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Oberheiden Attorneys

Medicare Fraud Legal Defense for Ogemaw County and all of Michigan

Oberheiden & McMurrey, LLP is a Medicare fraud defense law firm serving Ogemaw County, Michigan and the surrounding areas. We provide legal advocacy to individuals, businesses, and entities in the health care field that are being investigated by the federal government, named as a defendant in a qui tam lawsuit, jury trials, and during federal audits. We also help clients by planning and implementing a federal compliance program.

Defining Medicare Fraud

Medicare fraud is a federal offense that occurs when at least one claim with a mistake is filed with a federal health care program for reimbursement. This isn’t relegated to only Medicare. It also includes Medicaid, Tricare, and federal workers’ compensation. These claims are filed by medical providers, facilities, and businesses in an effort to get reimbursed for services and equipment provided to program recipients. If you’re accused of Medicare fraud, you’re going to be investigated for violating at least one of the following statutes:

Ogemaw County, Michigan is one of nine regions in the United States that is constantly supervised by the Medicare Fraud Strike Force. This happens because Ogemaw County has a large number of residents who rely on a federal health care program. This causes an increase in the number of claims filed for reimbursement. So, the Medicare Fraud Strike Force watches the area for an increase in Medicare fraud.

The Medicare Fraud Strike Force is a team of prosecutors and investigators from multiple federal agencies including the DOJ, DEA, DOD, Department of Human Services, the Office of Inspector General, the FBI, and the IRS. However, other federal agencies can be involved. If you’re being investigated by the Medicare Fraud Strike Force or if you’re contacted by a member from a federal agency, contact Oberheiden & McMurrey, LLP. The initial call is free and confidential.

Medicare Fraud Investigations in Ogemaw County, Michigan

Medicare fraud investigations start in Ogemaw County most often because of an error that was on a claim filed with a federal health care program. Often, the error is found either in the coding or the billing. The most common billing mistakes include an unauthorized charge, an incorrect charge, or an excessive charge. Other common mistakes include:

  • Phantom billing – billing for services that were never performed;
  • Double billing for medical equipment or services;
  • Submitting a claim for medically unnecessary medical services or equipment;
  • Submitting a claim for medically unnecessary medical supplies;
  • Submitting a claim for a medically unnecessary certification (including a claim for hospice or home health care);
  • Inflating charges;
  • Up-coding;
  • The overuse of medical equipment of services;
  • Providing or accepting kickbacks.

The most common investigated include doctors, nurses, DME companies, and cancer centers in Ogemaw County, Michigan. However, other people, businesses, and facilities that file a federal health care claim are at risk of being investigated.

The Civil and Criminal Penalties of Medicare Fraud

Medicare fraud allegations in Ogemaw County, Michigan and the surrounding areas can result in civil or criminal charges. Federal civil penalties include:

  • Repayment of claims in questions;
  • Future claims aren’t paid;
  • A fine of up to $11,000 per false claim;
  • Exclusion from federal health care programs;
  • Assignment of treble damages;
  • Attorney fees
  • You could also lose your hospital privileges and your professional license.

Federal criminal penalties include:

  • Fines that cost you hundreds of thousands of dollars, even for a misdemeanor;
  • A criminal record;
  • A federal prison sentence of up to 10 years for each count of Medicare fraud for which you are convicted;
  • Federal prison sentence of up to 20 years for each count of Medicare fraud that resulted in serious bodily harm to the patient or patients;
  • A life sentence in federal prison for Medicare fraud that results in the death of a patient.

Medicare Fraud Defense Attorney Serving Ogemaw County, Michigan

In Ogemaw County, Michigan, an allegation of this nature can ruin your business. You need to hire a health care fraud defense lawyer. This type of attorney can help you with both the violation of health care law or regulations and with any criminal charges, such as wire fraud, that may be levied against you. As you research attorneys, look for these traits:

  1. A successful record when handling Medicare fraud cases;
  2. Knowledge of the Medicare fraud and health care fraud laws and regulations;
  3. Knowledge of statutory exceptions;
  4. Both litigation and jury trial practices.

You should then ask the health care fraud defense attorney the following questions:

  1. How many Medicare fraud cases have you handled throughout your career?
  2. How many of those resulted in no civil or criminal charges or in dismissals for your clients?
  3. How many of those cases were tried in court?

Medicare Fraud Defense Strategies

Oberheiden & McMurrey, LLP serves clients in Ogemaw County, Michigan who are in need of Medicare fraud defense. We’ve represented hundreds of clients, and we’re ready to help you.

We reach out to the federal government. After we are retained, we immediately reach out to the federal government on behalf of clients. Our objective is to help clients avoid criminal charges and resolve the allegations made against them. To start the process, we get answers to the most important questions:

  • What is the investigation about?
  • What prompted the investigation?
  • Is the investigation civil or criminal?
  • Which federal agencies are involved?
  • What is the ultimate goal of the government?
  • How can this matter be resolved?

Getting answers to these questions can help us to plan your defense and it can make the difference between a civil settlement and criminal charges. Often, we are able to get answers in just a few hours.

We analyze the evidence. The government must provide evidence to prove that you committed a crime. This evidence must meet a high legal standard. We analyze and question federal evidence that is presented. This strategy often results in:

  • Dismissal of charges;
  • No criminal charges;
  • Client retains professional license;
  • Civil fine with no criminal plea;
  • Reducing a felony to a misdemeanor;
  • No federal prison sentence.

Proving that there is no criminal intent. The federal government must also prove that you acted with criminal intent. This is difficult for them to prove because most people do not set out with an intention to commit fraud. These investigations often start because of a mistake made by a person or a business. The most common mistakes made are:

  • Using unqualified staff;
  • Inadequate supervision;
  • Inappropriate delegation and outsourcing;
  • Structural errors;
  • Human errors;
  • Oversight;
  • Employees who are overwhelmed;
  • No Medicare compliance program in place;
  • The changing health care laws and rules.
  • Our objective is to show that you admit you made a mistake and you want to correct it.

Using custom Medicare fraud defense strategies. Our defense team takes the time to analyze the facts involved in each case. This enables us to use custom Medicare fraud defense strategies. One of our clients was accused of providing a fraudulent certification for home health care services. We were able to prove that our client was protected by a recognized delegation exception and that the certification was compliant within the law. In another recent case, we refused to admit liability on behalf of our client. Instead, we proved to the federal prosecutor that our client acted within a safe harbor exception.

Oberheiden & McMurrey, LLP

Oberheiden & McMurrey, LLP serves Ogemaw County, Michigan and the surrounding areas. We represent individuals, business owners, entire entities, attorneys, executives, hospitals, pharmacists, and pharmacies that are being investigated for fraudulent billing, illegal kickbacks, and allegations of medically unnecessary services, services not rendered, or unlawful joint ventures. We can help you in many areas, including:

  • Health care fraud defense
  • Compliance program creation and implementation
  • Internal investigations
  • Asset protection
  • Licensure or disciplinary proceedings
  • Jury trials

Oberheiden & McMurrey, LLP provides legal advocacy for individuals, entire health care systems, or businesses in Ogemaw County, Michigan and the surrounding areas if they are contacted by the DOJ, Department of Defense, the FBI, the DEA, the Office of Inspector General, Medicare Fraud Control Unit, the IRS, or Michigan law enforcement.

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.

Medicare Fraud Defense Lawyers Serving Ogemaw County, Michigan

Nick OberheidenNick Oberheiden is a Harvard-trained and internationally educated health care fraud defense attorney. Dr. 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. He is most known for stopping federal investigations before criminal charges can be filed. 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 knowledge 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 skills with health care law enforcement, and she regularly argues federal matters for her clients.

We are available every day of the year. You can call us directly or complete our contact form or by emailing us directly.

800-810-0259
Including Weekends
Oberheiden & McMurrey, LLP
Serving Ogemaw County, Michigan 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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