We are a team of
former federal prosecutors


Most of our cases have ended in
No Criminal Charges

Meet the Team
Oberheiden Attorneys

False Claims Act & Qui Tam Legal Defense Serving the Baton Rouge Area

9655 Perkins Rd, Suite C-203
Baton Rouge, LA 70810
225-308-2440
(Meeting location by appointment only)

The Oberheiden Law Group is a health care law defense firm with significant experience in the areas of regulatory compliance, corporate structuring, litigation, government investigations, and criminal defense. Among our attorneys are the former Chief Health Care Fraud Coordinator at the U.S. Attorney’s Office, former senior Department of Justice trial attorneys, former lead prosecutors of the elite Medicare Fraud Strike Force, and other talented attorneys with years of relevant experience and education from the country’s best schools such as Harvard Law School and Yale Law School. Our attorneys serve clients in Baton Rouge and surrounding areas.

The Oberheiden Law Group, PLLC’s nationally recognized Health Care Fraud Defense Group provides aggressive legal representation for False Claims Act investigations backed by decades of government and private experience in Baton Rouge, LA and nationwide. Our Health Care Fraud Defense Group is led by: (i) Dr. Nick Oberheiden, a career health care fraud defense attorney and our firm’s founder, and (ii) Lynette Byrd, a former Assistant United States Attorney with extensive False Claims Act experience.

Are You Facing a False Claims Act Investigation in Baton Rouge, LA?

Home to well over 100,000 Medicare, Medicaid, and Tricare beneficiaries, Baton Rouge has long been a central focus of the government’s enforcement efforts under the False Claims Act. Local health care service providers and other companies and individuals in the health care industry are increasingly finding themselves the targets of invasive federal investigations. This is due to two primary factors: (i) the government’s placement of a team from its elite HEAT task force in Baton Rouge, and (ii) the growing number of “qui tam” lawsuits in Louisiana and across the United States.

The Health Care Fraud Prevention and Enforcement Action Team (HEAT) is a federal task force that is focused on investigating and prosecuting individuals and companies suspected of False Claims Act violations involving Medicare reimbursements. There are only nine HEAT teams dispersed across the entire country, so the government’s decision to place a team in Baton Rouge tells you just how seriously the government is taking its local enforcement efforts. Unfortunately, due to HEAT’s data-oriented approach (which focuses on volume of claims rather than just specific evidence of fraudulent claims) and the consequences associated with defending a qui tam lawsuit, many health care providers and companies in Baton Rouge are being forced to defend against unwarranted investigations.

Introduction to the False Claims Act

The False Claims Act imposes civil and criminal penalties for individuals and businesses that submit false and fraudulent claims for payment to the United States government. It applies in two primary scenarios: (i) where a person or business contracts either directly or indirectly with the federal government, and (ii) where a person or business receives compensation from the government under a health care benefit programs (such as Medicare, Medicaid, or Tricare).

It is a violation of the False Claims Act to “knowingly” submit or cause the submission of false or fraudulent claim for payment. However, in this context, the word “knowingly” is misleading. This is because, under the statute, it is possible to “knowingly” submit a false claim even if you do not actually know it is false or fraudulent. If you “should have known” that the claim was improper (for example, if you make the common mistake of using an outdated billing code), this is enough to violate the False Claims Act. Other common allegations in False Claims Act cases include things like:

  • Billing for medically unnecessary services or services that were not actually provided
  • Billing for medically unnecessary supplies, equipment, or medications
  • Billing for supplies, equipment, or medications that were never ordered
  • Double-billing, unbundling, and upcoding reimbursable services and supplies

False Claims Act Penalties

Under the False Claims Act, individuals and companies found to have submitted false or fraudulent claims can face both civil and criminal penalties. These penalties include:

  • Civil Penalties – In a civil case, you can be held liable for treble damages (three times the government’s actual losses) and fines of up to $11,000 per false claim.
  • Criminal Penalties (18 U.S.C. § 287) – If the government proves that you intentionally presented false or fraudulent claims, you can face up to five years of federal imprisonment and fines of up to $250,000 (for individuals) or $500,000 (for companies). Again, these fines apply on a per-claim basis.

“Qui Tam” Lawsuits Under the False Claims Act

If you are facing a False Claims Act investigation, there is a strong chance that your case arose not out of government interest in your company (although HEAT is aggressively pursuing suspected fraud in Baton Rouge), but instead out of a claim filed by one of your former employees or competitors.

The False Claims Act includes a provision that allows private citizens to file lawsuits on behalf of the United States government when they believe that they have inside information about fraudulent billing practices. In these “qui tam” lawsuits, all it takes to initiate a claim is a simple allegation of a False Claims Act violation (see 31 U.S.C. § 3729). Since claimants (called “relators”) also receive a portion of the government’s recovery, qui tam litigation is becoming a growing problem for health care providers in Baton Rouge and across the country.

This is what happens in a qui tam lawsuit in Baton Rouge:

1. A Private Citizen Files a Qui Tam Complaint

The relator files a complaint in the U.S. District Court for the Middle District of Louisiana alleging that an individual or company has violated the False Claims Act. The qui tam complaint is filed under seal (to protect the relator’s anonymity), and copies are provided only to the assigned judge and certain government officials. If the relator requests, the complaint will be kept under seal under the government has conducted its investigation.

2. The Government Investigates the Relator’s Allegations

The government will review the complaint and determine whether to conduct an investigation or ignore the relator’s allegations based on lack of substantiation. If the government decides to investigate, it will issue subpoenas to the defendant requesting all corporate, financial, and other records that may indicate the submission of a false or fraudulent claim.

3. Will the Government Intervene?

The purpose of the government’s investigation at this stage is to assess whether the DOJ should “intervene” (that is, prosecute the case on the relator’s behalf), or whether the government should terminate its involvement in the case. If the DOJ intervenes, it will typically amend the relator’s complaint to include additional causes of action – such as violations of the Anti-Kickback Statute, the Truth in Negotiation Act, or other federal anti-fraud laws.

4. Case Settlement Negotiations Continue

Leading up to the decision on intervention, prosecutors from the DOJ will negotiate with the defendant’s attorneys regarding the possibility of a pre-trial settlement. Settlements can take time, but when effectively negotiated, they can result in a substantial reduction in liability and avoidance of other penalties.

5. The Case Closes and the Relator Gets Paid (if Successful)

If the case does not settle, prosecutors can seek penalties up to three times the government’s losses plus fines of up to $11,000 per false claim. For many providers, this can mean millions of dollars in liability. The relator is entitled to up to 25 percent of the amount collected if the government intervened, or up to 30 percent if it pursued the case independently.

Building a Successful False Claims Act Defense Strategy

The attorneys in our Health Care Fraud Defense Group have decades of experience in False Claims Act cases serving as both prosecutors and defense counsel. As a result of this experience, they have developed a proven strategy for defending Baton Rouge health care providers accused of submitting false and fraudulent claims. This strategy focuses in three key areas:

  • Avoiding Criminal Charges. If we can prevent the government from pressing criminal charges, you can breathe a sigh of relief knowing that federal prison time is no longer a possibility.
  • Convincing the Government Not to Intervene. In qui tam lawsuits, we aggressively attack the relator’s claims and credibility in order to cast as much doubt on the veracity of the allegations as possible. We want to show the government that the case isn’t worth its time.
  • Negotiating a Favorable Settlement. If civil penalties are a possibility, we will focus our efforts on negotiating the government’s demands down to as little as possible.

Put Experience on Your Side with the Oberheiden Law Group, PLLC

When facing allegations under the False Claims Act, you cannot afford to rely on an inexperienced attorney. At the Oberheiden Law Group, PLLC, we have successfully defended numerous physicians, practice owners, physician-owned entities, toxicology laboratories, medical device companies, pharmacies, service management organizations, health care marketing companies, hospitals, and other individuals and entities in federal cases nationwide. To hire our Health Care Fraud Defense Group for your False Claims Act investigation in Baton Rouge, contact us to schedule your free case evaluation now.

Our Track Record

  • False Claims Act Investigation (Pharmacy)
    Result: No Liability.
  • False Claims Act Investigation (Pharmacy)
    Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)
    Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)
    Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)
    Result: No Liability.
  • False Claims Act Investigation (Physician)
    Result: No Liability.
  • False Claims Act Investigation (Physician)
    Result: No Liability.
  • False Claims Act Investigation (DME Company)
    Result: No Liability.
  • False Claims Act Investigation (MSO)
    Result: No Liability.
  • False Claims Act Investigation (MSO)
    Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)
    Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)
    Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)
    Result: No Liability.
  • False Claims Act Investigation (Device Company)
    Result: No Liability.
  • False Claims Act Investigation (Health Care Service Provider)
    Result: No Liability.

False Claims Act Defense Attorneys Serving Baton Rouge, LA

Nick OberheidenDr. Nick Oberheiden has extensive experience representing clients in Qui Tam, False Claims Act, Medicare Fraud, Tricare Fraud, Stark Law, and anti-kickback proceedings nationwide in cases involving the Office of Inspector General (OIG), the Department of Health and Human Services (HHS), the Department of Defense (DOD), the Department of Justice (DOJ), the Department of Labor (DOL), and other federal agencies. Dr. Oberheiden trained in negotiation at Harvard Law School, holds a Juris Doctor from the University of California, Los Angeles, and also holds a Ph.D. in law.

Lynette ByrdLynette S. Byrd is a former Assistant United States Attorney (AUSA). During her time with the Department of Justice, Ms. Byrd prosecuted cases involving violations of the Anti-Kickback Statute, the False Claims Act, the Stark Law, and numerous other federal statutes on behalf of the United States. Ms. Byrd has extensive experience in health care law enforcement matters and regularly argues False Claims Act matters for all types of health care industry clients.

We are available to discuss your case. Call us directly or complete our contact form to schedule your free, confidential case evaluation today.

225-308-2440
Including Weekends
Oberheiden Law Group, PLLC
Serving Baton Rouge, 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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