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Oberheiden Attorneys

Medicare Fraud Defense for the Lakeland, FL Region

Lakeland, Florida and the surrounding areas have more Medicare fraud investigations than cities of similar size throughout the United States. If you’re being investigated for Medicare fraud, call the Oberheiden & McMurrey, LLP. We provide legal representation for people, clinics, hospitals, and businesses. We assist in federal investigations, federal audits, asset protection, federal compliance, qui tam defense, grand jury and OIG subpoenas, and with internal investigations. Our legal defense group includes attorneys with legal educations and with knowledge as federal health care prosecutors and federal trial attorneys. Oberheiden’s defense team is led by a former Chief Health Care Fraud Coordinator from the U.S. Attorney’s Office.

Medicare Fraud Is a Federal Offense

Medicare fraud is a federal offense that includes civil and criminal penalties. It occurs when one or more claims are filed for reimbursement with a federal health care program and the claim includes an inaccuracy of some sort. Medicare fraud also includes false claims filed with Medicaid, Tricare, and federal workers’ compensation. Medicare fraud includes an allegation that you’ve violated at least one of the following:

Physicians, nursing professionals, pharmacists, health care entities, and clinics in Lakeland, Florida are investigated for Medicare fraud more often than in other similar areas because of the number of residents who rely on a federal health care program. This means that the area sees an increase in claims. The increase in claims means that the federal government will constantly watch the area for more instances of Medicare fraud.

Medicare fraud in Lakeland, Florida investigated and prosecuted by the Medicare Fraud Strike Force. This is a team of federal investigators and prosecutors from several federal agencies. Commonly, the members are employees of 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. Initial consultations are free.

Medicare Fraud Investigations in Lakeland, Florida

Medicare fraud investigations in Lakeland, Florida and the surrounding areas often start because an inaccurate claim is filed with a federal health care program. The government notices the mistake and they believe that you intentionally tried to defraud them for payment. Often, claims include a charge for an unauthorized medical service, use of unauthorized medical equipment, an inaccurate charge, or an excessive charge. The most common billing errors made in Lakeland, Florida that trigger an investigation 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.

Nurses, doctors, pharmacists, physician-owned companies, nursing homes, and hospitals in Lakeland, Florida are some of the most common targets of these investigations. However, anyone or any business that files claims with federal health care programs for reimbursement can be investigated.

What Are the Civil and Criminal Penalties of Medicare Fraud?

When Medicare fraud allegations are made in Lakeland, Florida, they can result in civil and criminal lawsuits. Potential civil 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

Additionally, you could lose your license to practice or your hospital privileges.

Criminal penalties 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.

Hiring a Medicare Fraud Defense Attorney in Lakeland, Florida

An allegation of this nature can ruin your business. Often, it includes criminal charges like tax fraud or money laundering. You must hire a Medicare fraud defense attorney serving Lakeland, Florida.

Health care fraud defense attorneys handle Medicare fraud cases. Look for a health care fraud defense attorney who has the following characteristics:

  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.

Next, you should learn more about the skills that the health care fraud attorney has. To do this, you can ask these three 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?

Common Defense Strategies for Medicare Fraud Allegations

Oberheiden & McMurrey, LLP examines each Medicare fraud case to choose the right defense strategies. When we can, we work with the federal government to settle claims made against our clients. However, we’re also prepared to go to court on your behalf. We’ve represented hundreds of clients across the United States. Many of the lawyers on our team have skills as former federal health care prosecutors and trial attorneys.

Contact with federal prosecutors. We reach out immediately to contact federal prosecutors. We’ve learned that this is one of the most effective ways that we can get answers to the important questions and minimize the likelihood that our clients will face criminal charges.

  • 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’re able to get answers to these questions within just a few hours after we are retained.

Analyzing federal evidence. The government must provide evidence that shows “beyond a reasonable doubt” that you committed a crime. We analyze the evidence to determine if the federal government’s evidence meets this legal standard. This one strategy routinely helps clients and may result 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 you made a mistake. Federal investigators will often point to billing and coding mistakes to try to prove that you acted with criminal intent. Yet, most Medicare fraud investigations in Lakeland, Florida and the surrounding areas don’t start because someone actually wanted to defraud the government. The most common errors that start this type of investigation 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.

While these mistakes need to be corrected, they are not crimes. We work to prove to the federal government that you made a mistake.

Strategic Medicare fraud defenses. We analyze each case to locate the most strategic Medicare fraud defenses. One of our clients was recently accused of providing fraudulent certification for home health care services. We proved that our client was legally 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 provides Medicare fraud defense for Lakeland, Florida and the surrounding areas. We provide legal advocacy for medical 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 Lakeland, Florida and the surrounding areas. If you’re being investigated by the DOJ, Department of Defense, the FBI, the DEA, the Office of Inspector General, Medicare Fraud Control Unit, the IRS, Lakeland or Florida law enforcement, call Oberheiden & McMurrey, LLP immediately. The consultation 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 Lakeland, 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 Lakeland, 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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