We are a team of
former federal prosecutors


Meet the Team
Oberheiden Attorneys

Hospice & Home Health Fraud Legal Defense Serving the Detroit, Michigan Area

Michigan Office
615 Griswold Street, Suite 700
Detroit, MI 48226
313-888-8807
(Meeting location by appointment only)

The Oberheiden & McMurrey, LLP has significant experience in representing clients accused of hospice or home health care fraud. Our team is headed by former health care prosecutors and experienced defense counsel. Dr. Nick Oberheiden is a senior health care fraud defense attorney and managing principal of Oberheiden & McMurrey, LLP.

Detroit Medicare Fraud Investigations

Detroit is one of only nine U.S. cities in which the federal government has established special task forces to monitor, investigate, and prosecute Medicare Fraud. Health care practitioners and businesses in Detroit must be aware that government prosecutions in Detroit are more aggressive and significantly more frequent than in other communities and spearheaded by the elite Health Care Fraud Prevention and Enforcement Action Team (HEAT). HEAT is a coordinated federal task force composed of prosecutors from 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 others.

Hospice & Home Health Care Fraud

Oberheiden & McMurrey, LLP represents Detroit hospice and home health agencies, business owners, and medical professionals in connection with corporate compliance, internal investigations, Medicare audits, reimbursement and recoupment questions, as well as against civil and criminal government investigations.

  • OIG & Grand Jury Subpoenas
  • Medicare & Medicaid Fraud
  • Anti-Kickback Statute
  • False Claims Act & Qui Tam Defense
  • Stark Law (Self-Referrals)
  • HIPAA Compliance
  • DEA and Prescription Issues
  • Certifications of Medical Necessity
  • Billing Errors and Overbilling
  • Overutilization of Services and Equipment
  • RAC & ZPIC Audits
  • IRS Investigations

Oberheiden & McMurrey, LLP works with the National Association for Home Care & Hospice (NAHC), the National Hospice and Palliative Care Organization (NHPCO), the National Center for Assisted Living (NCAL) and similar programs and our attorneys are profoundly familiar with certification requirements, hospice re-certifications, clinical status determinations, respite care, homebound evaluations, medical necessity, conditions of coverage, and plan of care requirements.

What Are the Penalties?

Targets investigated for home health and hospice allegations are exposed to 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, attorney fees, criminal fines, criminal indictment, or imprisonment.

  • Up to 10 Years in Prison for Each Count of Medicare Fraud
  • Up to 20 Years in Prison If the Fraud Resulted in Serious Bodily Injury
  • Life in Prison If the Fraudulent Medicare Practice Resulted in the Patient’s Death.
  • Civil & Criminal Fines

Incorrectly prescribing, supervising, or certifying professionals may be excluded from all federal health care programs, prohibited from receiving reimbursement from any federal health care program and may face a suspension or revocation of their license.

Choosing the Right Defense Lawyer

The drastic penalties described above call for the hiring of a competent and successful attorney. Health care investigations jeopardize your business, your reputation, and your family livelihood. You need attorneys that vigorously defend you and that have the skills to convince the government, the media, and the public that you did not do anything wrong.

When it comes to picking the right attorney, home health and hospice care business owners and medical professionals should look for three criteria.

  • First, your attorney must be utmost familiar with all rules and regulations relating to home health and hospice care. When you defend against the government, you simply don’t have time to explain billing, coding, or certification rules to uninformed lawyers.
  • Second, you must pick a lawyer that has successfully resolved health care audit and fraud investigations. Most lawyers say that they are “aggressive” and “excellent,” but what does it help you to hire the best DWI or assault defense lawyer in town when that lawyer has no track record negotiating complex health care fraud cases with OIG and HHS agents?
  • Third, in addition to profound health care knowledge and prior success, your attorney must have superior litigation and trial experience. Prosecutors know exactly how good and experienced a defense lawyer is in court. Ask your lawyer how many actual health care fraud trials he or she have handled in their careers.

When interviewing with lawyers, smart clients ask smart questions. Test your lawyer candidate and insist on a concrete answer to the following question:

How many Medicare Fraud cases have you handled so far that resulted in no civil and no criminal liability for your client?

Our Proven Defense Strategies

What shapes the health care fraud defense reputation of Oberheiden & McMurrey, LLP are our experience and our track record. Throughout our careers, we have handled over 1,000 health care investigations and tried more than 200 criminal cases in court. Many of our attorneys were previously in charge of health care audits and fraud investigations at the Department of Justice and they now offer their valuable insights and contacts with our clients.

  • Pressure on the Government. Targets of government investigations need to act quickly. The longer the government scrutinizes and searches without firm opposition by experienced defense counsel, the easier it will be for a prosecutor to build a case. Don’t give the government that advantage. Hire the experienced attorneys of Oberheiden & McMurrey, LLP from the moment you become aware of an audit or an investigation. Let us use our contacts to provide you immediate answers to these pressing questions: What is this investigation about? Is the case civil or criminal? Does the government threaten jail time? What can my lawyers do to get the issue resolved?
  • No Intent. In our experience, we have found that many incidents that prompt health care investigations originate from organizational and human errors, not from criminal spite. Mistakes happen due to unqualified or overwhelmed staff, negligence, supervision errors, and unfamiliarity with constantly changing rules. Many of our home health and hospice care clients have seen fast growth in recent times and their corporate infrastructure could sometimes not catch up with their expansion. The U.S. justice system acknowledges the possibility of human errors and the U.S. Constitution puts a high burden of proof on the government to demonstrate criminal intent. In each and every case, our attorneys vigorously, aggressively, and relentlessly force the government to accept its constitutional burden.
  • Appropriate Certifications. Quite a few home health and hospice care fraud cases claim that the business owners and responsible providers incorrectly and thus unlawfully certified or re-certified medical necessity. The attorneys of Oberheiden & McMurrey, LLP know that while this is easy to say, it is hard to prove. Not just do we routinely work with high caliber experts to contradict the government; we also have the practical experience to direct judges and juries to the many certification exceptions and delegation rules that the government likes to omit in their complaints.
  • Media Intervention. Our commitment to defend our clients against unfounded allegations of fraud and wrongdoings goes far beyond establishing legal strategies and defense plans against government investigations. Many of our clients are equally concerned about their reputation and their perception in the public. The media has the power to ruin someone’s reputation or to ignite rumors about wrongdoings by offer biased and prejudicial news reports to its audience. Our attorneys routinely intervene into slandering reporting and obtain news spots and opportunities to correct, rectify, and educate the story on behalf of our clients.

Our Track Record

Our clients range from individual providers to entire health care systems. We represent clients in Detroit who are under investigation by the Department of Justice (DOJ), the Department of Defense (DOD), the Federal Bureau of Investigation (FBI), Drug Enforcement Administration (DEA), the Office of Inspector General (OIG), the Medicaid Fraud Control Unit (MFCU), Detroit and Michigan law enforcement, or the Internal Revenue Service (IRS).

  • Defense of Health Care Service Business Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of Health Care Service Business Investigated by the Department of Justice and the FBI for Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of Health Care Service Business Investigated by the Department of Justice and the FBI for Medicare Fraud and False Claims Act Violations.
    Result: No civil or criminal liability.
  • Defense of Health Care Service Business Investigated by the Department of Defense and the FBI for Tricare Fraud.
    Result: No civil or criminal liability.
  • Defense of Health Care Service Business Investigated by the Department of Defense and the OIG for Tricare Fraud.
    Result: No civil or criminal liability.
  • Defense of Physician Syndication Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud and Stark Law.
    Result: No civil or criminal liability.
  • Defense of Physician Investigated by the Department of Health and Human Services and the Office of Inspector General for Medicare Fraud and Stark Law Violations.
    Result: No civil or criminal liability.
  • Defense of Physician Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud and False Claims Act Violations.
    Result: No civil or criminal liability.
  • Defense of Health Care Service Business Investigated by the Office of Inspector General for Medicare Fraud and Stark Law Violations.
    Result: No civil or criminal liability.
  • Defense of Health Care Organization Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of Health Care Marketing Group Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud, Stark Law Violations, and False Claims Act Violations.
    Result: No civil or criminal liability.
  • Defense of Health Care Service Business Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of Health Care Service Business Investigated by the Department of Health and Human Services and the Office of Inspector General for Medicare and Tricare Fraud.
    Result: No civil or criminal liability.
  • Defense of Health Care Conglomerate Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud.
    Result: No civil or criminal liability.

Detroit Defense Attorneys

Nick Oberheiden Nick Oberheiden is a Harvard-trained and internationally educated health care fraud defense attorney. Nick has successfully represented health care executives, business owners, public officials, physicians, and lawyers in high profile prosecutions, scores of political corruption, government investigations, and 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, Nick 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 Lynette’s experience 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. Lynette has immense experience with health care law enforcement and she regularly argues federal matters for her clients.

We are available every day of the year, 24 hours a day. You can call us directly or complete our contact form or by emailing us directly.

313-888-8807
Including Weekends
Oberheiden & McMurrey, LLP
Serving Detroit, Michigan 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. Oberheiden & McMurrey, LLP is a Texas LLP with headquarters in Dallas. Mr. Oberheiden limits his practice to federal law.

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