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 all of Avoyelles Parish

If you’re facing an allegation of Medicare fraud, you understand just how much it can affect your life and your business. Oberheiden Law Group, PLLC represents individuals and entire facilities and businesses in Avoyelles Parish, Louisiana and the surrounding areas being investigated by the federal government, undergoing a Tricare or Medicare audit, establishing Medicare fraud strategies, protection of assets, compliance programs, jury trials, establishing fraud defense, qui tam defense, responding to subpoenas from the OIG or from a grand jury, those in need of criminal defense assistance, and assistance with internal investigations.

What You Need to Know About Medicare Fraud

Medicare fraud is a federal offense. It has civil and criminal penalties associated with it. Medicare fraud is the act of filing one or more false claims with a federal health care program. Health care providers, businesses, and entities file these claims to receive reimbursement from federal programs for medical services or equipment provided to a patient. Medicare fraud includes Medicare, Medicaid, Tricare, and federal workers’ compensation. If you’re accused of Medicare fraud, you’re facing an investigation for 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

Individual medical providers, pharmacists, health care-related businesses, and other entities are investigated for Medicare fraud in Avoyelles Parish, Louisiana more often when compared to counties of similar size throughout the nation. This is because it is one of nine regions in the United States with a large number of federal health care program recipients. The area is under constant surveillance by the Medicare Fraud Strike Force. In areas that see an increase in claims, the federal government believes that there is a greater chance of Medicare fraud.

The Medicare Fraud Strike Force is an agency made up of federal investigators and prosecutors who look for, investigate, and prosecute Medicare fraud. Common federal agencies involved include 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 contacted by the Medicare Fraud Strike Force or a member of a federal agency, immediately contact Oberheiden Law Group to learn more about your options.

Avoyelles Parish, Louisiana Medicare Fraud Investigations

Medicare fraud investigations in Avoyelles Parish, Louisiana and the surrounding areas often start because a claim that is filed with the federal health care program is determined to be inaccurate or fraudulent. These claims often include some sort of unauthorized medical service or equipment, including an incorrect charge or an excessive charge. The most common inaccuracies 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.

Individual providers such as doctors and nurses, physician-owned businesses, nursing homes, registered care facilities, clinics, pharmacies, cancer centers, and DME providers are some of the most common targets of Medicare fraud investigations in Avoyelles Parish, Louisiana.

Civil and Criminal Penalties of Medicare Fraud

Medicare fraud allegations can result in civil or criminal penalties. Civil penalties may 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

It’s also likely that you’ll be called in front of the disciplinary or licensing board. This could result in the loss of your professional license or in the loss of your hospital privileges.

The criminal consequences may 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.

How to Hire the Right Medicare Fraud Defense Attorney

Medicare fraud allegations can ruin your business. You must hire the right Medicare fraud defense attorney to help you. This allegation often includes federal criminal charges like mail fraud, wire fraud, money laundering, or tax fraud. It’s important that you do your research in order to hire the right Medicare fraud attorney.

In Avoyelles Parish, Louisiana, you should look for a health care fraud defense lawyer. A health care fraud defense attorney understands health care law and the federal criminal charges that you may be facing. Watch for these 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.

Additionally, there are three questions that you should ask to fully understand the skills of the lawyer:

  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?

Strategies for Medicare Fraud Defense

The Oberheiden Law Group reviews each case to determine the most effective strategies to use. Although we do look to settle with the federal government, we also have skills as federal trial lawyers. We’re ready to go to court on your behalf when necessary. We’ve represented hundreds of clients. Members of our team have former involvement as federal health care prosecutors and trial lawyers. We’ve used our understanding to develop the strategies that we use for our Avoyelles Parish, Louisiana clients.

Contact with the federal government. We immediately reach out to the federal government on behalf of our clients to minimize the risk of criminal charges. This gives us the opportunity to get answers to the 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?

We are able to get answers to those questions usually within just a few hours. If you’re being investigated for Medicare fraud, contact the Oberheiden Law Group. Don’t give the federal government too much time to investigate you without having a lawyer on your side.

Reviewing the evidence. The federal government presents evidence to try and prove that you committed a crime. Their evidence must meet a legal standard known as “beyond a reasonable doubt.” We review the evidence to determine if the federal government can reach this standard. This strategy has produced the following results on a regular basis:

  • 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.

Lack of criminal intent. The federal government also must prove that you acted with criminal intent. That’s difficult for the government because most Medicare fraud investigations in Avoyelles Parish, Louisiana start because of a mistake and not because of intentional fraud. Often, the mistake is made during the billing or coding process. Common errors 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.

The Oberheiden Law Group works to prove that you made a mistake and that you did not commit a crime.

Using the most efficient Medicare fraud defenses. Medicare fraud cases have the same basic allegation, but all claims involve different facts. We review each case so that we are able to determine the most effective Medicare fraud defenses. 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 legal advocacy for Medicare fraud defense for Avoyelles Parish, Louisiana 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 Avoyelles Parish, Louisiana and the surrounding areas. If you’re under investigation by the Department of Justice, the Department of Defense, the Federal Bureau of Investigation, DEA, the Office of Inspector General, Medicare Fraud Control Unit, the IRS, or Louisiana law enforcement, call the Oberheiden Law Group. The initial consultation is 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 Avoyelles Parish, Louisiana

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 Avoyelles Parish, 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. The Oberheiden Law Group PLLC is a Texas PLLC with headquarters in Dallas. Mr. Oberheiden limits his practice to federal law.

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