We are a team of
former federal prosecutors


Most of our cases have ended in
No Criminal Charges

Meet the Team
Oberheiden Attorneys

Miami, FL Home Health and Hospice Care Fraud Defense Attorneys

If you are facing allegations of home health and hospice fraud, you need a law firm with significant experience. The Oberheiden Law Group provides experienced representation to individuals and businesses facing these serious charges. Dr. Nick Oberheiden is a senior health care fraud defense lawyer for the Oberheiden Law Group.

Investigations of Medicare Fraud in Miami, Florida

There are nine cities in the nation that receive more government oversight and investigations regarding Medicare fraud. Miami, Florida is one of those cities. Miami has a specialized task force that monitors, investigates, and prosecutes Medicare fraud. Health Care practitioners and businesses, including home health care and hospice organizations, in Miami can be investigated by the Health Care Fraud Prevention and Enforcement Action Team (HEAT). HEAT is comprised of prosecutors and investigators from several government agencies including the Department of Justice, Department of Health and Human Services, Office of the Inspector General, the FBI, and other agencies.

Home Health Care and Hospice Fraud

The Oberheiden Law Group provides representation to Miami, Florida home health care and hospice organizations and their associated medical professionals and businesses. We can assist with corporate compliance, internal investigations, Medicare audits, reimbursement or recoupment concerns, and civil or criminal government investigations. Oberheiden Law Group can also assist you with:

  • Grand jury subpoenas
  • OIG subpoenas
  • Medicare fraud
  • Medicaid fraud
  • Violations of the Anti-Kickback Statute
  • Violations of the False Claims Act
  • Qui tam defense
  • Concerns over HIPAA compliance
  • Problems with the DEA or prescriptions
  • Errors in billing
  • Allegations of over-billing
  • False certifications regarding medical necessity
  • Overuse of services
  • Overuse of equipment
  • RAC audits
  • ZPIC audits
  • Investigations by the IRS

The Oberheiden Law Group also works with the National Association for Home Care & Hospice (NAHC), National Hospice and Palliative Care Organization (NHPCO), National Center for Assisted Living (NCAL), and related home health care and hospice organizations. We are intimately familiar with the certification requirements related to be home health and hospice care. This includes re-certification for hospice, certification requirements, clinical status determinations, respite care, homebound evaluations, medical necessities, coverage conditions, and requirements for plan of care.

The Penalties of Home Health Care and Hospice Fraud

Being investigated for home health care and hospice fraud can expose you to recoupment expenses, non-payment of future claims, civil fines of up to $11,000 per false claim, future exclusion from federal health care programs, assessment of treble damages, attorney fees, criminal fines, indictment, and even imprisonment.

Imprisonment can bring up to 10 years for each count of Medicare fraud. You may receive up to 20 years in prison if the fraud caused serious bodily injury. If the patient dies, you could receive a life sentence.

Common issues that may result in home health care or hospice fraud include incorrectly prescribing medication, the improper supervision of workers or staff, and improper certification of professionals. This often results in exclusion from federal health care programs, being unable to receive reimbursement for legitimate federal health care claims, and may have their professional license suspended or revoked.

The Importance of Choosing the Right Defense Lawyer

Because of the severity of the penalties associated with home health care and hospice fraud, it is imperative that you choose a competent and qualified defense attorney with a proven track record. An investigation of home health care or hospice fraud can put your business in danger, ruin your reputation, and destroy your ability to provide for your family. Choose a team of attorneys who can provide you with a zealous defense against government agencies, the media, and the public.

Here are the three most important considerations to keep in mind during your search:

  1. Is the attorney intimately familiar with the rules and regulations related to home health and hospice care? This includes billing, coding, and certification rules. Many attorneys simply do not have this knowledge, and you don’t need to squander time by teaching the attorney that you are paying to help you.
  2. Has the attorney successfully handled health care audits and fraud investigations? If the attorney doesn’t have a proven track record of negotiating complex health care fraud cases with OIG or HHS, you should be cautious to not hire an inexperienced attorney.
  3. Does the attorney have a proven history of trial and litigation success? Ask how many actual health care fraud trials the attorney has handled during the course of their career.

Oberheiden’s Proven Defenses

The Oberheiden Law Group has a proven track record that includes hundreds of health care investigations, on both sides of the table. Some of our attorneys are former prosecutors and senior government lawyers with the Department of Justice and now offer valuable and first-hand insights of how to defend against a government investigation.

Immediate Representation

If you are being investigated by a government entity, you must secure immediate representation. The more time that the government has to investigate your business, the easier it is for them to build their case. Hiring Oberheiden Law Group can help you get answers to your most pressing questions within hours of retaining us. We can find out what the investigation is about, whether the case is civil or criminal, if the government is considering claims that will include jail time, and what can be done to resolve the allegations.

Lack of Criminal Intent

During the course of our career, we have discovered that many of fraud allegations occur because of organizational and human errors. They do not happen because of criminal intent. Mistakes happen because of the use of unqualified staff, overwhelming staff members within their jobs, negligence, lack of supervision, and violating the ever-changing rules related to home health and hospice care.

Thankfully, the U.S. Constitution recognizes that making a mistake is not the same thing as being a criminal. This is why the government must meet a high burden of proof. The government must prove beyond a reasonable doubt that you intentionally committed fraud. Our attorneys provide aggressive and relentless defenses and force the investigating agencies to accept their burden of proof.

Certification Exceptions

A large amount of home health and hospice fraud claims occur because of incorrect certifications and re-certifications. Oberheiden Law Group understands that proving exceptions to certification and delegation rules takes experience. This experience and knowledge is important because the government tends to omit these exceptions in their complaints.

Working With the Media

We defend our clients on all fronts, including working with the media to expose the truth about unfounded allegations of wrongdoing by your organization. This helps protect your reputation. Oberheiden Law Group routinely assists clients by defending them from slanderous reports. Our goal is to correct and educate the media and the public.

Our Track Record

Our clients range from individual providers to entire health care systems. We represent clients in Miami who are under investigation by the Department of Justice (DOJ), the Department of Defense (DOD), the Federal Bureau of Investigation (FBI), Drug Enforcement Administration (DEA), the Office of Inspector General (OIG), the Medicaid Fraud Control Unit (MFCU), Miami and Florida law enforcement, or the Internal Revenue Service (IRS).

  • Defense of Health Care Service Business Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of Health Care Service Business Investigated by the Department of Justice and the FBI for Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of Health Care Service Business Investigated by the Department of Justice and the FBI for Medicare Fraud and False Claims Act Violations.
    Result: No civil or criminal liability.
  • Defense of Health Care Service Business Investigated by the Department of Defense and the FBI for Tricare Fraud.
    Result: No civil or criminal liability.
  • Defense of Health Care Service Business Investigated by the Department of Defense and the OIG for Tricare Fraud.
    Result: No civil or criminal liability.
  • Defense of Physician Syndication Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud and Stark Law.
    Result: No civil or criminal liability.
  • Defense of Physician Investigated by the Department of Health and Human Services and the Office of Inspector General for Medicare Fraud and Stark Law Violations.
    Result: No civil or criminal liability.
  • Defense 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.
  • Defense of Health Care Service Business Investigated by the Office of Inspector General for Medicare Fraud and Stark Law Violations.
    Result: No civil or criminal liability.
  • Defense 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.
  • Defense of Health Care Marketing 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.
  • Defense of Health Care Service Business Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of Health Care Service Business Investigated by the Department of Health and Human Services and the Office of Inspector General for Medicare and Tricare Fraud.
    Result: No civil or criminal liability.
  • Defense of Health Care Conglomerate Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud.
    Result: No civil or criminal liability.

Miami Defense Attorneys

Nick OberheidenDr. Nick Oberheiden is a Harvard-trained and internationally educated health care fraud defense attorney. Nick has successfully represented health care executives, business owners, public officials, physicians, and lawyers in high profile prosecutions, scores of political corruption, government investigations, and 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, Nick 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 Lynette’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. Lynette 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, 24 hours a day. You can call us directly, complete our contact form, or email us directly.

800-810-0259
Including Weekends
Oberheiden Law Group, PLLC
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. The Oberheiden Law Group PLLC is a Texas PLLC with headquarters in Dallas. Mr. Oberheiden limits his practice to federal law.

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