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Oberheiden Attorneys

Midland-Odessa, Texas Grand Jury Subpoenas

Serving health care service providers in the Midland/Odessa area of Texas, our Health Care Fraud Defense Group is headed by attorney Dr. Nick Oberheiden. Dr. Oberheiden is a nationally recognized health care fraud defense attorney with an extensive trial record. He is also the founder and managing principal of The Oberheiden & McMurrey, LLP, PLLC.

Are You Under Investigation for Medicare Fraud in Midland/Odessa, Texas?

Medicare fraud involves the submission of false or fictitious claims for Medicare reimbursement. Submitting false and fictitious claims to Medicare may violate a number of federal statutes, including the False Claims Act, the Anti-Kickback Statute, the Physician Self-Referral Laws (Stark Law), the Social Security Act, and various provisions of the U.S. Criminal Code. Due to the nature of the offense, many health care providers charged with Medicare fraud will face charges for Medicaid, Tricare, and federal workers’ compensation fraud, in addition to charges for a number of other types of serious federal offenses.

The Midland/Odessa, Texas region is home to numerous health care facilities. This type of fraud is closely watched in Texas. All health care practitioners and businesses in Midland and Odessa must be vigilant to avoid mistakes that can lead to federal scrutiny. Texas is one of nine areas within the United States that is closely watched. Medicare fraud is one of the federal government’s top priorities when it comes to fighting government program fraud. In fact, the Department of Justice (DOJ), Department of Health and Human Services (HHS), the Office of Inspector General (OIG), the Federal Bureau of Investigation (FBI), and other agencies have combined to form a special task force specifically to combat the rising prevalence of Medicare fraud. This special task force, called Health Care Fraud Prevention and Enforcement Action Team (HEAT), has teams in seven states around the country, and Texas is one of only two states nationwide with two HEAT teams assigned to combat in-state Medicare fraud.

Common Forms of Medicare Fraud

In most Medicare fraud investigations, government law enforcement officers and prosecutors allege that the health care provider has engaged in some form of fraudulent billing practice, which typically involves submitting reimbursement requests for excessive or unauthorized services, or for services that were not actually provided. Some of the more-specific allegations include:

  • “Phantom billing” (billing for services that were never performed);
  • Providing and billing for medically unnecessary services;
  • Billing for supplies and equipment that were never purchased;
  • Purchasing and billing for medically unnecessary supplies and equipment;
  • Obtaining fraudulent certifications for medically unnecessary services (a common allegation in home health and hospice fraud investigations);
  • Obtaining fraudulent certifications for medically unnecessary supplies (including durable medical equipment (DME));
  • Double-billing;
  • Upcoding, unbundling, and other forms of coding fraud; and
  • Entering into illegal kickback arrangements with physicians or other providers.

With the broad focus of the government’s Medicare enforcement efforts, physicians, nurses, home health care centers, hospices, nursing homes, registered care facilities, hospitals, pharmacies, toxicology laboratories, medical devices companies, physician syndications, DNA testing centers, cancer treatment centers, and other health care service providers are all increasingly finding themselves the targets of invasive – and potentially dangerous – federal investigations.

Understanding the Penalties for Medicare Fraud

If you are targeted in a federal Medicare fraud investigation, you need to take your situation extremely seriously. Providers in the Midland/Odessa, Texas area that are found civilly or criminally liable for Medicare fraud may be exposed to recoupment requests, non-payment of future claims, civil fines of up to $11,000 per false claim, exclusion from future participation in federal health care programs, treble damages, attorney fees, criminal fines, and federal imprisonment. The potential prison sentences for those facing criminal Medicare fraud investigations include:

  • Up to 10 years in prison for each count of Medicare fraud;
  • Up to 20 years in prison for fraud resulting in serious bodily injury (including billing for providing patients with counterfeit or excessive medication); and
  • A life sentence if a fraudulent Medicare practice results in a patient’s death.

Physicians and other health care professionals charged with Medicare fraud will often face licensing actions and loss of hospital privileges in addition to possible prison time and expensive fines.

How to Choose the Right Defense Lawyer

The Right Choice: A Health Care Fraud Defense Lawyer

The ideal lawyer for your Medicare fraud case in Midland or Odessa, Texas is someone who works in the practices area of health care fraud defense. A qualified health care fraud defense lawyer will have four key traits:

  • A proven track record;
  • Industry knowledge;
  • Intimate knowledge of federal health care laws and criminal procedure;
  • Extensive litigation and trial experience;

Before paying any retainer fees, you should request a free consultation and ask the lawyer the follow important questions:

  • How many Medicare fraud cases have you handled so far?
  • How many of those cases resulted in no civil and no criminal charges for your clients?
  • How many health care fraud cases have you tried in court?

Proven Defense Strategies for Your Medicare Fraud Investigation

At Oberheiden & McMurrey, LLP, our experience and our track record set us apart from other defense firms serving the Midland/Odessa, Texas region. Our attorneys have handled health care proceedings and conducted more than 200 criminal trials nationwide. As former senior federal health care prosecutors, many of our attorneys provide experience and insight that few others can match. Based on this experience and insight, we have developed a number of proven defense strategies for Medicare fraud investigations.

Early Intervention

Early intervention is critical in Medicare fraud investigations. This means hiring an attorney before your investigation leads to civil or criminal charges. Getting involved early with the government can change the entire outcome of your case. At Oberheiden & McMurrey, LLP, our Health Care Fraud Defense Team have a good history of communication with the federal investigating bodies. We can quickly get answers to questions like: What is the case about? What prompted the investigation? Is the case civil or criminal? What agencies are involved? Who else is under investigation? How can the issue be resolved? Getting answers to these questions early can be crucial to building a successful defense that avoids trial.

Arguing a Lack of Evidence

In order to convict you of Medicare fraud, the government must meet the burden of proof. This burden of proof, which is to prove beyond a reasonable doubt that (i) you committed an illegal act and (ii) you did so with “criminal intent,” is a high bar to meet. We will target exposing the government’s lack of evidence on both of these essential elements in order to secure a quick and favorable resolution. In every case, our goal is to achieve the following:

  • Dismissal;
  • No criminal charges;
  • Keep professional licenses;
  • Civil fines, but no criminal pleas;
  • Misdemeanor, and no felony charges; and
  • No prison time.

Demonstrating Lack of Intent

In our experience, most incidents that prompt Medicare investigations do not involve criminal intent, but are the result of organizational and human errors. Busy health care practices that are focused on caring for their patients will often make mistakes that the government misconstrues as fraud. Some of the more-common issues we encounter, which do not rise of the level of criminal intent, include:

  • Unqualified staff;
  • Supervision errors;
  • Delegation and outsourcing;
  • Structural deficits;
  • Organizational mistakes;
  • Human error; and
  • Lack of compliance program.

In addition, the constantly changing nature of the federal Medicare rules can make even the most compliance-minded practices susceptible to making mistakes that lead to improper allegations of fraud.

Intentional health care fraud is rare. Unfortunately, too many business owners are ready to roll over and accept penalties for simple oversights. Mistakes are common in a busy practice, and they should not result in fraud convictions or liabilities.

About Oberheiden & McMurrey, LLP

The health care fraud defense lawyers of Oberheiden & McMurrey, LLP represent business owners, health care executives, lawyers, health care providers, hospitals, pharmacies, laboratories, and other health care entities throughout the Midland and Odessa areas in cases involving all types of allegations of Medicare fraud. We have broad experience in health care fraud investigations and center our practice in the following areas:

  • Health care fraud defense;
  • Compliance programs;
  • Internal investigations;
  • Defense of qui tam lawsuits;
  • Protect assets;
  • Licensure & disciplinary hearings; and
  • Trial by jury.

Our clients range from individual providers and health care company executives to entire health care systems. We are available to represent health care clients in Midland and Odessa, Texas who are under investigation by the Department of Justice, the Department of Defense, the Federal Bureau of Investigation, Drug Enforcement Administration, the Office of Inspector General, the Medicaid Fraud Control Unit, Midland/Odessa and Texas law enforcement, the Internal Revenue Service, and other state or federal agencies.

Our Track Record

  • Defense of Medicare laboratory against investigations by the Department of Justice and the U.S. Attorney’s Office for alleged Medicare fraud.
    Result: No civil or criminal liability.
  • Defense 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.
  • Defense of Medicare laboratory against investigations by the Department of Health and Human Services and the Office of Inspector General for alleged health care fraud.
    Result: No civil or criminal liability.
  • Defense of nationally operating health care company against an investigation by the Department of Defense for alleged Tricare fraud.
    Result: No civil or criminal liability.
  • Defense of health care marketing company against an investigation by the Office of Inspector General for alleged False Claims Act and Medicare violations.
    Result: No civil or criminal liability.
  • Defense of a laboratory against an investigation by various branches of the federal government for alleged fraud.
    Result: No civil or criminal liability.
  • Defense of physician-owned entity against an investigation by the Department of Health and Human Services for alleged Stark Law violations.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Department of Justice for alleged fraud.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged Stark Law violations.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged False Claims Act violations.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by various branches of the federal government for alleged False Claims Act, Stark Law, and Medicare violations.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Department of Defense for alleged Tricare fraud.
    Result: No civil or criminal liability.
  • Defense of a physician-owned entity against an investigation by the Department of Justice for alleged Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of physician-owned entity against an investigation by the Department of Health and Human Services for alleged Stark Law violations.
    Result: No civil or criminal liability.
  • Defense of health care management organization against an investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for alleged Medicare Fraud.
    Result: No civil or criminal liability.
  • Defense of nationally operating laboratory against an investigation by the Office of Inspector General for alleged fraud.
    Result: No civil or criminal liability.

Midland/Odessa, Texas Health Care Fraud Defense Attorneys

Nick OberheidenDr. Nick Oberheiden is a Harvard-trained and internationally educated health care fraud defense attorney. Dr. Oberheiden has provided successful representation for health care executives, business owners, public officials, physicians, and lawyers in high profile prosecutions, allegations of political corruption, government investigations, and in media campaigns. Dr. Oberheiden is often called upon to help stop criminal charges in federal investigations. In addition to his health care defense practice, Dr. Oberheiden leads internal investigations, implements compliance programs, and teaches U.S. criminal law and federal litigation in the United States and abroad. Dr. Oberheiden is the managing principal of Oberheiden & McMurrey, LLP and he serves clients in Dallas, Garland, Mesquite, Richardson, McKinney and surrounding communities in federal health care investigations.

Lynette ByrdLynette S. Byrd is a former Assistant United States Attorney (AUSA). Ms. Byrd formerly prosecuted health care fraud allegations, Anti-Kickback Statute violations, violations of the False Claims Act, and Stark law violations. Her clients greatly benefit from her prosecutorial experience. Ms. Byrd’s intimate knowledge of health care law enforcement shines as she regularly argues federal matters on behalf of her clients.

We are available every day of the year, 24 hours a day. You can call us directly or complete our contact form to request a free consultation.

800-810-0259
Including Weekends
Oberheiden & McMurrey, LLP
Serving Midland / Odessa, 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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