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Oberheiden Attorneys

Legal Defense for Health Care Fraud in Las Vegas, Nevada

If you’re a health care provider or the owner of a health care practice or business doing business in Las Vegas, Nevada or the surrounding area and you’re being investigated for health care fraud, call the Oberheiden & McMurrey, LLP. Oberheiden & McMurrey, LLP has in-depth legal experience in health care fraud defense, 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 Health Care Fraud Defense Team includes such talent as a former Chief Health Care Fraud Coordinator for the U.S. Attorney’s Office, several former health care fraud prosecutors, and elite former lead prosecutors of the Medicare Fraud Strike Force. We serve clients in Las Vegas as well as Nevada State.

To learn about your defense options, call Oberheiden & McMurrey, LLP and ask to speak with a member of our Health Care Fraud Defense Team. Initial calls are free and confidential.

Las Vegas Is Diligently Observed for Health Care Fraud

Las Vegas, Nevada is one of nine venues in the United States that is diligently observed for health care fraud. The area is monitored by the Medicare Fraud Strike Force. The Medicare Fraud Strike Force is an investigative team made up of prosecutors and investigators from several federal agencies, including the Department of Justice, Department of Health and Human Services, Office of Inspector General, and the Federal Bureau of Investigation. This list isn’t all-inclusive. Other federal agencies may have a presence on the team for any given investigation.

Las Vegas and the surrounding areas are constantly watched because of the number of residents in the area who rely on a federal health care program. This causes an increase in the number of claims that are filed with the federal government for reimbursement. This increase in claims causes the federal government to pay more attention to the area. In 2016, the Department of Justice investigated more than 300 cases of health care fraud. Around 80 of those allegations involved individual health care providers. The rest of the cases centered on a health care entity or business. The agency reported a recovery of more than $900 million in fraudulently paid out claims.

Explaining Health Care Fraud

Federal health care fraud is an attempt to receive reimbursement for medical services or equipment through a government health care program, including Medicaid, Medicare, Tricare, or federal workers’ compensation by filing one or more bogue claims. It likely 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 up-coding of claims. Up-coding 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 track record of success in helping clients avoid criminal charges. If you’re being investigated for health care fraud in Las Vegas or the surrounding areas, call Oberheiden & McMurrey, LLP immediately. The call is free and confidential.

A Look at the Civil and Criminal Penalties of Health Care Fraud

Health care fraud can cause you to face charges in both civil and criminal court. These courts can levy harsh penalties against you or your business. In civil court, you may be ordered to repay claims, be denied payment on future claims, and you may be excluded from federal health care programs in the future. You could also be called before the state disciplinary board. You could lose your license and your hospital privileges.

Criminal penalties include more than a criminal record. You could be ordered to pay fines that cost you hundreds of thousands of dollars. You could also be sentenced to federal prison:

  • 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, clients ask us about the worst-case scenario for health care fraud that occurs in Las Vegas. The possibility of facing criminal charges or being sentenced to federal prison depends on several factors such as the severity of any injury suffered by patients, whether a prosecutor is interested in pursuing criminal charges, and why the investigation was started.

Oberheiden & McMurrey, LLP stands ready to assist Las Vegas area providers, entities, and businesses in their health care fraud defense cases. Our mix of experience as former health care prosecutors and as defense attorneys gives us a unique insight that we use to assist our clients. If you’re being investigated for health care fraud, call us immediately. The call is free and confidential.

How to Know If a Health Care Fraud Investigation is Criminal

Health care fraud investigations in Las Vegas can be civil or criminal. In fact, investigations that start off as civil may turn criminal. It is important to plan your defense right away in order to protect yourself from criminal charges. Call us immediately if you’re being investigated.

Contact by a prosecutor is not an absolute indicator of a criminal investigation. Federal agencies that have prosecutors have civil and criminal divisions. This is why you cannot rely on being contacted by a prosecutor as an indication of a criminal investigation. Signs of a criminal investigation into health care fraud includes the receipt of OIG subpoenas, the way that an inquiry or the allegation is made, receiving a search warrant, a seizure warrant, an arrest warrant, target letters, involvement of federal criminal prosecutors, IRS involvement, or grand jury subpoenas.

Call Oberheiden & McMurrey, LLP if you have questions about whether you are facing a civil or criminal investigation. We represent individual providers, entire health care systems, and related businesses. We provide our health care defense services to individuals, businesses, and entities in and around Las Vegas 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, Las Vegas or Nevada law enforcement, or the Internal Revenue Service.

Health Care Fraud Defenses in Las Vegas

Oberheiden & McMurrey, LLP is a health care fraud defense law firm that provides legal advocacy to health care providers, systems, and businesses in Las Vegas, Nevada and the surrounding areas. During our time as a firm, we’ve been involved in hundreds of health care fraud cases. Many of our team members have previous experience as health care auditors and health care fraud prosecutors with the Department of Justice. We use this experience to assist our clients to get them the most desirable possible outcome.

Contacting the federal government right away. Our main objective is to help our clients avoid criminal charges. In our experience, the most effective way to do this is by immediately contacting the federal government. This minimizes the time that the federal government has to investigation you without interruption. We can usually get answers to the most important questions within just a few hours after we are retained:

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

Examining the legal standards. In each case, the federal government must meet high legal standards to show that our clients committed a crime and acted with criminal intent. We look at the evidence in each case. We’ve learned from our experience that the billing inaccuracies that the government will try to use to show you committed a crime actually happened because of a mistake. Mistakes should be corrected, but they shouldn’t mean that you are guilty and should be punished because of a crime. The most common mistakes include the use of unqualified workers, delegation errors, outsourcing errors, lack of oversight, insufficient supervision, and the frequently changing laws and rules that are involved in health care.

The use of strategic defenses. Oberheiden & McMurrey, LLP develops strategic legal defenses for our Las Vegas clients. This includes locating and utilizing the applicable statutory loopholes and exceptions. For example, in the context of Stark Law which involves medical necessity certifications, we have been able to point to exceptions to either attenuate or entirely resolve a health care fraud case.

Securing your reputation. Health care fraud allegations can damage your professional reputation. Oberheiden & McMurrey, LLP looks for opportunities to correct misinformation released by the media. We also address slanderous comments made about our clients. We are committed to you inside and outside of the courtroom.

If you’re being investigated for health care fraud, call Oberheiden & McMurrey, LLP right away. The call is free and confidential.

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 Las Vegas

Nick OberheidenNick Oberheidenis a 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 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 Las Vegas, Nevada 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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