We are a team of
former federal prosecutors


Meet the Team
Oberheiden Attorneys

Health Care Fraud Legal Defense for the Miami Area

Oberheiden & McMurrey, LLP provides health care fraud defense for medical practitioners, facilities, pharmacies, laboratories, and health care related businesses. Dr. Nick Oberheiden, managing attorney, is a health care fraud defense lawyer with extensive trial experience throughout the United States. Oberheiden & McMurrey, LLP is also proud to announce that we have a former Assistant United States Attorney, Lynette Byrd, on our team. We can assist you with:

  • Grand jury and OIG subpoenas
  • Medicare audits
  • Tricare audits
  • Fraud allegation defenses
  • Internal investigations
  • Compliance
  • Qui tam defense
  • Protection of assets
  • Jury trials
  • Criminal defense

Need assistance or have questions? Call our office and ask to speak with Lynette Byrd, former Assistant United States Attorney, or Dr. Nick Oberheiden, managing partner. Calls are kept confidential and they are free.

Miami, Florida Health Care Fraud Investigations

Miami is one of nine cities with an established federal task force that monitors, investigates, and prosecutes Medicare fraud. If you are part of a health care facility, are a health care practitioner, or part of a health care related business, you should know that your presence in Miami puts you at a higher risk of being investigated and prosecuted for Medicare fraud.

Miami has an elite investigative team known as the Health Care Fraud Prevention and Enforcement Action Team (HEAT). HEAT is comprised of prosecutors from several federal agencies: Department of Justice, Department of Health and Human Services, Office of the Inspector General, Federal Bureau of Investigation, and more.

Explaining Health Care Fraud

Health care fraud at a federal level is an attempt to be paid for fake or fictitious government health care claims. These claims don’t just happen in Medicare. It applies to all government sponsored health programs: Medicare, Medicaid, Tricare, and federal workers’ compensation. Health care fraud violations can occur in several ways. Some common ways include:

  • Violation of anti-kickback laws. If you offer or receive payment of money or other valuables for referrals, you are violating anti-kickback laws and may be subject to prosecution.
  • Stark Law violations. The Stark Law prohibits doctors from referring patients to specific health related entities in which the doctor or their immediate family member(s) have ownership or investment interests. Other compensation arrangements are also illegal unless they meet statutory exceptions.
  • Violating the False Claims Act. When a claim is submitted to Medicare, the False Claim Act applies. When a bill is incorrect, regardless of whether it was an accident, you could be subject to civil or criminal penalties.
  • Prescription fraud. The federal government pays close attention to doctors who prescribe unusually high amounts of narcotics. If you’re suspected of running a “pill mill,” you may be investigated for fraud and for violating DEA dispensing rules.
  • Billing fraud. There are many instances that can trigger a federal investigation into your billing practices. Up-billing is a practice where you use a higher code than the service level that you provided, which can draw the attention of investigating bodies. Billing for services not provided, phantom billing, and billing for patients who don’t exist (ghost-patients) also count as fraudulent health care practices.
  • Errors in certification. One of the common allegations against home health care companies and hospice organizations is errors in certification. This occurs when a doctor or nurse provide a fraudulently certification for the need of medical or hospice services.

Oberheiden & McMurrey, LLP has a track record of assisting clients in avoiding criminal charges. If you, your facility, or business is under investigation for health care fraud, call us and ask to speak with one of our former prosecutors. These calls are free and totally confidential.

Potential Health Care Fraud Penalties

HealthHealth Carecare fraud is an offense that may carry serious consequences for Miami health care providers and facilities. You could face civil recoupment, denial of payout for future claims, exclusion from providing services with federal health care programs, criminal prosecution, fines, or incarceration.

You could receive a prison sentence of up to 10 years for each count of health care fraud. You may receive a sentence of up to 20 years for health care fraud claims that result in serious bodily injury. If a patient dies, you could receive a life sentence.

Each case is different. Ultimately, the penalties that you may receive for health care fraud allegations will depend on the specific facts in your case. It will also depend upon the seriousness, the interest of the prosecutor in the claims, and the intent.

Oberheiden & McMurrey, LLP provides zealous representation. This is because of our unique blend of backgrounds as former health care prosecutors and well-respected defense attorneys. Our track record shows that we help our clients avoid criminal prosecution. If you are facing an investigation or if you have questions, call Oberheiden & McMurrey, LLP to discuss your needs at no charge. All calls are confidential.

Criminal Health Care Fraud

As discussed earlier, health care fraud can be civil or criminal. Using early intervention and strategic defense strategies, Oberheiden & McMurrey, LLP helps clients avoid criminal charges during federal health care investigations. Call us immediately if you are being investigated or if you have questions. We can help you strategize an effective plan to minimize your risk.

During the beginning of a federal health care investigation, it may not be clear whether it is civil or criminal. The U.S. Attorney’s office has both a civil and a criminal division. The presence of a prosecutor doesn’t automatically mean that the investigation is criminal in nature. It’s the same with the other federal agencies. The presence of a representative from any federal agency does not necessarily mean that a case may be criminal in nature. Our experience has shown us that most health care fraud cases begin as a civil investigation and may turn into a criminal matter if a good defense isn’t instituted from the very beginning of the investigation.

Oberheiden & McMurrey, LLP can help you by providing a skillful interaction and interpretation of your investigation. However, there are some signs that indicate that a civil matter is turning into a criminal concern. These signs include search and seizure warrants, arrest warrants, target letters, criminal prosecutors, IRS involvement, and grand jury subpoenas.

Questions? Call us immediately. We represent a large variety of health care clients, from individuals to entire health care entities in Miami, Florida. If you are under investigation by the Department of Justice, the Department of Defense, the FBI, the DEA, the Office of the Inspector General, Medicaid Fraud Control Unit, Miami or Florida law enforcement, or the IRS, call us right away.

Health Care Fraud Defense

Throughout the lifetime of Oberheiden & McMurrey, LLP, we’ve handled more than 1,000 health care cases and tried more than 200 criminal cases. Several of our attorneys have previous experience in health care auditing and fraud investigations with the Department of Justice. This experience provides extremely valuable insight for our clients.

An Immediate Defense

One of the best ways to avoid criminal charges is for Oberheiden & McMurrey, LLP to get involved as soon as possible. It is imperative to not allow the government too much time to build a case. Our immediate involvement can help protect your practice, business, and even your license. We can get answers to the questions that you have about your case within hours. We’ll help you:

  • Find out what the investigation is about
  • Find out the purpose of the investigation
  • Determine approximately how long the investigation may take
  • Discuss the most likely outcome of the case

Lack of Intent

When it comes to criminal charges, the U.S. Constitution provides a standard for the government. They must prove beyond a reasonable doubt that you acted with criminal intent. This is a high burden of proof to meet, and Oberheiden & McMurrey, LLP will test the standard. Although prosecutors like to use inaccuracies in billing records to try to determine intent, we know that honest mistakes don’t amount to criminal intent. We’ve successfully defended clients throughout the United States by showing that inaccurate billing entries happened because of an organizational or human error and not because of criminal intent.

The most common causes of billing errors include:

  • Unqualified staff
  • Outsourcing
  • Improper delegation
  • Lack of oversight by supervisors
  • Constantly changing health care laws
  • Changes in billing rules

Oberheiden & McMurrey, LLP knows that honest mistakes should not make someone a criminal.

Presenting a Legal Defense

When you’re facing allegations of health care fraud, it’s important that you’re able to use applicable defenses. Not all defenses are right for every case. Oberheiden & McMurrey, LLP has the experience to develop the applicable legal defenses and can find any accessible statute exceptions or loopholes to help. In a recent case, we found exceptions to the Stark Law that negated the government’s fraud claims.

Your Reputation Is Important

Oberheiden & McMurrey, LLP works hard to defend clients against unfounded allegations of health care fraud. We understand how important your reputation is to the public. We assist our clients by intervening in slanderous situations and look for opportunities to educate the public about the truth.

Oberheiden & McMurrey, LLP has nationwide experience with health care fraud claims. We provide free and confidential phone calls.

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 Legal Team Serving Miami

Nick OberheidenDr. Nick Oberheiden has represented clients in Qui Tams, False Claims Act, Medicare Fraud, Tricare Fraud, Stark Law, and anti-kickback proceedings before 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). Dr. Oberheiden is trained in negotiations by Harvard Law School and holds a Juris Doctor as well as a Ph.D. in law.

Lynette ByrdLynette S. Byrd helps clients with her experience as a former federal prosecutor for health care matters. During her tenure as an Assistant United States Attorney (AUSA), Ms. Byrd worked for the U.S. Attorney’s Office and was profoundly involved in some of the district’s biggest health care cases at the time. Since Lynette left the Department of Justice, clients of Oberheiden & McMurrey, LLP have benefited from Ms. Byrd’s regulatory and law enforcement experience in health care matters.

Call us today and speak to one of our experienced attorneys directly. We are available to discuss your situation in a free and confidential call, including on weekends. You can also fill out our online contact form to receive a quick response.

800-810-0259
Including Weekends
Oberheiden & McMurrey, LLP
Serving Miami, 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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