We are a team of
former federal prosecutors


Meet the Team
Oberheiden Attorneys

Home Health Care and Hospice Fraud Defense Legal Team Serving the San Diego Area

California Office
550 W C St #1150
San Diego, CA 92101

(Meeting location by appointment only)

The Oberheiden & McMurrey, LLP is a health care law firm with meaningful experience in regulatory compliance, corporate structuring, litigation, civil government investigations, criminal government investigations, and in criminal defense. Members of our Health Care Fraud Defense Team include a former Chief Health Care Fraud Coordinator with the U.S. Attorney’s Office, former senior Department of Justice trial attorneys, former lead prosecutors from the elite Medicare Fraud Strike Force, and talented attorneys with years of experience and with education from the nation’s best law schools, including Yale, Harvard, and UCLA. Our attorneys routinely serve clients in San Diego, California and the surrounding areas.

If you’re being investigated for home health care or hospice fraud in San Diego, California or the surrounding area, call Oberheiden & McMurrey, LLP right away to speak with a member of our Health Care Fraud Defense Team. The call is free and confidential.

San Diego Is Closely Watched by the Federal Government

San Diego, California is closely watched by the federal government’s Medicare Fraud Strike Force. It is one of nine locations in the United States that is constantly monitored. The Medicare Fraud Strike Force is a team of federal investigators and prosecutors from multiple agencies, including the Department of Justice, Department of Health and Human Services, the Office of Inspector General, the FBI, the IRS, 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.

Home Health Care and Hospice Fraud in San Diego, California

Oberheiden & McMurrey, LLP represents hospice facilities, home health care agencies, business owners, and health care providers in San Diego, California and the surrounding areas. We are experienced in matters related to 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 side by side 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 understand the 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

Home health care and hospice fraud investigations that occur in San Diego, California and the surrounding area are acutely important to your professional life. 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, a criminal indictment, and 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

Keep in mind that if you’re investigated for and found guilty of incorrectly prescribing medications, improper supervision of another person, or of false certification, you may be excluded from all federal health care programs, prohibited from being reimbursed, and you may lose your professional license.

Look for These Three Characteristics in the Right San Diego Lawyer

When you’re facing a home health care or hospice fraud investigation in San Diego, California, you must choose the right lawyer to help you. This allegation can ruin your life. Choosing the right attorney can give you the best possible chance against these disastrous allegations. Look for the following three characteristics while you’re considering your options:

  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 your 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.

Compelling Home health care and Hospice Fraud Defenses

As prosecutors and defense attorneys, the lawyers of Oberheiden & McMurrey, LLP have been involved in a significant number of home health care and hospice fraud investigations. Our lawyers have previous experience in health care auditing – and as former federal health care fraud investigators and prosecutors – has led us to develop compelling defenses for home health care and hospice fraud clients.

Contacting federal prosecutors. When you’re under investigation, you should immediately retain Oberheiden & McMurrey, LLP. If the federal government has enough time to build its case against you, you could face criminal charges. Once we are retained, we contact federal prosecutors right away on your behalf. We get answers to the important questions and we can usually do it in just a few hours. The answers we get from the federal government to the following questions help us develop the best defenses for your case:

  • What started the investigation?
  • Is the investigation a civil or criminal matter?
  • Are you facing prison time?
  • What can be done to resolve the matter?

Showing our clients made a mistake. Most home health care and hospice fraud investigations that start in San Diego, California do so because of a mistake that’s been made. Very few of these investigations are caused by someone with the actual intention of defrauding the government. The errors that we see the most include the use of unqualified or overwhelmed employees, negligence, supervision errors, and being unfamiliar with the constantly changing rules. Thankfully, our court system acknowledges that sometimes good people make mistakes. While these mistakes should be corrected, they should not lead to criminal punishments. This is why the federal government has an incredibly high burden of proof to meet to show that you committed a crime and acted with criminal intent. We analyze the evidence presented by the federal government to determine if it meets the high standard. Our goal is to prove that our clients made a mistake and did not act with criminal intent.

The use of appropriate certifications. Many of these investigations include an allegation that the owner or the health care provider incorrectly certified or re-certified 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 they often will not bring them up in their complaint or in their arguments. Oberheiden & McMurrey, LLP uses industry authorities and our trial experience to provide explanation to a judge or jury about the legal exceptions and delegation rules.

We work to protect your reputation. Our clients often come to us with great concern about their professional reputation. They worry about how the public may view them in light of these allegations. We understand. The media is known for giving biased reports. If this happens to our clients, we get involved. We address slander and look for opportunities to correct misinformation and to protect your professional reputation.

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), 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 San Diego, 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 for our clients. Call us directly, complete our contact form, or email us.

714-294-2000
Including Weekends
Oberheiden & McMurrey, LLP
Serving San Diego, 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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