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Oberheiden Attorneys

Medicare Fraud Defense for Medical Professionals in the Jacksonville, FL Area

Oberheiden & McMurrey, LLP is a Medicare fraud defense law firm serving Jacksonville, Florida and the surrounding area. We represent clients being investigated by the federal government, those in need of qui tam defense, in jury trials, and in federal audits. We also help clients minimize the likelihood of facing this allegation by designing and implementing federal compliance programs. Oberheiden & McMurrey, LLP’s defense team is managed by a former Chief Health Care Fraud Coordinator from the U.S. Attorney’s Office. Clients are represented by our highly educated and skilled defense team.

Medicare Fraud Is a Violation of Federal Law

Medicare fraud is a violation of federal law that can cost you your career. It happens when an inaccurate claim is filed with a federal health care program including Medicare, Medicaid, Tricare, and federal workers’ compensation. Claims are filed by medical professionals, businesses, and entities that want to receive reimbursement for providing medical services or equipment to a patient who is a beneficiary of the federal program. When you face this allegation, it means that you’re being investigated for violating at least one of the following statutes:

Jacksonville, Florida is one of nine locations under constant examination by the Medicare Fraud Strike Force. Jacksonville has many citizens who rely on a federal health care program for services. Because of this, there are more claims filed in the area. The Medicare Fraud Strike Force monitors, investigates, and prosecutes Medicare fraud.

The Medicare Fraud Strike Force is an organization of prosecutors and investigators from 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 & McMurrey, LLP right away. Your first call is free and confidential.

Jacksonville, Florida Medicare Fraud Investigations

Medicare fraud investigations in Jacksonville, Florida start because a claim with a mistake is filed with the federal health care program. Usually, the claim includes an unauthorized charge of some kind, an excessive charge, or the amount listed for a charge is incorrect. The most common mistakes that cause a Medicare fraud investigation to start 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.

Nursing professionals, doctors, physician-owned entities, nursing homes, and registered care facilities in Jacksonville, Florida are the most common targets of this sort of investigations. Other entities and people can be investigated for Medicare fraud if they file a claim with a federal health care program for reimbursement.

The Civil and Criminal Penalties of Medicare Fraud

Medicare fraud allegations in Jacksonville can mean that you have civil or criminal charges filed against you. Civil federal penalties are:

  • 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 are:

  • 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.

Finding the Right Medicare Fraud Defense Lawyer in Jacksonville, Florida

In Jacksonville, Florida, an allegation of Medicare fraud is extremely serious. You should seek out the services of a health care fraud defense lawyer. This type of lawyer can assist you with the health care aspects of the case and with the potential criminal charges such as tax fraud. As you research attorneys, watch for:

  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 for Jacksonville, Florida Clients

Oberheiden & McMurrey, LLP provides Medicare fraud defenses in Jacksonville, Florida. In cases where it is possible, we seek to resolve the allegations made against you by the federal government through a settlement. We’ve represented hundreds of clients throughout the nation.

We contact the federal government on behalf of our clients. After we are retained, we immediately contact the federal government on behalf of our client. 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?

Often, we are able to get answers to those questions in just a few hours.

We review the federal 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 our client made a mistake. The federal government must also show that you acted with criminal intent. This is hard for the federal government to do since most Medicare fraud doesn’t happen because someone intentionally set out to defraud the government. It usually happens because of a mistake that is made by a person or a business. The most common mistakes 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.

Mistakes of this nature should certainly be addressed and corrected, but they don’t make you a criminal. Our priority is to prove to the federal government that you made a mistake that you’re willing to correct.

We determine the most efficient Medicare fraud defenses to use. We take the time to review the facts in each case. This helps us determine the right Medicare fraud defenses to use for each client. One of our recent clients 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 & McMurrey, LLP

Oberheiden & McMurrey, LLP serves Jacksonville, Florida and the surrounding areas with Medicare fraud defense strategies. We 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

Oberheiden & McMurrey, LLP represents both individuals and entire health care systems or businesses in Jacksonville, Florida and the surrounding areas. If you’re contacted by the DOJ, Department of Defense, the FBI, the DEA, the Office of Inspector General, Medicare Fraud Control Unit, the IRS, Jacksonville or Florida law enforcement, call us right away. 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 CareFraud.
    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 Jacksonville, Florida

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 & McMurrey, LLP
Serving Jacksonville, 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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