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 Legal Defense Team 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, PLLC is a national health care fraud defense law firm that represents clients in Medicare fraud investigations and prosecutions in Baton Rouge, Louisiana. Headed by attorney Dr. Nick Oberheiden, the firm’s Health Care Fraud Defense Group has successfully represented clients across the country resulting in no civil or criminal liability. If your hospital, hospice company, private practice, home health company, or other health care services business is facing a federal Medicare investigation in Baton Rouge, we encourage you to contact us immediately so that we can start building your defense.

This page is intended as a resource for individuals and health care businesses in Baton Rouge, Louisiana facing Medicare fraud investigations. You will find answers to the following questions:

  • What is Medicare fraud?
  • What is the risk involved to you or your company?
  • What options are available for your defense?
  • How should you choose the right defense lawyer?
  • What separates The Oberheiden Law Group, PLLC from other law groups?

Medicare Fraud in Baton Rouge: A Top Federal Government Priority

Baton Rouge is one of only nine cities in the United States that is home to an elite Medicare Fraud Strike Force task force. The Health Care Fraud Prevention and Enforcement Action Team (HEAT) is a coordinated effort of the Department of Justice (DOJ), Department of Health and Human Services (HHS), the Office of Inspector General (OIG), the Federal Bureau of Investigation (FBI), and other federal agencies that specifically targets Medicare fraud. HEAT focuses on using a mix of data analysis techniques and local enforcement efforts to identify potential targets for Medicare fraud investigations. Unfortunately, the task force’s data-oriented approach is forcing many growing health care service providers to face unjustified investigations and unsubstantiated allegations of fraud.

What is Medicare Fraud?

Medicare fraud refers to the practice of submitting false or fictitious reimbursement claims for services, supplies, and equipment that may or may not have been provided to Medicare beneficiaries. Practices constituting Medicare fraud can be prosecuted under the False Claims Act, the Anti-Kickback Statute, the Physician Self-Referral Laws (Stark Law), the Social Security Act, and various statutes found in the U.S. Criminal Code. Federal investigators and prosecutors regularly pursue Medicare fraud cases in Baton Rouge, Louisiana involving allegations of:

  • Billing for services never performed (sometimes referred to as “phantom billing”);
  • Billing for medically unnecessary services;
  • Billing for supplies and equipment that were never ordered;
  • Billing for medically unnecessary supplies and equipment;
  • Obtaining certification for medically unnecessary services (common in Home Health and Hospice Fraud Investigations);
  • Obtaining certification for medically unnecessary supplies (such as Durable Medical Equipment (DME));
  • Double billing, upcoding, or unbundling services;
  • Overuse of services and equipment; and
  • Offering and accepting kickbacks.

In the health care industry, almost no one is safe from becoming the target of a Medicare fraud investigation. The Department of Justice doesn’t just focus on companies. They also focus on individuals. Common investigations involve physicians, executives, nurses, home health care centers, hospice care centers, nursing homes, registered care facilities, hospitals, pharmacies, toxicology laboratories, medical devices companies, physician syndications, DNA testing centers, and cancer treatment centers in Baton Rouge, Louisiana. These investigations can result in either a civil or criminal charges.

What is the Risk for You and Your Company?

Failing to mount an effective defense in a Medicare fraud case can have severe consequences for you as an individual and for your company. The potential penalties for Medicare fraud include:

  • Recoupment requests;
  • Non-payment of future claims;
  • Civil fines of up to $11,000 per false claim;
  • Exclusion from federal health care programs;
  • Treble damages;
  • Paying attorneys fees;
  • Criminal fines; or
  • Incarceration in federal prison.

The prison sentence for a typical Medicare fraud allegation can be up to 10 years. If a fraud results in serious bodily injury or death, this can increase to 20 years in prison or even life imprisonment.

Medical professionals in Baton Rouge, Louisiana charged with Medicare fraud will often face licensing actions and loss of hospital privileges.

What Options are Available for Your Defense?

While each case is different, the following four defense strategies have proven to consistently produce favorable results for our clients in federal Medicare fraud investigations:

1. Early Intervention

If you are facing a Medicare fraud investigation, engaging a legal defense team early can be extremely beneficial later. The longer the government has to build its case against you without interruption, the greater the chance you will be forced to defend against criminal charges in court. Do not sit back and wait for the government to build its case against you.

At The Oberheiden Law Group, PLLC, our experienced health care fraud defense lawyers and former federal prosecutors have open channels to the government. We can immediately initiate a dialogue to get answers to your most pressing questions:

  • What is this case about?
  • What prompted the investigation?
  • Is the case civil or criminal?
  • What agencies are involved?
  • Who else is under investigation?

We strive to obtain these answers within the first hours of our engagement so that we can immediately get to work on a comprehensive defense strategy tailored to the specific circumstances involved in your case.

2. Lack of Evidence

The U.S. justice system places a heavy burden on the government to prove that criminal suspects are guilty beyond a reasonable doubt. To hold you criminally accountable for Medicare fraud, the government must meet this burden with respect to proving that you committed a criminal offense and that you did so with criminal intent. We challenge the government’s evidence on both points in order to obtain the following results for our clients:

  • Having the case dismissed;
  • Avoiding criminal charges;
  • Keeping a professional license and hospital privileges (where applicable);
  • Civil fines and no criminal plea;
  • Misdemeanor charges instead of felony charges; and
  • No incarceration.

3. Lack of Intent

Establishing that any billing mistakes resulted from organizational or human errors is an effective method for preventing the government from proving the criminal intent necessary to sustain a conviction for Medicare fraud in Baton Rouge, Louisiana. In a busy practice, mistakes happen. But, this does not mean that the practice needs to be shut down or that its owners or employees deserve to be sent to prison.

In Medicare fraud cases, we have repeatedly experienced success by challenging the government’s evidence of criminal intent by arguing that our clients’ billing errors are attributable to factors such as:

  • The use of unqualified or untrained staff;
  • Lack of supervision;
  • Delegation;
  • Outsourcing;
  • Structural deficits;
  • Poor business decisions;
  • Human error;
  • Oversight;
  • Lack of a corporate compliance program; and
  • Fast changing Medicare rules and laws.

4. Applicable Defenses

A thorough case assessment will often reveal a variety of applicable defenses that can be used to successfully defend against the government’s investigation. For example, in one recent Medicare fraud case, the government accused our client of fraudulently certifying a patient for home health care services. Using the facts of the case and our in-depth knowledge of federal health care law, we were able to convince the government that a recognized delegation exception actually rendered the certification fully compliant. In another recent case, we refused to admit liability and ultimately convinced the prosecutors that our client acted within a safe harbor exception that precluded liability for Medicare fraud.

How Should You Choose the Right Defense Lawyer?

When facing a Medicare fraud investigation, engaging an experienced legal defense team should be your top priority. What type of lawyer should you choose?

The Right Choice: Hire a Health Care Fraud Defense Lawyer

When choosing a lawyer for your Medicare fraud investigation in Baton Rouge, you need someone with specific and extensive experience in the area of Medicare fraud. You need a health care fraud defense lawyer who has:

  • A proven track record of experience and success;
  • Industry knowledge;
  • Demonstrated familiarity with federal health care and criminal laws; and
  • Extensive litigation & trial experience

Before investing money in an attorney, you should ask the following three highly important questions:

  • How many Medicare fraud cases have you handled so far during your career?
  • How many of the health care fraud cases that you handled resulted in no civil and no criminal charges or resulted in dismissals for your clients?
  • How many health care fraud cases have you tried in court?

What Separates The Oberheiden Law Group, PLLC from Other Law Groups?

The Oberheiden Law Group’s most-distinguishing characteristics are: (i) our experience, and (ii) our track record. Several of our attorneys come from senior positions within the Department of Justice, and our entire team of health care fraud defense lawyers collaborate on every case to make sure that we are presenting the strongest possible defense. All of our lawyers have extensive experience in:

  • Health care fraud defense;
  • Compliance programs;
  • Internal investigations;
  • Qui tam defense;
  • Asset protection;
  • Licensure & disciplinary proceedings;
  • Jury trials.

Our clients range from individual providers to entire health care systems. We represent clients in Baton Rouge, Louisiana who are under investigation by state and federal agencies including the Department of Justice, the Department of Defense, the Federal Bureau of Investigation, Drug Enforcement Administration, the Office of Inspector General, the Medicaid Fraud Control Unit, Baton Rouge and Louisiana law enforcement, and the Internal Revenue Service.

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 violations 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 a 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.

Baton Rouge, Louisiana Defense Attorneys

Nick OberheidenDr. Nick Oberheiden is a Harvard-trained and internationally educated health care fraud defense attorney. Dr. Oberheiden has a track record of successful representation of health care executives, business owners, public officials, physicians, and lawyers in high profile prosecutions, against accusations of political corruption, government investigations, and against media campaigns, including 60 Minutes. Dr. Oberheiden has a reputation of being able to stop 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 former experience working with the AUSA. Formerly, she prosecuted health care fraud, Anti-Kickback violations, False Claims Act violations, 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 on behalf of her clients.

We are available every day of the year, 24 hours a day. You can call us directly or complete our contact form to request a free consultation.

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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