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 all of Chicagoland

The Oberheiden Law Group is a Medicare fraud defense law firm serving Chicago, Illinois and the surrounding area. We represent individuals and entire health care systems under investigation by the federal government, in need of qui tam defense, jury trials, and involved in a federal audit. Additionally, we help our clients by designing and implementing compliance programs for federal regulations. The Oberheiden Law Group includes lawyers with legal educations and knowledge as health care fraud prosecutors and senior trial lawyers.

What Is Medicare Fraud?

Medicare fraud occurs when at least one claim is filed with a federal health care program and the claim includes an error. This includes more than Medicare. It also includes Medicaid, Tricare, and federal workers’ compensation. These claims are filed with a federal health care program by providers, businesses, and entities that want to be reimbursed for providing care or equipment to a program beneficiary. When you’re accused of Medicare fraud, you’re being accused of violating at least one of the following statutes:

Chicago is one of nine areas in the nation that is under constant watch by the Medicare Fraud Strike Force for instances of Medicare fraud. Chicago has a large population of residents who rely on a federal health care program. Because of the number of beneficiaries in the area, more claims are filed for reimbursement. This is what causes the federal government to watch for Medicare fraud.

The Medicare Fraud Strike Force is a team of prosecutors and investigators from various federal agencies including 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 being investigated by the Medicare Fraud Strike Force or if you’re contacted by a member from a federal agency, contact Oberheiden Law Group, PLLC right away. Your first call is free and confidential.

Chicago Medicare Fraud Investigations

Medicare fraud investigations in Chicago often start because of a mistake made on a claim. Often, the mistake relates to billing, such as an unauthorized charge, an excessive charge, or an incorrect charge. The most common errors made on Chicago claims are:

  • 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 Chicago are doctors, nurses, and nursing homes. However, other individuals, businesses, and facilities that file federal health care claims can be investigated.

The Civil and Criminal Penalties of Medicare Fraud in Chicago

Medicare fraud allegations in Chicago may result in civil or criminal charges being filed against you or your business. Civil federal 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
  • You could also lose your hospital privileges and your professional license.

Criminal federal penalties in Chicago 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.

Choosing the Right Chicago Medicare Fraud Lawyer

In Chicago, Illinois, a Medicare fraud allegation is very serious. You need to hire a health care fraud defense lawyer to help you during this time. As you look for an attorney, watch for the following:

  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.

You should then ask the health care fraud defense attorney the following questions:

  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 Defenses in Chicago

The Oberheiden Law Group provides Medicare fraud defenses for Chicago clients. We are knowledgable federal trial lawyers and negotiators. We understand the importance of settling with the federal government where we can, but we’re also ready to go to court on your behalf. We’ve represented hundreds of clients across the nation.

We make immediate contact with the federal government. Immediately after we are retained, we contact the federal government. Our objective is to get answers to the most 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?

Getting answers to these questions can help us to plan your defense and it can mean the difference between a civil settlement and criminal charges. Often, we are able to get answers in just a few hours.

Analyzing the evidence. The government must meet a legal standard known as “beyond a reasonable doubt” when they present evidence to attempt to prove that you committed a crime. We review the evidence. This is an important strategy that often results in:

  • 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 that there is no criminal intent. The federal government must also prove that you acted with criminal intent. This is difficult for them to prove because most people do not set out with an intention to commit fraud. These investigations often start because of a mistake made by a person or a business. The most common mistakes made are:

  • 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.

We work to prove that you made a mistake and that you did not act with criminal intent.

Choosing the most effective Medicare fraud defenses for Chicago clients. Reviewing each case allows us to choose the right Medicare fraud defenses for each client. In one of our recent cases, a client was accused of providing a fraudulent certification for home health care services. We were able to prove that our client was 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 serves Chicago, Illinois and the surrounding areas. We represent represent individual 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 provides legal advocacy for individuals, entire health care systems, or businesses in Chicago, Illinois and the surrounding areas when they are contacted by the DOJ, Department of Defense, the FBI, the DEA, the Office of Inspector General, Medicare Fraud Control Unit, the IRS, Chicago or Illinois law enforcement. The initial 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 Chicago, Illinois

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 Chicago, Illinois 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.

IF YOUR FREEDOM IS AT STAKE

YOU SHOULD CONTACT US TODAY

Contact the Experienced Attorneys of the Oberheiden Law Group Now for a Confidential Consultation

Contact Us Now
×