We are a team of
former federal prosecutors


Meet the Team
Oberheiden Attorneys

California Health Care Fraud Defense Legal Representation for all of Orange County

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 leading schools such as Harvard Law School, Yale Law School, and UCLA. Our attorneys routinely serve clients in Orange County as well as throughout California State.

If you’re in Orange County, California and you’re facing an allegation of health care fraud, you should call Oberheiden & McMurrey, LLP. We provide health care fraud defense strategies. We have extensive legal experience with OIG and grand jury subpoenas, Medicare and Tricare audits, fraud allegation defense, internal investigations, compliance programs, qui tam defense, protection of assets, criminal defense, and with federal jury trials. Our Health Care Fraud Defense Team includes a former Chief Health care Fraud Coordinator for the U.S. Attorney’s Office, several former health care fraud prosecutors, elite former lead prosecutors of the Medicare Fraud Strike Force, and accomplished lawyers with education from the country’s leading law schools, including Yale and Harvard.

If you’re being investigated by the federal government, call Oberheiden & McMurrey, LLP and ask to speak with a member of our Health Care Fraud Defense Team. Initial consultations are confidential and free of charge.

Orange County, California Is Scrutinized Closely for Health Care Fraud

Orange County, California is scrutinized by the Medicare Fraud Strike Force for instances of health care fraud. This elite team of prosecutors and investigators is made up of members from various federal agencies, including the Department of Justice, Department of Health and Human Services, Office of Inspector General, and the Federal Bureau of Investigation. However, this list isn’t all-inclusive. Other agencies may have representatives who are members of the Medicare Fraud Strike Force.

Orange County, California and the surrounding areas are scrutinized because of a large number of residents who rely on a federal health care program. This reliance increases the number of claims filed with the federal government. This leads the government to aggressively monitor, investigate, and prosecute allegations of health care fraud. In 2016, the Department of Justice investigated more than 300 cases. Around 80 of those centered on individual health care providers. The rest of the cases involved a health care entity or business. The agency reported that it recovered more than $900 million in fraudulently paid out claims.

Defining Health Care Fraud

Federal health care fraud is defined as an attempt to obtain reimbursement for medical services or equipment from a federal health care program, such as Medicare, Medicaid, Tricare, or federal workers’ compensation, by filing fraudulent claims. It includes a violation of at least one of the following:

  • The Anti-Kickback Statute. Federal health care law prohibits kickbacks in exchange for referrals. Any individual (including doctors, marketing representatives, and business owners) may face prosecution for violating the Anti-Kickback statute for offering or providing payment or other valuables in return for patient referrals.
  • Stark Law. Stark Law is also known as the Self-Referral Law. It prohibits doctors from referring patients to specific health care service entities if the doctor (or a member of the doctor’s immediate family) has an ownership or investment interest, or if there is a compensation arrangement. However, there are statutory exceptions to this law.
  • False Claims Act. If you submit a claim to Medicare or any other federal health care program, you must abide by the False Claims Act. If the claim submitted to the federal government is inaccurate, the federal government may launch an investigation into your billing practices under the criminal provisions of the False Claims Act.
  • Prescription Fraud. The federal government keeps a close eye on health care practices that have an unusually high number of narcotic prescriptions. If you’re suspected of running a “pill mill,” you may be investigated for insurance fraud and for violating DEA dispensing rules.
  • Billing Fraud. The federal government investigates the upcoding of claims. Upcoding means that the next higher code is used for a service when the billing is done. The federal government will also investigate phantom billing (billing for services not provided), billing for patients who don’t exist (referred to as ghost patients), and billing for equipment or services that are not medically necessary.
  • Certification Errors. The federal government closely watches the home health care and hospice industry. The most common allegation includes fraudulent certification for home health care and hospice care.

Oberheiden & McMurrey, LLP has a track record of success helping clients avoid criminal charges. If you or your health care practice or your business are being investigated for health care fraud in Orange County, California or the surrounding areas, it is important that you call us immediately. The call is free and confidential.

Civil and Criminal Health Care Fraud Penalties

Health Care fraud allegations can result in civil or criminal charges. Civil penalties may include civil repayment, non-payment of future claims, and you may be excluded from federal health care programs. Criminal penalties may include criminal prosecution, federal prison time, and fines that cost you hundreds and thousands of dollars.

If you are found guilty of criminal health care fraud, you may receive a prison sentence:

  • Up to 10 years for each count of health care fraud
  • Up to 20 years for each count of fraud that resulted in serious bodily injury to the patient
  • Life sentence if the health care fraud resulted in the death of a patient

One of the most common questions that we are asked is what the worst-case scenario is for health care fraud in Orange County, California. Determining whether you may face criminal prosecution or receive a federal prison sentence can depend on many factors, such as the severity of the injury suffered by the patient (if any), the interest of the federal prosecutor, and the reason why the investigation was pursued by the federal government. Oberheiden & McMurrey, LLP is ready to help you with your health care fraud defense case. Call us now. Initial consultations are free and confidential.

Indications of Criminal Charges

Health Care fraud investigations can be civil or criminal. Early intervention by Oberheiden & McMurrey, LLP and the use of compelling defense strategies can help you avoid criminal charges. Call us now if you’re being investigated for health care fraud in Orange County, California.

At the beginning of most health care fraud investigations, most clients are unsure whether they are facing civil or criminal charges. The U.S. Attorney’s Office has two divisions: One is civil and one is criminal. There are prosecutors who are employed for each division. Just because you’ve been contacted by a federal prosecutor doesn’t necessarily mean that you’re going to face criminal charges. The same is true regardless of which federal agency prosecutor contacts you. We can help you by contacting the federal prosecutor on your behalf to determine if your charges are civil or criminal. It is important that you keep in mind that a civil investigation can morph into a criminal matter if it isn’t properly defended. That’s why it is so important that you call Oberheiden & McMurrey, LLP right away if you’re contacted by a federal prosecutor.

Determining the nature of the case can depend on the legal interpretation of many things, such as OIG subpoenas, the manner in which the inquiry is made or in the way in which the allegations are made, and other indicators of criminal prosecution. Criminal prosecution may be signaled by search warrants, seizure warrants, arrest warrants, target letters, involvement of federal criminal prosecutors, IRS involvement, or grand jury subpoenas.

If you have questions about whether you are facing criminal or civil charges, contact Oberheiden & McMurrey, LLP right away. We represent individual providers, entire health care systems, and other related businesses. We provide health care defense services to individuals, businesses, and entities in and around Orange County, California that are being investigated by the Department of Justice, the Department of Defense, the Federal Bureau of Investigation, Drug Enforcement Administration, Office of Inspector General, Medicare Fraud Control unit, Orange County or California state law enforcement, or the Internal Revenue Service.

Health Care Fraud Defenses for Orange County, California

Oberheiden & McMurrey, LLP is a health care fraud defense law firm providing services in Orange County, California and the surrounding area. Many of our lawyers have previous experience as health care auditors and health care fraud prosecutors with the Department of Justice. We provide their extraordinary insight to our clients.

Immediate legal advocacy for our clients. The main objective for each client is to help avoid criminal charges. Our experience and track record prove that the best way to defend against criminal prosecution is to intervene early and not give the government a lot of uninterrupted time to build their case against you. We constantly work to protect your freedom and your professional aspirations. Usually, we can get answers to the most important questions within just a few hours:

  • What is the investigation about?
  • What is the purpose of it?
  • How long will the investigation take?
  • What is the most likely outcome?

Testing the Constitutional standards. The Constitution requires the federal government to prove beyond a reasonable doubt that you acted with criminal intent. We test this high standard in each and every case where the federal government indicates that there may be criminal charges involved. Prosecutors often point to billing inaccuracies to attempt to prove criminal intent. However, we know from experience that mistakes happen, and that those mistakes do not and should not equate to fraudulent activity. Oberheiden & McMurrey, LLP has provided successful legal defense for clients across the United States by proving that the inaccuracies in billing are results of organization or human error and did not happen because of intent to defraud the government. In our experience, we’ve noted that the use of unqualified workers, delegation errors, outsourcing errors, lack of oversight, insufficient supervision, and the constantly changing laws and rules that are involved in health care are the most common errors that cause these investigations. Although these issues should be corrected, they should not lead to criminal liability.

The use of strategic defenses. Oberheiden & McMurrey, LLP has the experience that you need to develop strategic defenses, including locating applicable defenses and statutory loopholes. Many of our cases have been successful because of our use of legal exceptions. For instance, in the context of Stark Law, which involves medical necessity certifications, we’ve been able to use exceptions to either mitigate or entirely resolve a health care fraud case.

Defending your professional reputation. Oberheiden & McMurrey, LLP is about more than just defending you in the courtroom. We’re also here to help protect your professional reputation. Rightfully, many of our clients are concerned about how these allegations will affect their future. The media has the power to tarnish someone’s image or spread rumors. Reports are often biased and don’t always include the whole story. Our attorneys routinely address concerns about slander, and book news spots and other opportunities to correct misinformation about our clients.

Oberheiden & McMurrey, LLP has assisted clients with health care fraud defense all over the country. Call us right away to discuss your case. The call is free and confidential.

Our Track Record

The commitment of Oberheiden & McMurrey, LLP is to avoid criminal charges and to shield our client’s medical business from government intrusion. Our team of former health care prosecutors and experienced defense attorneys have a distinguished history of protecting business owners, executives, lawyers, physicians, hospitals, laboratories, pharmacies, home health care entities, and many other health care organizations against any form of alleged health care fraud. Here are some recent examples of our case outcomes.

  • Representation of a Pharmacy Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation of a Marketing Group Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation of Physicians Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation of Laboratory against an Investigation by the Department of Justice and the U.S. Attorney’s Office for Alleged Medicare Fraud.
    Result: No civil or criminal liability.
  • Representation of Laboratory against an Investigation by the Department of Health and Human Services and the U.S. Attorney’s Office for Alleged Medicare Fraud.
    Result: No civil or criminal liability.
  • Representation of Laboratory against an Investigation by the Department of Justice and the U.S. Attorney’s Office for alleged Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation 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.
  • Representation of a Health Care Marketing Group Against an Investigation by the Office of Inspector General for Alleged Health Care Fraud.
    Result: No civil or criminal liability.
  • Representation of a Physician against an Investigation by the Department of Health and Human Services and the U.S. Attorney’s Office for Alleged Medicare Fraud, Stark Law Violations, and Anti-Kickbacks.
    Result: No civil or criminal liability.
  • Representation of Laboratory against an Investigation by the Department of Justice and the Office of Inspector General for Alleged False Claims Act and Medicare Violations.
    Result: No civil or criminal liability.
  • Representation 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.
  • Representation of Physician Investigated by the Office of Inspector General for Medicaid Fraud and Stark Law Violations.
    Result: No civil or criminal liability.
  • Representation 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.
  • Representation of Physician 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.
  • Representation of Physician Group Investigated by the Department of Health and Human Services and the Office of Inspector General for False Claims Act Violations.
    Result: No civil or criminal liability.
  • Representation of a Physician Investigated by the Department of Defense and the Office of Inspector General for Tricare Fraud.
    Result: No civil or criminal liability.
  • Representation of Pharmacy Investigated by the Department of Justice and the Office of Inspector General for Department of Labor Program Fraud.
    Result: No civil or criminal liability.

Health Care Fraud Defense Attorneys Serving Orange County, California

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, complete our contact form, or email us directly.

800-810-0259
Including Weekends
Oberheiden & McMurrey, LLP
Serving Orange County, CA 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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