We are a team of
former federal prosecutors


Most of our cases have ended in
No Criminal Charges

Meet the Team
Oberheiden Attorneys

Medicare Fraud Legal Defense Team serving the Orlando Area

Orlando physicians, nurses, entities, and health care businesses can be destroyed by an allegation of Medicare fraud. If you’re being investigated for Medicare fraud, call Oberheiden Law Group, PLLC now. We’re a law firm providing legal advocacy and defense to Orlando, Florida and the surrounding area. Our law firm has skills in Medicare fraud defense, qui tam defense, jury trials, federal investigations, and federal audits. We also assist clients with federal compliance. The Oberheiden Law Group’s defense team is headed by a former Chief Health Care Fraud Coordinator from the U.S. Attorney’s Office.

Medicare Fraud Is a Federal Violation

Medicare fraud is a federal violation. If can cause you to face civil or criminal penalties. Medicare fraud happens when an inaccurate claim is filed with a federal health care program. Claims are filed by medical professionals, entities, and business for reimbursement on medical services and equipment. These claims are filed with Medicare, Medicaid, Tricare, and federal workers’ compensation. An allegation of Medicare fraud means that the federal government believes that you violated at least one of the following laws or statutes:

  • Anti-Kickback Statute
  • False Claims Act
  • Stark Law
  • Social Security Act
  • S. Criminal Code

Because Orlando has such a large number of citizens who rely on a federal health care program, it is one of nine locations in the United States that is constantly watched by the federal government for instances of Medicare fraud.

The area is monitored by the Medicare Fraud Strike Force. This is a mixed team of investigators and prosecutors from 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 Law Group right away. Initial consultations are free.

Medicare Fraud Investigations in Orlando, Florida

Commonly, Medicare fraud investigations in Orlando, Florida and the surrounding area are started because of an inaccurate claim that is filed with a federal health care program. The claim usually has a mistake such as a charge for an unauthorized medical care or equipment, an incorrect charge, or an excessive charge. The main mistakes that trigger a Medicare fraud investigation in Orlando, Florida are:

  • 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.

Nursing professionals, doctors, physician-owned entities, nursing homes, and registered care facilities in Orlando are the most common Medicare fraud investigation targets. However, any person or business that is part of the health care field can face this allegation if they file a claim with a federal health care program.

Civil and Criminal Consequences of Medicare Fraud in Orlando

Medicare fraud allegations in Orlando can result in civil or criminal charges. The civil consequences are:

  • 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 may also have your professional license revoked or you could lose your hospital privileges.

Criminal consequences may cause you to face:

  • 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.

Four Qualities of a Medicare Fraud Defense Attorney in Orlando

A Medicare fraud defense attorney in Orlando helps clients facing Medicare fraud allegations. These allegations often include a criminal charge such as tax fraud. A health care fraud defense attorney is the type of attorney that you need to help you. Look for these four qualities of an Orlando health care fraud defense attorney:

  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.

Next, you should learn more about the skills that the health care fraud attorney has. To do this, you can ask these three 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?

Comprehensive Medicare Fraud Defense

The Oberheiden Law Group makes it a point to review each case in order to plan the most comprehensive Medicare fraud defense. While we do look to settle these allegations with the federal government when possible, we are also skilled trial attorneys. We will provide a zealous defense in federal court for you if necessary. We’ve represented hundreds of clients.

Contact with federal prosecutors. First, our defense team contacts federal prosecutors directly after we are retained. Our goal is to 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?

We use this strategy because we’ve found that it helps reduce the likelihood that our clients will face criminal charges. We are often able to get the answers in just a few hours after we are retained.

Analyzing federal evidence. The government has the burden of producing evidence that meets a legal standard known as “beyond a reasonable doubt.” Taking the time to analyze the evidence provided is a core defense strategy that 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.

Lack of criminal intent. The federal government will attempt to use your inaccurate claim to prove that you acted with criminal intent. However, most Medicare fraud investigations in Orlando, Florida start because someone made a mistake and not because they set out to defraud the government. The most common mistakes 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.

Mistakes of this nature should certainly be addressed and corrected, but they don’t make you a criminal. Our priority is to prove to the federal government that you made a mistake that you’re willing to correct.

Strategic use of defenses. By reviewing the facts involved in each case, we are able to determine the most effective defenses for our clients. Recently, one of our clients faced an accusation 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 Law Group, PLLC

The Oberheiden Law Group provides Medicare fraud defense for Orlando, Florida and the surrounding areas. We provide legal defenses for medical providers, entities, business owners, executives, lawyers, clinics, pharmacists, pharmacies, and other related medical entities under investigation 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

The Oberheiden Law Group represents both individuals and entire health care systems or businesses in Orlando, Florida and the surrounding areas. If you’re under investigation by the DOJ, Department of Defense, the FBI, the DEA, the Office of Inspector General, Medicare Fraud Control Unit, the IRS, Orlando or Florida law enforcement, call Oberheiden Law Group. Initial consultations are free and confidential.

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 Orlando, Florida

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 Law Group, PLLC
Serving Orlando, Florida 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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