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Oberheiden Attorneys

Medicare Fraud Defense Lawyers Serving the Brownsville, Texas Area

Medicare fraud allegations in the State of Texas can ruin your career. If you’re being investigated for Medicare fraud in Brownsville, Texas or the surrounding areas, call the Oberheiden Law Group, PLLC. We are a Texas law firm providing legal representation for Medicare fraud allegations, jury trial defense, qui tam defense, and other legal matters. We also assist Texas clients involved in federal health care program audits and those in need of a federal compliance program, or those who are in receipt of an OIG or grand jury subpoena.  The Oberheiden Law Group’s legal team is headed by a former Chief Health Care Fraud Coordinator for the Dallas U.S. Attorney’s Office.

What Is Medicare Fraud?

Medicare fraud is a federal offense with both civil and criminal penalties. It involves the filing of one or more inaccurate claims with a federal health care program. It doesn’t have to be Medicare. It also includes Tricare, Medicaid, and federal workers’ compensation. Claims are filed by medical professionals, facilities, and companies in order to receive compensation for services or medical equipment that was provided to recipients of those programs. If you’re accused of committing Medicare fraud, 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.

Medical providers, pharmacies, labs, and facilities in Brownsville, Texas are investigated more often for Medicare fraud than similar providers in similar cities. This is because Brownsville, Texas is one of nine locations in the nation that has a large number of federal health care program recipients. This means that more claims are filed with the federal programs for reimbursement. The increase in the number of claims causes the Medicare Fraud Strike Force to constantly scrutinize the claims from this area for instances of Medicare Fraud.

The Medicare Fraud Strike Force is a team of federal investigators and prosecutors for multiple federal agencies including the DOJ, DEA, DOD, Department of Human Services, the Office of Inspector General, the FBI, and the IRS. This list isn’t all-inclusive. In fact, the Medicare Fraud Strike Force often includes members of other federal agencies. If you’re contacted by a representative of a federal agency, immediately contact the Oberheiden Law Group.

Common Causes of Medicare Fraud Investigations in Brownsville, Texas

Medicare fraud investigations that happen in Brownsville, Texas and the surrounding areas start because of a claim that is labeled as inaccurate by the federal government. Usually, the claim is for an unauthorized service or medical equipment, may include an excessive charge, or has an incorrect claim amount. The most common causes 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.

Common targets of Medicare fraud investigations in Brownsville, Texas include doctors, nurses, physician-owned entities, nursing and registered care facilities, clinics, pharmacies, labs, DME providers, and cancer centers.

What Are the Civil and Criminal Penalties for Medicare Fraud?

Medicare fraud is a federal offense that can lead to civil or criminal charges. Civil penalties in Brownsville, Texas 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.

You could also lose your professional license and your hospital privileges.

Criminal penalties for Medicare fraud in Brownsville, Texas 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.

Choosing a Medicare Fraud Lawyer in Brownsville, Texas

Medicare fraud is a federal offense. You need to choose the right Medicare fraud lawyer in Brownsville, Texas to help you. This charge often includes federal criminal allegations like mail fraud and money laundering. You need a lawyer that understand both health care law and federal criminal defense. Look for these four signs of a good health care fraud defense lawyer in Brownsville, Texas:

  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.

Once you’ve made a list of potential lawyers, ask them the following questions to learn more about their true skills:

  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?

Medicare Fraud Defense Strategies in Brownsville, Texas

The Oberheiden Law Group uses several strategies in each Brownsville, Texas Medicare fraud case. We do settle cases where possible, but we’re also prepared to go to court on your behalf. We’ve helped hundreds of clients and we’re standing by to help you.

Immediate contact with federal prosecutors. Our number one priority is to resolve the allegations against you and to help you avoid criminal charges. After we are retained, we immediately contact federal prosecutors to get answers to the most pressing 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?

Usually, we are able to get answers to those questions within hours.

Legal standards are important. The federal government must be able to prove that you committed a crime. To do this, they present evidence. Their evidence must meet an important legal standard known as “beyond a reasonable doubt.” Our lawyers evaluate the evidence to determine if the federal government is able to meet this burden of proof. This single strategy has helped our clients see 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.

Proving you made a mistake. The federal government must be able to prove that you acted with criminal intent. This means that you made the decision to attempt to file a fraudulent claim. Yet, that’s hard for the federal government to prove because in Brownsville, Texas most of the Medicare fraud cases don’t start because of criminal intent. They start because someone made a mistake. The most 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.

These mistakes should be addressed and corrected by our clients, but they shouldn’t be held to criminal standards. The Oberheiden Law Group, PLLC works to prove that you made a mistake and that you did not act with criminal intent.

Applicable Medicare fraud defenses. All Medicare fraud cases are different. This is why we take the time to analyze each case to find the applicable defenses. Sometimes these defenses are legal exceptions. Recently, one of our clients was accused of providing fraudulent certifications for home health care services. We were able to prove that our client was legally protected by a delegation exception and that the certification was compliant with the law. In a separate case, we did not admit liability on behalf of our client. Rather, we proved to the federal prosecutor that our client acted within a safe harbor exception.

The Oberheiden Law Group, PLLC

The Oberheiden Law Group provides legal representation for people and businesses in Brownsville, Texas and the surrounding areas. We represent doctors, nurses, business owners, entities, business executives, attorneys, hospitals, clinics, pharmacies, labs, and other medical businesses under investigation for matters related to 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

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, Brownsville or Texas state law enforcement, call us immediately. The call 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 Brownsville, Texas

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 Brownsville, Texas 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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