We are a team of
former federal prosecutors


Meet the Team
Oberheiden Attorneys

Experienced False Claims Act and Qui Tam Defense Attorneys Serving all of Louisiana

The 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 Louisiana and surrounding areas.

Oberheiden & McMurrey, LLP’s nationally recognized Health Care Fraud Defense Group provides aggressive representation backed by extensive legal and health care industry knowledge for False Claims Act matters in Louisiana and across the country. The False Claims Act imposes severe civil and criminal penalties for health care service providers and other companies that submit false and fraudulent claims – and even innocent individuals and companies can face severe consequences if they do not mount a quick and effective defense. If you are facing a federal investigation or “qui tam” complaint, you need to take your situation very seriously, and you do not have any time to lose.

Our Health Care Fraud Defense Group is led by a team of senior attorneys: Firm founder and experienced health care fraud defense attorney Dr. Nick Oberheiden, and former False Claims Act prosecutor Lynette Byrd. Together, these seasoned attorneys offer decades of experience on both sides of complex federal False Claims Act investigations.

This page is intended as a resource for individuals and companies facing False Claims Act investigations and private citizen-initiated “qui tam” complaints in Louisiana. Continue reading to find out:

  • What is the False Claims Act?
  • What Does it Mean to “Knowingly” Submit a False or Fraudulent Claim?
  • What are the Risks of Violating the False Claims Act?
  • What Happens in a “Qui Tam” Lawsuit?
  • What are the Keys to a Successful False Claims Act Defense?

Louisiana Remains a Top Priority in Federal False Claims Act Investigations

Louisiana is among a small handful of states, predominantly in the South, where the federal government is aggressively pursuing health care service providers and other companies in the health care industry for fraudulent reimbursement claims involving Medicare, Medicaid, Tricare, and other federal benefit programs. In recent years, the Department of Justice has executed several high-profile takedowns in Louisiana, and in many cases, securing tens or even hundreds of millions of dollars in recoupments, penalties, and fines.

In order to combat False Claims Act violations involving Medicare in Louisiana, the federal government has placed a task force from its elite Health Care Fraud Prevention and Enforcement Action Team (HEAT) in Baton Rouge. This is one of only nine such task forces in the United States – which tells you just how focused the federal government is on targeting local providers. HEAT is a coordinated effort of the Department of Justice (DOJ), the Department of Health and Human Services (HHS), the Office of Inspector General (OIG), the Federal Bureau of Investigation (FBI), and other federal agencies, and is comprised of experienced prosecutors who are committed to holding companies and individuals responsible for False Claims Act violations.

1. What is the False Claims Act?

The False Claims Act is a federal law that is designed to protect taxpayers. It applies to individuals and companies that either have federal government contracts or provide services to federal program beneficiaries, and it prohibits “knowingly” submitting false or fraudulent claims for compensation.

2. What Does it Mean to “Knowingly” Submit a False or Fraudulent Claim?

Importantly, in order to “knowingly” submit a false or fraudulent claim, you do not actually have to know that the claim is false or fraudulent. If due diligence would have revealed that the claim was false or fraudulent (in other words, if you “should have known” that the claim was unlawful), this is enough to face civil liability under the False Claims Act. As a result, the following can all constitute unlawful “false or fraudulent” claims:

  • Mistakenly using an old (“false”) billing code after an update in the Medicare billing system
  • Unbundling or upcoding services and double-billing for services, supplies, medication, or equipment
  • Seeking reimbursement for medically unnecessary services or services that were not provided
  • Seeking reimbursement for supplies, medication, or equipment that were not purchased or that were medically unnecessary

For individuals and companies throughout Louisiana, these and other common human errors and organizational miscues are regularly leading to invasive False Claims Act investigations.

3. What are the Risks of Violating the False Claims Act?

Depending on the nature and scope of the alleged offense, False Claims Act violations can result in both civil and criminal penalties.

Civil Penalties

If you “knowingly” violate the False Claims Act, you can be held liable for three times the government’s actual losses plus fines of up to $11,000 per false claim.

Criminal Penalties (18 U.S.C. § 287)

For “intentional” violations of the False Claims Act, you can face criminal penalties including up to five years of federal imprisonment and fines of:

  • For felony offenses, up to $250,000 (for individuals) or $500,000 (for companies) for each false claim; or,
  • For misdemeanor offenses, up to $100,000 (for individuals) or $200,000 (for companies) for each false claim.

4. What Happens in a “Qui Tam” Lawsuit?

The government is not alone in its efforts to combat federal fraud. In many cases, False Claims Act investigations will arise out of “qui tam” actions initiated by private citizens (called “relators”). Unfortunately, while the False Claims Act’s “qui tam” provisions are designed to help protect the government, in many cases they are used maliciously by unscrupulous competitors and disgruntled ex-employees. To make matters worse, all it takes to initiate a qui tam lawsuit is a simple allegation that a company or individual has submitted a false or fraudulent claim (see 31 U.S.C. § 3729).

Here is a brief overview of what you can expect if you are facing a qui tam lawsuit in Louisiana:

  • The Relator’s Complaint. The lawsuit begins with the relator filing a complaint in the local U.S. federal district court alleging a violation of the False Claims Act. The complaint is filed “under seal,” which means that it is only made available to the assigned judge and select government officials.
  • Initial Government Assessment. Upon filing of the complaint, the government will conduct an initial assessment of the relator’s allegations.  If the allegations are unsubstantiated, the government will decline to investigate further. However, if the allegations suggest that a false or fraudulent claim has been submitted, federal prosecutors – with assistance from the FBI and other agencies – will conduct an investigation.
  • Government Intervention. Based on the results of this investigation and initial negotiations with the defendant’s attorneys, the assigned prosecutors will either terminate the government’s involvement (in which case the relator can still choose pursue the case independently) or they will “intervene.” If they choose to intervene, they will typically amend the complaint to add allegations such as violation of the Anti-Kickback Statute, the Truth in Negotiation Act, and other federal laws.
  • Negotiations Regarding Settlement. Throughout the case thus far, the prosecutors and defense lawyers will be engaging in negotiations regarding the possibility of a pre-trial settlement. If liability appears likely, settling can often be the best option for minimizing the defendant’s liability.
  • Liability. If the defendant is found civilly liable, as noted above, it can face penalties of up to three times the government’s losses plus civil fines of $11,000 per false claim. This can easily add up to hundreds of thousands or millions of dollars in damages.

5. What are the Keys to a Successful False Claims Act Defense?

Based on decades of private and government experience, the attorneys in our Health Care Fraud Defense Group have developed a proven False Claims Act defense strategy that emphasizes three key components:

  1. Keep the Case Civil. We want to keep the case civil in nature so that criminal penalties stay off of the table.
  1. Prevent the Government from Intervening. In qui tam cases, we seek to expose the flaws in the relator’s complaint and destroy the relator’s credibility in order to convince the government not to intervene.
  1. Negotiate Strategically for a Favorable Settlement. Finally, if the evidence supports a finding of civil liability, we will seek to negotiate a settlement that is a small fraction of the overall exposure.

In False Claims Act investigations, early intervention is critical. If you delay in seeking representation, you could increase your chances of facing criminal charges. At Oberheiden & McMurrey, LLP, we are able to act quickly to defend physicians, practice owners, physician-owned entities, toxicology laboratories, medical device companies, pharmacies, service management organizations, health care marketing companies, hospitals, and other individuals and entities in False Claims Act matters throughout Louisiana and nationwide. To get started with your defense, request a free, confidential case evaluation now.

Our Track Record

  • False Claims Act Investigation (Pharmacy)
    Result: No Liability.
  • False Claims Act Investigation (Pharmacy)
    Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)
    Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)
    Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)
    Result: No Liability.
  • False Claims Act Investigation (Physician)
    Result: No Liability.
  • False Claims Act Investigation (Physician)
    Result: No Liability.
  • False Claims Act Investigation (DME Company)
    Result: No Liability.
  • False Claims Act Investigation (MSO)
    Result: No Liability.
  • False Claims Act Investigation (MSO)
    Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)
    Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)
    Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)
    Result: No Liability.
  • False Claims Act Investigation (Device Company)
    Result: No Liability.
  • False Claims Act Investigation (Health Care Service Provider)
    Result: No Liability.

False Claims Act Defense Attorneys Serving Louisiana

Nick OberheidenDr. Nick Oberheiden is a Harvard-trained negotiator who holds a Juris Doctor from the University of California, Los Angeles and a Ph.D. in law from the University of Heidelberg in Germany. He regularly represents clients in qui tam litigation as well as government-initiated investigations involving the False Claims Act, the Stark Law, the Anti-Kickback Statute and a wide variety of other federal laws. He has obtained successful results for his clients in proceedings involving virtually all federal agencies – including, but not limited to: the Office of Inspector General (OIG), the Department of Health and Human Services (HHS), the Department of Defense (DOD), the Department of Justice (DOJ), and the Department of Labor (DOL).

Lynette ByrdLynette S. Byrd is a former Assistant United States Attorney (AUSA) who has experience in dozens of high-profile federal investigations. Clients of Oberheiden & McMurrey, LLP benefit greatly from Ms. Byrd’s experience in the Department of Justice. Ms. Byrd offers a wealth of knowledge and insights as a result of her history as a federal health care prosecutor, as she is regularly able to secure highly favorable outcomes in complex qui tam actions and False Claims Act investigations.

We are available to discuss your case. Call us directly or complete our contact form to schedule your free, confidential case evaluation today.

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

IF YOUR FREEDOM IS AT STAKE

YOU SHOULD CONTACT US TODAY

Contact the Experienced Attorneys of Oberheiden & McMurrey, LLP Now for a Confidential Consultation

Contact Us Now
×