We are a team of
former federal prosecutors


Most of our cases have ended in
No Criminal Charges

Meet the Team
Oberheiden Attorneys

Home Health Care and Hospice Fraud Defense Serving the State of Missouri

The Oberheiden Law Group is a health care law firm with experience in multiple areas, including regulatory compliance, corporate structuring, litigation, civil government investigations, criminal government investigations, and in criminal defense. Members of our Health Care Fraud Defense Team include a former Chief Health Care Fraud Coordinator with the U.S. Attorney’s Office, former senior Department of Justice trial attorneys, former lead prosecutors from the elite Medicare Fraud Strike Force, and talented attorneys with years of experience and education from the nation’s best law schools, including Yale and Harvard. Our attorneys serve clients in the State of Missouri.

If you’re under investigation for home health care or hospice fraud in Missouri, call us immediately and ask to speak with a member of our Health Care Fraud Defense Team. Initial calls are confidential and free of charge.

Missouri Is Under Constant Surveillance

The State of Missouri is under constant surveillance by the federal government via the Medicare Fraud Strike Force. Missouri is one of nine locations in the United States that undergoes this constant monitoring. The Medicare Fraud Strike Force is a coordinated effort between several federal agencies, including the Department of Justice, Department of Health and Human Services, the Office of Inspector General, the FBI, and the IRS. However, other federal agencies can be involved. The job of the team is to monitor, investigate, and prosecute the different types of health care fraud, including home health care and hospice fraud.

Home Health Care and Hospice Fraud in Missouri

The Oberheiden Law Group provides legal advocacy for hospice facilities, home health care agencies, business executives and owners, and health care providers in Missouri. We are also experienced in matters related to corporate compliance, internal investigations, Medicare audits, recoupment questions and requests, and both civil and criminal government investigations. We can also help if you’re facing:

  • OIG subpoenas
  • Grand jury subpoenas
  • Medicare fraud
  • Medicaid fraud
  • Violations of the Anti-Kickback Statute
  • Violations of the False Claims Act
  • Qui tam defense
  • Violations of Stark Law (Self-Referral Law)
  • HIPAA compliance
  • DEA investigations
  • Certifications involving medical necessity
  • Billing inaccuracies
  • Overbilling
  • Overuse of services
  • Overuse of equipment
  • RAC audits
  • ZPIC audits
  • IRS investigations

The Oberheiden Law Group partners with the National Association for Home Care & Hospice (NAHC), the National Hospice and Palliative Care Organization (NHPCO), the National Center for Assisted Living (NCAL), and other related programs. We understand the requirements related to certification and re-certification, determinations of clinical status, respite care requirements, homebound evaluations, medical necessity certification, and plan of care requirements.

Civil and Criminal Penalties Related to Home Health Care and Hospice Fraud

Home health care and hospice fraud investigations are somber and can cause you to face civil or criminal penalties in court. Civil penalties may include fines up to $11,000 per false claim, recoupment of involved claims, exclusion from federal health care programs, non-payment of claims, treble damages, and attorney fees.

Criminal penalties may include expensive criminal fines that cost you hundreds of thousands of dollars, a criminal record, and you could be given a federal prison sentence of:

  • Up to 10 years for each count of fraud,
  • Up to 20 years if the fraud resulted in serious bodily injury to the patient,
  • A life sentence if the fraud resulted in the death of a patient.

Realize that if you’re found guilty of incorrectly prescribing medications, improper supervision, or of providing false certifications that you could be excluded from federal health care programs, prohibited from receiving reimbursement, and you could face the loss of your professional license.

Vital Traits of the Right Missouri Defense Lawyer

Home health care or hospice fraud investigations in Missouri require the right defense lawyer. An allegation of this nature can devastate your career. Choosing the best Missouri defense lawyer gives you the best possible chance at regaining your reputation and continuing in your chosen profession. As you do your research, look for the following vital traits that signify that you may have found the right defense lawyer:

  1. Demonstrated familiarity of the rules and regulations related to home health care and hospice care. This is important because you’re not going to have the time to explain billing, coding, and certification rules to a lawyer who doesn’t have this knowledge.
  2. A successful track record of resolving health care audits and health care fraud investigations. Additionally, they should have a proven track record of successfully negotiating complex health care fraud cases involving various federal agencies, such as the OIG, DOJ, HHS, and IRS.
  3. Experienced litigators and trial lawyers. Federal prosecutors will know if your defense lawyer is any good. Ask each potential lawyer how many health care fraud trials they’ve managed that resulted in no civil or criminal liabilities for their clients.

Key Home Health Care and Hospice Fraud Defenses

The Oberheiden Law Group has provided legal advocacy in hundreds of health care fraud cases. Many of our lawyers have experience in health care auditing and as former federal health care fraud investigators and prosecutors. This experience has led us to develop key home health care and hospice fraud defenses for our clients in Missouri.

Immediate contact with federal investigators. If you’re under investigation for home health care or hospice fraud, don’t wait to get a lawyer. When the federal government has a large amount of time to investigate you without an interruption, you might face criminal charges. When we are retained, we immediately contact federal investigators. Usually, we are able to get answers to the most important questions within hours:

  • Why was the investigation started?
  • Is the investigation a civil or criminal matter?
  • Are you facing federal prison time?
  • What can be done to resolve the matter?

Showing a mistake was made. A lot of the home health care and hospice fraud investigations that happen in Missouri do so because of a mistake made by a person or because of a bad business decision. The most common mistakes that cause an investigation by the federal government include the use of unqualified or overwhelmed employees, negligence, supervision errors, and being unfamiliar with the constantly changing rules. Thankfully, our court system acknowledges that sometimes good people make mistakes. While these mistakes should be corrected, they should not lead you to facing criminal punishments. This is why the federal government has an incredibly high burden of proof to meet to show that you committed a crime and acted with the intent to commit a crime. Our objective is to show that our clients made a mistake and did not commit a crime.

Appropriate use of certifications. A large number of the home health care and hospice fraud investigations that take place in Missouri include an argument by the federal government that the business owner or the health care provider did not properly certify or re-certify medical necessity. The Oberheiden Law Group uses known legal exceptions and delegations to certifications and re-certification rules to prove that your actions were appropriate. The federal government is aware of these exceptions, but they often will not bring them up in their complaint or in their arguments. The Oberheiden Law Group uses industry authorities and our trial experience to provide explanation to a judge or jury about the legal exceptions and delegation rules.

Defending your professional reputation. The Oberheiden Law Group knows that these allegations can ruin your professional reputation. If the media releases a biased report, our attorneys step up. We address slander and will also look to correct misinformation. We work to protect your professional reputation.

Our Track Record

Our clients range from individual providers to entire health care systems. We represent clients in Detroit 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), Missouri 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.

Home Health Care and Hospice Fraud Defense Lawyers Serving Missouri

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 for our clients. Call us directly, complete our contact form, or email us.

800-810-0259
Including Weekends
Oberheiden Law Group, PLLC
Serving the State of Missouri 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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