We are a team of
former federal prosecutors


Meet the Team
Oberheiden Attorneys

Legal Defense for Home Health Care and Hospice Fraud in the McAllen Area

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 McAllen as well as throughout Texas State.

Allegations of health care fraud in McAllen, Texas are extremely serious matters. If you’re being investigated for health care fraud, call the Oberheiden & McMurrey, LLP. We are a Texas firm worked on health care fraud defense. We have extensive legal experience in OIG and grand jury subpoenas, Medicare and Tricare audits, fraud allegation defense, internal investigations, compliance programs, qui tam defense, protection of assets, criminal defense, and in jury trials. Our Health Care Fraud Defense Team includes lawyers with extensive and impressive backgrounds, including a former Chief Health Care Fraud Coordinator for the U.S. Attorney’s Office, several former health care fraud prosecutors, elite former lead prosecutors of the Medicare Fraud Strike Force, and accomplished lawyers with leading education from the best law schools in the United States.

Dr. Nick Oberheiden is a Harvard-trained lawyer and negotiator. Dr. Oberheiden provides legal assistance to clients in McAllen and throughout Texas. Dr. Oberheiden is a health care fraud defense attorney and is the managing partner of Oberheiden & McMurrey, LLP.

Lynette Byrd is a former federal health care fraud prosecutor who brings her insight and experience to Oberheiden & McMurrey, LLP’s clients. Prior to joining Oberheiden, Ms. Byrd prosecuted False Claims Act violations, Stark Law violations, Anti-Kickback violations, and health care fraud on behalf of the federal government.

If you want to learn more about your legal options, contact Oberheiden & McMurrey, LLP now and ask to speak with a member of our Health Care Fraud Defense Team. Initial consultations are totally confidential and free of charge.

McAllen, Texas Is Closely Monitored for Health Care Fraud

The Medicare Fraud Strike Force is a combined team 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 prosecutors and investigators can be involved in the Medicare Fraud Strike Force.

McAllen, Texas and the surrounding area are closely monitored, since many of the residents are beneficiaries of a federal health care program. Because of this, more claims are filed in this area for reimbursement from the federal government. The increase in federal claims filed makes the federal government pay more attention to the area for instances of health care fraud. In 2016, the Department of Justice released a statement that it investigated more than 300 cases of health care fraud. Almost 80 of those cases were on individual health care providers. The other cases were on a business or an entity. The Department of Justice stated that it recovered more than $900 million in fraudulently paid out claims.

Basics of Health Care Fraud

Health care fraud is an attempt at receiving reimbursement from a federal health care program for medical services or equipment. Federal health care programs include Medicare, Medicaid, Tricare, and federal workers’ compensation. It includes at least one of the following:

  • A Violation of the Anti-Kickback Statute – Federal health care law restricts receiving money or other valuables in exchange for patient referrals. Any individual (including doctors, marketing professionals, or a health care entity or business owner) may be prosecuted for violating the Anti-Kickback statute for offering or providing payment or other valuables in exchange for those referrals.
  • A Violation of Stark Law – Stark Law is also referred to as the Self-Referral Law. It restricts doctors from referring patients to certain health care service entities if the doctor or a member of the doctor’s immediate family has an ownership or investment interest in it, or if there is some compensation arrangement. There are statutory exceptions to this law.
  • Prescription Fraud – Health care practices that prescribe a high volume of narcotics are closely monitored by the federal government. If you’re suspected of operating a “pill mill,” you may be investigated for insurance fraud or for violating DEA dispensing rules.
  • Billing Fraud – One of the most common occurrences of billing fraud is upcoding. This means that the next higher code is used on claims to federal health care programs. The federal government also investigates phantom billing for services that weren’t provided, ghost patients (patients who do not exist), and billing for services or equipment not medically necessary.
  • Certification Errors – The federal government pays particular attention to the home health care and hospice industry. The most common allegation is fraudulent certification for care.

Oberheiden & McMurrey, LLP has a record of helping clients avoid criminal charges throughout the entire nation. If you or your health care practice or your business are being investigated for health care fraud in McAllen, Texas or the surrounding areas, call us now. Initial consultations are free and confidential.

The Penalties of Health Care Fraud

Health care fraud have serious civil and criminal penalties. Civil penalties can include repayment of claims, non-payment of your future claims, and you may be excluded from federal health care programs in the future. You could also be called before your state disciplinary board. You could lose your license or your hospital privileges.

Criminal penalties include fines that cost you hundreds of thousands of dollars, a criminal record, and prison time:

  • 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

We’re often asked about what the worst-case scenario is for health care fraud in McAllen, Texas. Criminal prosecution depends on several factors. Some of the factors considered include the severity of the injury suffered by the patient, whether or not the prosecutor is interested in pursuing criminal charges, and the reason why the investigation was initiated. If you’re being investigated for health care fraud, you need to call Oberheiden & McMurrey, LLP now to learn about your legal options. Initial consultations are confidential and free.

What Are the Signs of a Criminal Investigation?

Health care fraud charges can be civil or criminal in nature. Oberheiden & McMurrey, LLP uses early intervention and strategic defense to assist our McAllen, Texas clients. Call us now if you are being investigated. We can develop a custom defense.

It can be difficult for clients to know whether they are facing civil or criminal charges at the beginning of a health care fraud investigation. The U.S. Attorney’s Office has a civil division and a criminal division. There are prosecutors who work for each division. So, being contacted by a prosecutor from the U.S. Attorney’s Office really isn’t an indicator of criminal charges. The same is true with being contacted by other federal prosecutors. Most agencies have both a civil and criminal division. However, a civil investigation can become criminal in nature quite fast. Oberheiden & McMurrey, LLP can help by contacting federal prosecutors on your behalf. Call us immediately if you are contacted by a federal prosecutor.

Determining the nature of the charges depends on the legal interpretation of many factors including 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 imminent if you receive a search warrant, seizure warrant, arrest warrant, target letter, IRS involvement, grand jury subpoena, or if there is the involvement of a federal criminal prosecutor.

If you have questions about the charges that you may be facing, call Oberheiden & McMurrey, LLP. We provide advocacy for individual practitioners, entire health care systems, and other related health care businesses. If you are a health care provider, business, or entity in McAllen, Texas or the surrounding area and are being investigated by the Department of Justice, the Department of Defense, the Federal Bureau of Investigation, Drug Enforcement Administration, Office of Inspector General, Medicare Fraud Control unit, McAllen or Texas state law enforcement, or the IRS, contact us today.

The Use of Compelling and Strategic Health Care Fraud Defenses

Oberheiden & McMurrey, LLP is a Texas law firm serving health care fraud defense clients in McAllen, Texas and the surrounding areas. Many of our lawyers have experience as health care auditors and as former health care fraud prosecutors with the Department of Justice. Our McAllen, Texas clients receive valuable insight for their health care fraud defense cases.

Immediate contact on your behalf. Our main objective is to help our McAllen, Texas clients avoid criminal charges. Experience has taught us that the best way we can advocate for our clients is to get into immediate contact with the federal government. We get answers to the most important questions and limit the amount of time that the federal government has to investigate you without interruption. We work to protect your career and your freedom. We can get answers to these questions usually within just a few hours after we are retained by you:

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

Mistakes shouldn’t be treated as crimes. The federal government must meet a high Constitutional standard to show that you committed a crime and had criminal intent. This standard is known as “beyond a reasonable doubt.” In cases that may involve criminal charges, we put these standards to the test. Often, the government will try to use billing inaccuracies to prove that you had criminal intent. Oberheiden & McMurrey, LLP has learned that most often it is simply the result of an organizational or human error. These mistakes should not be held to criminal standards. We’ve noted that the use of unqualified workers, delegation errors, outsourcing errors, lack of oversight, insufficient supervision, and the constantly changing laws and rules that are involved in health care are the most common errors that cause these investigations. Although these issues should be corrected, they should not lead to criminal liability.

Strategic health care fraud defense. Oberheiden & McMurrey, LLP develops strategic health care fraud defenses for each client. Many of our cases were successful because of statutory loopholes and exceptions. For instance, in the context of Stark Law which involves medical necessity certifications, we’ve been able to use exceptions to either mitigate or entirely resolve a health care fraud case.

Protecting your professional reputation. We are committed to doing more than providing health care fraud defense. We are also committed to defending your professional reputation. Allegations of health care fraud can be extremely damaging to your career. Your reputation could be destroyed by rumors spread by the media. Our attorneys routinely address concerns about slander, and book news spots and other opportunities to correct misinformation about our clients.

Oberheiden & McMurrey, LLP has provided legal advocacy to clients across the country who were accused of health care fraud. Call us now to learn about your options. The call is confidential and free.

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 McAllen, Texas
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 McAllen, Texas 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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