We are a team of
former federal prosecutors


Meet the Team
Oberheiden Attorneys

Your New York and New Jersey False Claims Act & Qui Tam Defense Attorneys

New York/New Jersey Office
30 Wall Street, 8th Floor
New York, NY 10005
1-800-810-0259
(Meeting location by appointment only)

The 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 are licensed in New York and New Jersey as well as authorized to appear in New York and New Jersey federal courts.

We recognize the importance of each matter and we dedicate our fullest attention to each client. All clients of Oberheiden & McMurrey, LLP are represented by senior attorneys only. We are available for free and confidential consultations.

At Oberheiden & McMurrey, LLP, we have the experience to advise you and defend you, if need be, against qui tam cases and cases brought under the False Claims Act.  Our Health Care Fraud Defense Group includes former Assistant United States Attorney Lynette Byrd, as well as Dr. Nick Oberheiden, the founder and managing principal of the firm with years of experience in health care fraud defense.

Medicare Fraud Investigations in New York and New Jersey

Brooklyn is one of nine U.S. cities in which the DOJ has created special Medicare Fraud Task Forces. The Brooklyn task force investigates, monitors, and prosecutes cases of suspected Medicare fraud throughout New York and New Jersey.  Because Brooklyn has been targeted by the Strike Force by being named as one of the nine host cities, local medical practitioners must be aware that investigations into Medicare fraud, and health care fraud generally, will probably be more frequent and more aggressive than in other geographic areas.  Such investigations will likely be conducted by HEAT, the Health Care Fraud Prevention and Enforcement Action Team, which consists of investigators and prosecutors from several agencies, including the DOJ, the Office of Inspector General, the Department of Health and Human Services, and the FBI, among others.

False Claims Act Explained

The False Claims Act applies that anyone – whether a business or person – who contracts with the United States and is paid for their services or products by the United States, whether directly or indirectly.  Thus, all types of persons and entities may be subject to the False Claims Act, including medical providers, administrative personnel, billing companies, organizations, contractors, and corporations.  Liability accrues when a person knowingly submits, or knowingly causes another person to submit, a false or fraudulent claim in order to obtain approval or payment from the government.  Under the False Claims Act, knowingly means either actual knowledge of the claim’s falsity or the failure to complete an investigation to determine whether or not the claim was false.  In other words, a person will be liable for a False Claims Act violation when they actually knew or should have known that a submission to the federal government was inaccurate.  A common example of such a scenario would be submitting a claim under a billing code that is no longer in use.

Civil & Criminal Liability

Any potential defendant must take False Claims Act charges seriously because both civil and criminal penalties are possible under federal law.  Often, at the beginning of the investigation, the government does not specify whether its investigation is civil or criminal in nature.  The penalties to which you may be subject vary accordingly.

  • Civil claim: Under the False Claims Act, any person who knowingly submits or causes the submission of a false or fraudulent claim to the federal government can be required to pay a fine of up to $ 11,000 per claim as well as treble damages and attorney’s fees.
  • Criminal charges: (18 U.S.C. § 287): Anyone who knowingly submits or causes submission of a false or fraudulent claim to the United States is subject to a five year term in prison plus a fine of up to $ 250,000, for individuals, or $ 500,000, for a corporation, for felony convictions and $ 100,000 (individuals) or $ 200,000 (corporations) for misdemeanor convictions. These separate penalties may be applied to each false claim made by such a person.

What Is a Qui Tam Lawsuit?

As noted above, the federal government is emphasizing False Claims Act cases through its Brooklyn HEAT task force.  Still, most False Claims Act investigations are initiated when a private citizen files a lawsuit.  Such lawsuits, which are specifically provided for by the False Claims Act, are known as qui tam cases.  Qui tam means “for the king and himself” in Latin; in the United States, a qui tam case is one in which the person filing the suit is seeking to recover money that is owed to the government under 31 U.S.C. § 3729.  If he is successful, he will receive a portion of that money for himself.  The individual who files a qui tam lawsuit is most likely a disgruntled current or former employee or a competitor looking to harm your business.  The process of a qui tam suit is as follows:

Complaint.  The person filing the qui tam case is known as the relator.  He or she will file the case in a federal court in either New York or New Jersey against defendants, who may include individuals, businesses, or both.  The relator’s identity is protected, and the government is given time to analyze the allegations in the lawsuit, by the fact that all qui tam lawsuits are filed under seal.  Only the assigned judge and certain government officials receive copies.  Thus, the defendant or defendants may not even be aware that they are under investigation.  Normally, the qui tam case is sealed for six months, but this period can be renewed if the investigation isn’t finished and the government asks for more time.

Evidence.  Once the court informs the government that a qui tam lawsuit has been filed, federal investigators will review the complaint and reject any that are implausible or unsubstantiated on their face.  But, if the complaint seems persuasive and cites believable evidence, the government will proceed to investigate the claims alleged therein through one or more of the FBI, the DEA, the OIG, the DOJ, or other agencies, correlated by the type of allegations made in the complaint.  Usually, this investigation is handled through subpoenas issued both to the defendants named in the complaint and to third parties, seeking corporate, financial, business, billing, and communications records.

Government Intervention.  Once the government receives and reviews the records it requested, and possibly once it has negotiated with attorneys for the defendants, it needs to decide whether or not to formally intervene in the case and prosecute the case through government attorneys, or refuse to intervene and let the relator handle the case on his or her own. In order for the government to choose intervention, it must obtain approval from DOJ headquarters in Washington, D.C.  If it does intervene, it typically amends the complaint to add the facts it learned during the investigation as well as additional causes of action against the defendants that it thinks may create liability.

Case Settlement. During the time of their investigation, the government attorneys may also be trying to reach an agreement with the defendant or defendants that would settle the case.  Once subpoenas have been served, the defendants are aware of the case and that they are being investigated by the federal government.  The prosecutors and defense attorneys may spend weeks or even months trying to negotiate an agreement that will satisfy both sides.  Investigation and settlement negotiations may move slowly, as it takes time for the government to fully investigate and analyze its options, particularly in a complicated case.

Liability and Rewards.  As noted above, the civil penalty for False Claims Act cases includes treble damages and a fine of up to $11,000 per fraudulent claim. The person who brought the qui tam case is rewarded with 25 percent of these damages if the government intervened in the case, and up to 30 percent if the government did not intervene.  Such incentives are a common reason for qui tam cases to be initiated.

Proven Defense Strategies

At Oberheiden & McMurrey, LLP, our attorneys have successfully resolved many False Claims Act investigations and qui tam lawsuits in New York, New Jersey, and throughout the country.   In fact, many of our attorneys are former federal prosecutors and health care fraud specialists.  We know that the distinction between human error and intentional fraud is a fine one, and that keeping our clients in compliance with health care regulations and out of the government’s crosshairs requires an emphasis on details, superb skills at the negotiating table, and years of experience in the industry.  These principles guide us in every case. 

  • No Criminal Charges. Our number one goal in every False Claims Act case is to prevent the imposition of federal criminal charges. Our years of experience in federal health care cases – both as prosecutors and defense attorneys – allow us to focus quickly to determine the intent of the prosecutors.  What result do they seek?  Is the investigation civil or criminal?  How can we achieve a fast, fair resolution?  Generally, we can answer these questions within hours of being retained.
  • No Government Intervention. Next, if we are faced with a qui tam case, we will try to persuade the government not to intervene. As we have noted, most cases under the False Claims Act are initiated by employees or ex-employees with an axe to grind or by competitors hoping to steal away business.  Our attorneys work to expose the relators’ disingenuous agendas to the government, challenge their so-called evidence, and ultimately destroy their credibility.  By doing so, we may persuade the government not to waste the taxpayers’ money and its attorneys’ limited time by intervening.  After all, it is easier to defeat one or two people than to take on the full power of the United States government.
  • Favorable Settlement. Most importantly, we always seek the most favorable resolution for our clients, whether through settlement or otherwise. We take pride in negotiating to reduce damages to mere fractions of what was demanded.  To date, not one of our False Claims Act clients has been forced to resign their professional license, cease operations, or close their business.

Call us at Oberheiden & McMurrey, LLP today to discuss your situation with one or more of our senior attorneys.  All initial consultations are free and confidential. You can call us directly, complete our contact form, or contact us by email.

Oberheiden & McMurrey, LLP

At Oberheiden & McMurrey, LLP, our attorneys have successfully defended physicians, nurses, medical practice owners, physician owned entities, toxicology laboratories, device companies, pharmacies, service management organizations, health care marketing companies, hospitals, and many others in cases involving the False Claims Act, qui tam, Stark Law, Anti-Kickback, Medicare, Medicaid, Tricare, and DOL investigations.  Our recent successes include:

  • False Claims Act Investigation (Pharmacy)
    Result: No Liability.
  • False Claims Act Investigation (Pharmacy)
    Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)
    Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)
    Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)
    Result: No Liability.
  • False Claims Act Investigation (Physician)
    Result: No Liability.
  • False Claims Act Investigation (Physician)
    Result: No Liability.
  • False Claims Act Investigation (DME Company)
    Result: No Liability.
  • False Claims Act Investigation (MSO)
    Result: No Liability.
  • False Claims Act Investigation (MSO)
    Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)
    Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)
    Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)
    Result: No Liability.
  • False Claims Act Investigation (Device Company)
    Result: No Liability.
  • False Claims Act Investigation (Health Care Service Provider)
    Result: No Liability.

Call Oberheiden & McMurrey, LLP today and speak with former federal prosecutors and established defense counsel about your case. All initial consultations are free and confidential.

False Claims Act Defense Attorneys Serving New York and New Jersey

Nick OberheidenNick Oberheiden has represented clients in Qui Tam, False Claims Act, Medicare Fraud, Tricare Fraud, Stark Law, and anti-kickback proceedings before virtually all federal agencies, including 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 from the University of California, Los Angeles, as well as a Ph.D. in law.

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 always available to discuss your case.  Call us today.

800-810-0259
Including Weekends
Oberheiden & McMurrey, LLP
Serving New York, New Jersey, 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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