We are a team of
former federal prosecutors


Meet the Team
Oberheiden Attorneys

Health Care Fraud Defense Team Serving the State of Florida

Oberheiden & McMurrey, LLP 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 the state of Florida as well as surrounding areas.

If you’re a health care provider, entity, or business providing services in the State of Florida and if you’re being investigated for health care fraud, call the Oberheiden & McMurrey, LLP right now. We are a health care fraud defense law firm providing services in the State of Florida. Additionally, we have substantial experience in Medicare and Tricare audits, protection of assets, compliance programs, jury trials, fraud allegation defense, qui tam defense, OIG and grand jury subpoenas, criminal defense, and internal investigations. Our dedicated Health CareFraud Defense Team includes a former Chief Health Care Fraud Coordinator for the U.S. Attorney’s office, multiple former health care fraud prosecutors, former lead prosecutors from the Medicare Fraud Strike Force, and attorneys with leading law school education.

Pick up the phone and call Oberheiden & McMurrey, LLP now if you’re being investigated for health care fraud. Ask to speak with a member of our Health Care Fraud Defense Team. The call is free and confidential.

Florida Is Watched by the Medicare Fraud Strike Force

The State of Florida is watched by the Medicare Fraud Strike Force because it is one of nine areas with a large population that depends on a federal health care program for assistance. The Medicare Fraud Strike Force is a team of prosecutors and investigators from various federal agencies, including the Department of Justice, Department of Health and Human Services, Office of Inspector General, and the Federal Bureau of Investigation. Other federal agencies may also have an investigator or prosecutor who is a member of this team, as well.

Since the State of Florida has such a large number of citizens who depend on a federal health care program for benefits, more claims are filed. The government keeps a close eye on the area because of the increased number of claims to ensure that they’re not reimbursing a false claim. The Medicare Fraud Strike Force monitors, investigates, and prosecutes health care fraud that occurs in the State of Florida. The Department of Justice investigated more than 300 allegations of health care fraud during 2016. They released a statement breaking down the investigations to include around 80 individual providers and more than 200 entities and businesses. The agency recovered more than $900 million in claims.

The Definition of Health Care Fraud

Health care fraud that occurs at the federal level is an attempt to receive reimbursement for medical equipment or services from a federal health care program, such as Medicaid, Medicare, Tricare, or federal workers’ compensation with one or more false claims. It includes a violation of at least one of the following:

  • The Anti-Kickback Statute. Federal health care law outright prohibits kickbacks in exchange for referrals. Any individual (including doctors, marketing representatives, and business owners) is subject to prosecution for violating the Anti-Kickback statute for offering or providing payment or other valuables in exchange for patient referrals.
  • Stark Law. Stark Law, also known as the Self-Referral Law, prohibits doctors from referring patients to specific health care service entities if the doctor (or a member of the doctor’s immediate family) has an ownership or investment interest, or if there is a compensation arrangement. Note, however, that there are statutory exceptions to this law.
  • False Claims Act. If you submit a claim to Medicare or any other federal health care program, you are required by law to abide by the False Claims Act. If the claim submitted to the federal government is discovered to be inaccurate, the federal government will likely launch an investigation into your billing practices under the criminal provisions of the False Claims Act.
  • Prescription Fraud. The federal government pays special attention to health care practices that have an unusually high number of narcotic prescriptions. If you are suspected of running a “pill mill,” you are at a high risk of being investigated for insurance fraud and for violating DEA dispensing rules.
  • Billing Fraud. The federal government is persistent about investigating the upcoding of claims. Upcoding means that the next higher code is used for a service when the billing is done. The federal government is also prone to investigating phantom billing (billing for services that were not provided), billing for patients who do not exist (referred to as ghost patients), and billing for equipment or services that are deemed not medically necessary.
  • Certification Errors. The home health care and hospice industry is frequently a practice that the federal government chooses to maintain a close eye on. The most common accusations include fraudulent certification for home health care and hospice care.

Oberheiden & McMurrey, LLP has a distinguished track record of helping clients avoid criminal charges. If you’re being investigated for health care fraud in the State of Florida, call Oberheiden & McMurrey, LLP now. Initial consultations are free and confidential.

The Civil and Criminal Repercussions of Health Care Fraud

Health Care fraud is a serious matter that may lead to civil or criminal charges. These charges can result in serious penalties. Civil penalties include repayment of claims and non-payment of future claims, and you may be excluded from federal health care programs. Additionally, you could be called before the Florida disciplinary board, lose your license, and lose your hospital privileges. Criminal penalties include fines in the hundreds of thousands of dollars, a criminal record, or a federal prison sentence of:

  • Up to 10 years for each count of health care fraud
  • Up to 20 years for each count of fraud that resulted in serious bodily injury to the patient
  • Life sentence if the health care fraud resulted in the death of a patient

Often, health care providers in the State of Florida call us and ask about the worst-case scenario. The worst-case scenario includes criminal charges and a prison sentence. However, whether these will be on the table will depend on several factors, such as the severity of any injury suffered by a patient, the interest the prosecutor has in pursuing criminal charges, and the reason why the investigation was launched.

Oberheiden & McMurrey, LLP is prepared to defend clients in the State of Florida against allegations of health care fraud. Our prior experience as federal health care fraud prosecutors and our experience as defense attorneys has given us the ability to find the best defenses for our clients. If you’re being investigated for health care fraud in the State of Florida, call now. The call is free and confidential.

How Can I Tell If I’m Facing Criminal Charges?

Another common question that we’re asked is how you can tell if you’re facing criminal charges. Health care fraud investigations can be civil or criminal. Oberheiden & McMurrey, LLP is renowned for our ability to help clients avoid criminal charges. This is often accomplished because we understand the importance of immediately contacting federal prosecutors to begin to advocate on behalf of our clients. Call us right away if you’re contacted about a health care fraud matter so that we may begin to immediately advocate for you.

Health care fraud investigations are extremely serious, regardless of whether they are civil or criminal. Civil matters can become criminal. Contact from a federal prosecutor isn’t a good indicator of criminal charges. All federal agencies with prosecutors have a civil and a criminal division. That’s why you can’t determine the nature of the charges you may face based solely on the fact that you’ve been contacted by a prosecutor. Determining whether the investigation is criminal in nature can depend on the legal interpretation of many different elements, such as OIG subpoenas, the manner in which the inquiry is made or in the way in which the allegations are made, and other indicators of criminal prosecution. Criminal prosecution may be signaled by the use of search warrants, seizure warrants, arrest warrants, target letters, involvement of federal criminal prosecutors, IRS involvement, or grand jury subpoenas.

If you need help determining whether the investigation against you is civil or criminal, call Oberheiden & McMurrey, LLP. We’ve worked with individuals, businesses, and entities in and around Florida that are being investigated by the Department of Justice, the Department of Defense, Office of Inspector General, Drug Enforcement Administration, the Federal Bureau of Investigation, Medicare Fraud Control unit, Florida state law enforcement, or the Internal Revenue Service.

Compelling Defense Strategies for Clients

Oberheiden & McMurrey, LLP has successfully represented individuals, businesses, and entire entities being accused of health care fraud. We’ve handled thousands of cases and trials. Several of our lawyers have previous experience as health care auditors and as federal prosecutors working with the Department of Justice. This experience is an asset that our clients can rely on, and it has led us to develop some outstanding and compelling defense strategies.

Immediate contact with federal investigators. Our first objective is to help our clients in Florida avoid criminal charges. The best way to do this is by making immediate contact with federal investigators. This also helps us prepare your defense because we’re able to get answers to the most important questions within just a few hours of being retained:

  • What is the investigation about?
  • What is the purpose of it?
  • How long will the investigation take?
  • What is the most likely outcome?

Questioning federal evidence. Federal prosecutors must meet high Constitutional standards in order to file charges against you. They must prove beyond a reasonable doubt that you committed a crime and that you performed your actions with criminal intent. In each case, we test the standard. Often, federal prosecutors will try to use your billing inaccuracies against you as an example of criminal intent. However, we’ve learned from experience that mistakes happen. Mistakes do not and should not be held as a crime. Oberheiden & McMurrey, LLP continues to provide successful legal defenses for our Florida clients. We show that these billing inaccuracies occur because of a human or business error and that they did not occur because of an intention to defraud the government. Using unqualified workers, delegation errors, outsourcing errors, lack of oversight, insufficient supervision, and the frequently changing laws and rules that are involved in health care are the most frequent errors that cause health care fraud investigations. Although these mistakes should certainly be addressed and corrected by our clients, they should not lead to criminal charges.

Specific health care fraud defenses. Oberheiden & McMurrey, LLP takes the time to review the facts of each case in order to develop specific health care fraud defenses. This may include locating applicable defenses and statutory loopholes. Many of our cases have been successful based on these legal exceptions. As an example, Stark Law involves medical necessity certifications and we’ve been able to point to exceptions that either mitigate or entirely resolve a health care fraud matter.

We help protect your reputation. Oberheiden & McMurrey, LLP is just as concerned with protecting your reputation as you are. We understand that these allegations can ruin your career. The media has a lot of power, and biased reporting can affect you and your business. Our lawyers address slander and seek opportunities to correct misinformation about our Florida clients.

If you’re being investigated for health care fraud in Florida, call Oberheiden & McMurrey, LLP right now to learn more about how we can help. Initial calls are confidential and free of charge.

Our Track Record

The commitment of Oberheiden & McMurrey, LLP is to avoid criminal charges and to shield our client’s medical business from government intrusion. Our team of former health care prosecutors and experienced defense attorneys have a distinguished history of protecting business owners, executives, lawyers, physicians, hospitals, laboratories, pharmacies, home health care entities, and many other health care organizations against any form of alleged health care fraud. Here are some recent examples of our case outcomes.

  • Representation of a Pharmacy Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation of a Marketing Group Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation of Physicians Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation of Laboratory against an Investigation by the Department of Justice and the U.S. Attorney’s Office for Alleged Medicare Fraud.
    Result: No civil or criminal liability.
  • Representation of Laboratory against an Investigation by the Department of Health and Human Services and the U.S. Attorney’s Office for Alleged Medicare Fraud.
    Result: No civil or criminal liability.
  • Representation of Laboratory against an Investigation by the Department of Justice and the U.S. Attorney’s Office for alleged Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation 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.
  • Representation of a Health Care Marketing Group Against an Investigation by the Office of Inspector General for Alleged Health Care Fraud.
    Result: No civil or criminal liability.
  • Representation of a Physician against an Investigation by the Department of Health and Human Services and the U.S. Attorney’s Office for Alleged Medicare Fraud, Stark Law Violations, and Anti-Kickbacks.
    Result: No civil or criminal liability.
  • Representation of Laboratory against an Investigation by the Department of Justice and the Office of Inspector General for Alleged False Claims Act and Medicare Violations.
    Result: No civil or criminal liability.
  • Representation 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.
  • Representation of Physician Investigated by the Office of Inspector General for Medicaid Fraud and Stark Law Violations.
    Result: No civil or criminal liability.
  • Representation 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.
  • Representation of Physician 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.
  • Representation of Physician Group Investigated by the Department of Health and Human Services and the Office of Inspector General for False Claims Act Violations.
    Result: No civil or criminal liability.
  • Representation of a Physician Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation of Pharmacy Investigated by the Department of Justice and the Office of Inspector General for Department of Labor Program Fraud.
    Result: No civil or criminal liability.

Health Care Fraud Defense Lawyers Serving the State of Florida

Nick OberheidenNick 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. 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 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. Ms. Byrd 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. You can call us directly or complete our contact form or by emailing us directly.

800-810-0259
Including Weekends
Oberheiden & McMurrey, LLP
Serving the State of Florida 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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