We are a team of
former federal prosecutors


Meet the Team
Oberheiden Attorneys

Defending Home Health Care and Hospice Fraud Charges in Ohio

The Oberheiden & McMurrey, LLP is an experienced health care law firm in regulatory compliance, litigation, civil and criminal government inspections, corporate structures, and in criminal defense. Members of our Health Care Fraud Defense Team include former senior Department of Justice attorneys, former lead prosecutors from the elite Medicare Fraud Strike Force, a former chief Health Care Fraud Coordinator with the U.S. Attorney’s Office, and talented attorneys with years of experience and with education from the nation’s best law schools, including Yale and Harvard. Our attorneys serve clients in the State of Ohio and the surrounding area.

If you are being investigated for home health care or hospice fraud in Ohio, call Oberheiden & McMurrey, LLP and ask to speak with a member of our Health Care Fraud Defense Team. The call is free and confidential.

Ohio Is Closely Scrutinized by a Federal Group

Ohio is under constant scrutiny by the federal government’s Medicare Fraud Strike Force. Ohio is one of nine areas in the nation that withstands this constant monitoring. Members of this team are investigators and prosecutors from multiple agencies, including the Department of Justice, Department of Health, and Human Services, the IRS, the Office of inspector General, the FBI, and may also include representatives from other federal agencies. The job of this team is to watch for, investigate, and prosecute various types of health care fraud, including home health care and hospice fraud.

Home Health Care and Hospice Fraud in Ohio

Oberheiden & McMurrey, LLP provides legal representation for Ohio area hospice companies, home health care agencies, business owners, and health care providers. We have experience in corporate compliance, internal investigations, Medicare audits, recoupment questions and requests, and both civil and criminal government investigations. We also have experience in:

  • 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

Oberheiden & McMurrey, LLP works 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 are familiar with the extensive requirements of 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 of Home Health Care and Hospice Fraud in Ohio

Home health care and hospice fraud investigations are serious. You could be charged in civil or criminal court. Civil penalties can include civil fines of up to $11,000 per false claim, recoupment of claims, future exclusion from federal health care programs, non-payment of your claims, being assessed with treble damages, and attorney fees.

Criminal penalties can include criminal fines in the hundreds of thousands of dollars, criminal indictment, and federal prison time 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,
  • Life in prison if the fraud resulted in the death of a patient.

It’s important to know that if you’re found guilty of incorrectly prescribing medications, improper supervision, or of completing false medical necessity certifications, you could be excluded from all federal health care programs, prohibited from reimbursement of claims made, and you could lose your professional license.

The Three Traits of the Best Ohio Defense Lawyer

If you’re being investigated for home health care or hospice fraud in Ohio, you must hire a defense lawyer that can help you. This must be done right away. This type of allegation can ruin your life. Choosing the right defense attorney can increase your chances to defeat the allegations.. As you consider your options, watch for the following traits:

  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 you’re 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.

Established Home Health Care and Hospice Fraud Defenses

The attorneys of Oberheiden & McMurrey, LLP have experience with hundreds of health care fraud investigations. Our attorneys have experience in health care auditing and as former federal health care fraud investigators and prosecutors. We use a set of established defenses for home health care and hospice fraud clients in the Ohio area.

Immediate legal advocacy. When you’re being investigated, you should not wait to get legal representation. Time is not your friend. The longer the federal government has to investigate you without an interruption, the more likely it is that you will face criminal charges. Once we are retained, we will immediately begin our advocacy for you. We contact federal prosecutors immediately to get answers to the important questions. Usually, we can get the answers to those questions within just a few hours:

  • Why is there an investigation taking place?
  • Is the investigation a civil or criminal matter?
  • Are you facing prison time?
  • What can be done to resolve the matter?

We work to prove that our clients made a mistake. Most investigations in Ohio start because of a mistake that was made either by an individual or because of a bad business decision. Very few investigations start because someone set out to commit fraud. The most common errors that we’ve seen during our practice experience include the use of unqualified or overwhelmed employees, negligence, supervision errors, and being unfamiliar with the constantly changing rules. Our court system acknowledges that sometimes good people make mistakes. While these mistakes should be corrected, they should not lead you to face criminal punishments. This is why the federal government has an incredibly high burden of proof to meet to prove that you committed a crime and acted with criminal intent. We scrutinize the evidence presented by the federal government to determine if it meets that standard. Our objective is to prove that our clients made a mistake and did not act with criminal intent.

Showing that certifications were appropriate. Most Ohio investigations of this nature include an allegation that the owner or the health care provider did not correctly certify or re-certify medical necessity. Oberheiden & McMurrey, LLP 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 it often will not bring them up in its complaint or in its arguments. Oberheiden & McMurrey, LLP uses industry witnesses and our trial experience to provide an easy to understand legal explanation to a judge or jury about the exceptions and delegation rules.

We work to protect your professional reputation. A common concern of our clients is their professional reputation. You have worked hard to establish your reputation–  even something as small as an allegation could be detrimental. They worry about how the public may view them because of the allegations of health care or hospice fraud. Oberheiden & McMurrey, LLP is committed to defending you both inside and outside of the courtroom. If the media gives a biased report or slanders our client, we address the issue and look for other opportunities to correct this misinformation. Our goal is to protect your professional reputation that you have worked so hard to obtain.

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), Ohio 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 Ohio

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. You can call us directly or complete our contact form or email us directly.

800-810-0259
Including Weekends
Oberheiden & McMurrey, LLP
Serving the State of Ohio 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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