal criminal charges such as mail fraud, wire fraud, or tax fraud. You need to hire a Medicare fraud defense attorney.

Health care fraud defense attorneys are attorneys who represent clients being accused of Medicare fraud. Look for an Ada health care fraud defense attorney who has these four traits:

  1. A successful record when handling Medicare fraud cases;
  2. Knowledge of the Medicare fraud and health care fraud laws and regulations;
  3. Knowledge of statutory exceptions;
  4. Both litigation and jury trial practices.

Next, you should learn more about the skills the health care fraud attorney has. To do this, you can ask these three questions:

  1. How many Medicare fraud cases have you handled throughout your career?
  2. How many of those resulted in no civil or criminal charges or in dismissals for your clients?
  3. How many of those cases were tried in court?

Defense Strategies for Medicare Fraud Allegations

The Oberheiden Law Group looks at each case to determine the right defense strategies for each case. Where possible, we settle with the federal government. Yet, we are also prepared to go to trial on your behalf. We’ve represented hundreds of clients across the nation. Several of our team members have involvement as former federal health care prosecutors. Using our knowledge, we’ve developed certain defense strategies that we use for our clients in Ada, Oklahoma.

Immediate contact with federal investigators. Our main priority is to protect you from criminal charges. One of the ways that we accomplish this is by immediately contacting federal investigators. This allows us to get answers to the most important questions:

  • What is the investigation about?
  • What prompted the investigation?
  • Is the investigation civil or criminal?
  • Which federal agencies are involved?
  • What is the ultimate goal of the government?
  • How can this matter be resolved?

Often, we’re able to get answers to these questions within just a few hours after we are retained.

Reviewing federal evidence. The government must present evidence that proves “beyond a reasonable doubt” that you committed a crime. We review the evidence provided by the federal government to determine if they can meet that standard. Taking the time to do this often results in:

  • Dismissal of charges;
  • No criminal charges;
  • Client retains professional license;
  • Civil fine with no criminal plea;
  • Reducing a felony to a misdemeanor;
  • No federal prison sentence.

No criminal intent. Investigators must also prove that you acted with criminal intent. That’s difficult for the government since most Medicare fraud investigations in Ada and the surrounding areas start because of a mistake made during the billing or coding process and not because someone had the intent to defraud the government. Common mistakes include:

  • Using unqualified staff;
  • Inadequate supervision;
  • Inappropriate delegation and outsourcing;
  • Structural errors;
  • Human errors;
  • Oversight;
  • Employees who are overwhelmed;
  • No Medicare compliance program in place;
  • The changing health care laws and rules.
  • While these mistakes should certainly be addressed and corrected, they aren’t crimes.

Using the ideal Medicare fraud defenses for each client. We analyze the facts surrounding each case to determine the most efficient Medicare fraud defenses that can be used. One of our clients was recently accused of providing fraudulent certification for home health care services. We proved that our client was legally protected by a recognized delegation exception and that the certification was compliant within the law. In another recent case, we refused to admit liability on behalf of our client. Instead, we proved to the federal prosecutor that our client acted within a safe harbor exception.

Oberheiden Law Group, PLLC

The Oberheiden Law Group provides Medicare fraud defense for Ada, Oklahoma and the surrounding areas. We represent medical providers, entities, business owners, executives, lawyers, clinics, pharmacists, pharmacies, and other related medical entities under investigation for fraudulent billing, illegal kickbacks, and allegations of medically unnecessary services, services not rendered, or unlawful joint ventures. We can help you in many areas, including:

  • Health care fraud defense
  • Compliance program creation and implementation
  • Internal investigations
  • Asset protection
  • Licensure or disciplinary proceedings
  • Jury trials

The Oberheiden Law Group represents both individuals and entire health care systems or businesses in Ada, Oklahoma and the surrounding areas. If you’re being investigated by the DOJ, Department of Defense, the FBI, the DEA, the Office of Inspector General, Medicare Fraud Control Unit, the IRS, Ada or Oklahoma law enforcement, contact Oberheiden Law Group right away. Consultations are free and confidential.

Our Track Record

  • Defense of Medicare laboratory against investigations by the Department of Justice and the U.S. Attorney’s Office for alleged Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of a health care services company against an investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for alleged False Claims Act and Stark Law violations.
    Result: No civil or criminal liability.
  • Defense of Medicare laboratory against investigations by the Department of Health and Human Services and the Office of Inspector General for alleged Health Care Fraud.
    Result: No civil or criminal liability.
  • Defense of nationally operating health care company against an investigation by the Department of Defense for alleged Tricare fraud.
    Result: No civil or criminal liability.
  • Defense of health care marketing company against an investigation by the Office of Inspector General for alleged False Claims Act and Medicare violations.
    Result: No civil or criminal liability.
  • Defense of a laboratory against an investigation by various branches of the federal government for alleged fraud.
    Result: No civil or criminal liability.
  • Defense of physician-owned entity against an investigation by the Department of Health and Human Services for alleged Stark Law violations.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Department of Justice for alleged fraud.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged Stark Law violations.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged False Claims Act violations.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by various branches of the federal government for alleged False Claims Act, Stark Law, and Medicare violations.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Department of Defense for alleged Tricare fraud.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Department of Justice for alleged Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of physician-owned entity against an investigation by the Department of Health and Human Services for alleged Stark Law violations.
    Result: No civil or criminal liability.
  • Defense of health care management organization against an investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for alleged Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of nationally operating laboratory against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability.

Medicare Fraud Defense Lawyers Serving Ada, Oklahoma

Nick OberheidenNick Oberheiden is a Harvard-trained and internationally educated health care fraud defense attorney. Dr. Oberheiden has successfully represented health care executives, business owners, public officials, physicians, and lawyers in high profile prosecutions, during accusations of political corruption, government investigations, and directed media campaigns, including 60 Minutes. He is most known for stopping federal investigations before criminal charges can be filed. In addition to his health care defense practice, Dr. Oberheiden leads internal investigations, implements corporate compliance programs, and teaches U.S. criminal law and federal litigation in the United States and abroad.

Lynette ByrdLynette S. Byrd is a former Assistant United States Attorney (AUSA). Clients greatly benefit from Ms. Byrd’s knowledge from the Department of Justice, where she prosecuted health care fraud, Anti-Kickback violations, False Claims Act, and Stark violations on behalf of the United States. Ms. Byrd has skills with health care law enforcement, and she regularly argues federal matters for her clients.

We are available every day of the year. You can call us directly or complete our contact form or by emailing us directly.

800-810-0259
Including Weekends
Oberheiden Law Group, PLLC
Serving Ada, Oklahoma and Surrounding Areas
www.federal-lawyer.com
This information has been prepared for informational purposes only and does not constitute legal advice. This information may constitute attorney advertising in some jurisdictions. Reading of this information does not create an attorney-client relationship. Prior results do not guarantee similar future outcomes. The Oberheiden Law Group PLLC is a Texas PLLC with headquarters in Dallas. Mr. Oberheiden limits his practice to federal law.

IF YOUR FREEDOM IS AT STAKE

YOU SHOULD CONTACT US TODAY

Contact the Experienced Attorneys of the Oberheiden Law Group Now for a Confidential Consultation

Contact Us Now
×