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Oberheiden Attorneys

Health Care Fraud Defense Lawyers Serving all of Avoyelles Parish in Louisiana

Health care providers, entities, and businesses in Avoyelles Parish, Louisiana now have a knowledgeable legal advocate if they’re accused of health care fraud. The Oberheiden & McMurrey, LLP has extensive legal experience in health care fraud defense, Medicare and Tricare audits, protection of assets, compliance programs, jury trials, fraud allegation defense, qui tam defense, OIG and grand jury subpoenas, criminal defense, and internal investigations. Our Health Care Fraud Defense Team includes such talent as a former Chief Health Care Fraud Coordinator for the U.S. Attorney’s Office, several former health care fraud prosecutors, and elite former lead prosecutors of the Medicare Fraud Strike Force. Our lawyers represent clients in Avoyelles Parish as well as throughout the state of Louisiana.

If you’re being investigated for health care fraud in Avoyelles Parish, Louisiana, call Oberheiden & McMurrey, LLP immediately. Ask to speak with a member of our Health Care Fraud Defense Team. Initial calls are free and confidential.

Avoyelles Parish, Louisiana Is Continually Monitored for Health Care Fraud

Avoyelles Parish, Louisiana is one of nine regions in the United States that undergoes continual monitoring for health care fraud by the Medicare Fraud Strike Force. This federal investigative body is made up of prosecutors and investigators from several federal agencies. Usually, this team is made up of investigators and prosecutors from the Department of Justice, Department of Health and Human Services, Office of Inspector General, and the Federal Bureau of Investigation. However, other federal agencies often have representatives who are part of this team.

Avoyelles Parish, Louisiana undergoes this constant monitoring because of the large number of citizens in the area who rely on a federal health care program. The high number of recipients increases the number of claims filed by health care providers, entities, and businesses for reimbursement. The government believes that when an area has a particularly high number of claims that there must also be higher instances of health care fraud.

During 2016, the Department of Justice released a statement that revealed that they had investigated around 300 cases of health care fraud. Individual health care providers were the center of 80 of those investigations. The rest of the cases centered on a health care entity or business. The agency stated that they recovered more than $900 million in fraudulently paid out claims.

Defining Health Care Fraud

Federal health care fraud is an attempt to receive reimbursement for medical services or equipment from a federal health care program such as Medicaid, Medicare, Tricare, or federal workers’ compensation. It is the filing of one or more false claims and includes a violation of at least one of the following laws:

  • The Anti-Kickback Statute. Federal health care law outright prohibits kickbacks in exchange for referrals. Any individual (including doctors, marketing representatives, and business owners) is subject to prosecution for violating the Anti-Kickback statute for offering or providing payment or other valuables in exchange for patient referrals.
  • Stark Law. Stark Law, also known as the Self-Referral Law, prohibits doctors from referring patients to specific health care service entities if the doctor (or a member of the doctor’s immediate family) has an ownership or investment interest or if there is a compensation arrangement. Note, however, that there are statutory exceptions to this law.
  • False Claims Act. If you submit a claim to Medicare or any other federal health care program, you are required by law to abide by the False Claims Act. If the claim submitted to the federal government is discovered to be inaccurate, the federal government will likely launch an investigation into your billing practices under the criminal provisions of the False Claims Act.
  • Prescription Fraud. The federal government pays special attention to health care practices that have an unusually high number of narcotic prescriptions. If you are suspected of running a “pill mill,” you are at a high risk of being investigated for insurance fraud and for violating DEA dispensing rules.
  • Billing Fraud. The federal government is persistent about investigating the up-coding of claims. Up-coding means that the next higher code is used for a service when the billing is done. The federal government is also prone to investigating phantom billing (billing for services that were not provided), billing for patients who do not exist (referred to as ghost patients), and billing for equipment or services that are deemed not medically necessary.
  • Certification Errors. The home health care and hospice industry is frequently a practice that the federal government chooses to maintain a close eye on. The most common accusations include fraudulent certification for home health care and hospice care.

Oberheiden & McMurrey, LLP has a successful record of helping clients avoid criminal charges when they are being investigated for health care fraud. If you’re under investigation by the federal government for health care fraud in Avoyelles Parish Louisiana or the surrounding area, call us now. The call is free and confidential.

Health Care Fraud Has Civil and Criminal Penalties

Health care fraud in Avoyelles Parish, Louisiana can result in civil or criminal charges. In civil court, you could be ordered to repay the federal claims, not get reimbursement on future claims, and you could be barred from participating in federal health care programs in the future.

Criminal penalties include more than an indictment. It also includes hefty fines that can cost you hundreds of thousands of dollars and a federal prison sentence of:

  • Up to 10 years for each count of health care fraud
  • Up to 20 years for each count of fraud that resulted in serious bodily injury to the patient
  • Life sentence if the health care fraud resulted in the death of a patient

Avoyelles Parish, Louisiana clients have one question that they always ask during their initial call: What is the worst-case scenario when it comes to health care fraud? The worst-case scenario is facing criminal charges and being given a federal prison sentence. However, whether you will face those penalties depends on many factors, including the severity of any injury suffered by the patient, whether the prosecutor is interested in pursuing criminal charges, and the reason why the investigation was started.

Oberheiden & McMurrey, LLP provides legal advocacy for Avoyelles Parish, Louisiana health care providers, entities, and businesses facing health care fraud charges.

Is the Investigation Against You Criminal?

Health care fraud investigations can be civil or criminal in nature. They often start off as civil and then become criminal as the federal government continues to investigate you. That’s why it is extremely important for you to immediately contact Oberheiden & McMurrey, LLP if you are being investigated.

It’s not necessarily criminal if you’re contacted by a prosecutor. Federal agencies with prosecutors have both civil and criminal branches. That’s why you can’t use contact by a prosecutor as an indicator. Signs of a criminal investigation include the receipt of search warrants, seizure warrants, arrest warrants, target letters, contact from a federal criminal prosecutor, involvement from the IRS, or the receipt of a grand jury subpoena.

Health Care Fraud Defenses

Oberheiden & McMurrey, LLP is a health care fraud defense firm. We provide legal advocacy to individual providers, entire health care systems, and businesses in Avoyelles Parish, Louisiana and the surrounding areas. We’ve managed hundreds of cases during our time as a firm. Several members of our Health Care Fraud Defense Team have prior experience as health care auditors and as health care fraud prosecutors with both the Department of Justice and the Medicare Fraud Strike Force. We use this experience to develop strategic defenses for each of our clients.

Advocacy begins right away. Because our priority is to help clients avoid criminal charges, we immediately reach out to speak with the named federal investigator or prosecutor involved in your case. Because we reach out immediately, it cuts down the amount of time that the federal government has to investigate you. Generally, the longer period of time that the government has to investigate you without an interruption, the more likely it is that you will face criminal charges. Usually, within hours of being retained by our clients, we can get answers to the most important questions:

  • What is the investigation about?
  • What is the purpose of it?
  • How long will the investigation take?
  • What is the most likely outcome?

Showing our clients made a mistake. The federal government must meet a high burden of proof to show that you committed a crime and acted with criminal intent. We evaluate the evidence given by the federal government to determine if they are able to meet that burden of proof. Often, the federal government will point to billing inaccuracies to say that you committed a crime. Yet, we’ve found that these inaccuracies occur not because of fraud, but because of a mistake. While these mistakes should certainly be addressed and corrected, they shouldn’t cause you to face criminal penalties. Mistakes often occur when health care practices or businesses grow quickly or because someone makes a mistake. The most common mistakes that cause these allegations include the use of unqualified workers, delegation errors, outsourcing errors, lack of oversight, insufficient supervision, and the frequently changing laws and rules that are involved in health care.

Researching and using strategic legal defenses. Oberheiden & McMurrey, LLP evaluates each case in order to research and utilize the right strategic legal defenses. This may include using statutory loopholes and exceptions. For example, the Stark Law involves medical necessity certifications. Where applicable, we will point to these exceptions to either mitigate or entire resolve a health care fraud case.

Defending your professional reputation. Health care fraud allegations can damage your professional reputation. Our attorneys work to defend your professional reputation by correcting misinformation about clients and addressing slanderous comments.

If you’re being investigated for health care fraud in Avoyelles Parish, Louisiana or the surrounding areas, call Oberheiden & McMurrey, LLP. Initial calls are free and confidential.

Our Track Record

The commitment of Oberheiden & McMurrey, LLP is to avoid criminal charges and to shield our client’s medical business from government intrusion. Our team of former health care prosecutors and experienced defense attorneys have a distinguished history of protecting business owners, executives, lawyers, physicians, hospitals, laboratories, pharmacies, home health care entities, and many other health care organizations against any form of alleged health care fraud. Here are some recent examples of our case outcomes.

  • Representation of a Pharmacy Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation of a Marketing Group Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation of Physicians Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation of Laboratory against an Investigation by the Department of Justice and the U.S. Attorney’s Office for Alleged Medicare Fraud.
    Result: No civil or criminal liability.
  • Representation of Laboratory against an Investigation by the Department of Health and Human Services and the U.S. Attorney’s Office for Alleged Medicare Fraud.
    Result: No civil or criminal liability.
  • Representation of Laboratory against an Investigation by the Department of Justice and the U.S. Attorney’s Office for alleged Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation 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.
  • Representation of a Health Care Marketing Group Against an Investigation by the Office of Inspector General for Alleged Health Care Fraud.
    Result: No civil or criminal liability.
  • Representation of a Physician against an Investigation by the Department of Health and Human Services and the U.S. Attorney’s Office for Alleged Medicare Fraud, Stark Law Violations, and Anti-Kickbacks.
    Result: No civil or criminal liability.
  • Representation of Laboratory against an Investigation by the Department of Justice and the Office of Inspector General for Alleged False Claims Act and Medicare Violations.
    Result: No civil or criminal liability.
  • Representation of Physician Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud and False Claims Act Violations.
    Result: No civil or criminal liability.
  • Representation of Physician Investigated by the Office of Inspector General for Medicaid Fraud and Stark Law Violations.
    Result: No civil or criminal liability.
  • Representation of Health Care Organization Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud.
    Result: No civil or criminal liability.
  • Representation of Physician Group Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud, Stark Law Violations, and False Claims Act Violations.
    Result: No civil or criminal liability.
  • Representation of Physician Group Investigated by the Department of Health and Human Services and the Office of Inspector General for False Claims Act Violations.
    Result: No civil or criminal liability.
  • Representation of a Physician Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation of Pharmacy Investigated by the Department of Justice and the Office of Inspector General for Department of Labor Program Fraud.
    Result: No civil or criminal liability.

Health Care Fraud Defense Lawyers Serving Avoyelles Parish, Louisiana

Nick OberheidenNick Oberheiden is a 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 experience 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 immense experience 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 & McMurrey, LLP
Serving Avoyelles County, Louisiana 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. Oberheiden & McMurrey, LLP is a Texas LLP with headquarters in Dallas. Mr. Oberheiden limits his practice to federal law.

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