We are a team of
former federal prosecutors


Most of our cases have ended in
No Criminal Charges

Meet the Team
Oberheiden Attorneys

Providing Experienced Health Care Fraud Legal Defense in St. Louis

The Oberheiden Law Group 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 and Yale Law School. Our attorneys serve clients in St. Louis as well as throughout Missouri State.

If you’re in St. Louis and being investigated for health care fraud, call the Oberheiden Law Group, PLLC right away. We provide health care fraud defense strategies, and 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 leading law school training from the country’s top law schools, including Yale and Harvard.

If you’re being investigated for health care fraud in St. Louis or the surrounding areas, call the Oberheiden Law Group and ask to speak with a member of our Health Care Fraud Defense Team. Calls are confidential and free of charge.

St. Louis Is Watched Closely for Health Care Fraud

St. Louis is one of nine locations within the United States that is closely watched 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.

St. Louis and the surrounding areas are closely watched because of the number of citizens who rely on a federal health care program. The number of beneficiaries means that there is an increase in claims filed for reimbursement by the federal government. This causes the federal government to pay closer attention to the area to look for 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

The definition of federal health care fraud is defined as the attempt to receive 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.

The Oberheiden Law Group invites you to review our track record of success that shows our history of helping clients around the nation avoid federal criminal charges. If you or your health care practice or business is being investigated for health care fraud in St. Louis or the surrounding area, call us right away. The call is free and confidential.

Health Care Fraud Has Civil and Criminal Penalties

Health care fraud allegations may result in civil or criminal charges and penalties. Civil penalties may include civil repayment and 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 inquiries that we receive is about the worst-case scenario for St. Louis health care fraud allegations. Whether or not you may face criminal prosecution or a prison sentence will depend on several factors, such as 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. The Oberheiden Law Group is ready to help you with your health care fraud defense case. Call us today. Initial consultations are free and confidential.

Signs That You’re Facing Criminal Charges

Health care fraud investigations can be civil or criminal. They can start out civil and quickly turn criminal. The Oberheiden Law Group provides early intervention and custom defenses to help our clients avoid criminal charges. Call us immediately if you’re being investigated in St. Louis or the surrounding areas.

Many clients are unsure whether they are facing civil or criminal charges. This is understandable because 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 the Oberheiden Law Group 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 need help determining whether you’re facing civil or criminal charges, contact the Oberheiden Law Group now. 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 St. Louis 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, St. Louis or state law enforcement, or the Internal Revenue Service.

Health Care Fraud Defenses for St. Louis Clients

The Oberheiden Law Group provides legal advocacy to health care fraud defense clients in and around St. Louis. 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 government intervention. Our main objective for each client facing health care fraud charges is to help them 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 uninterrupted time to build its 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?

Challenging the government’s allegations. The U.S. Constitution places a high standard against the 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 inaccuracies found in billing records to attempt to prove criminal intent. However, we know from experience that mistakes happen – those mistakes do not and should not equate to fraudulent activity. The Oberheiden Law Group 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 an 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.

Protecting your reputation. The Oberheiden Law Group is devoted to you inside and outside of the courtroom. 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.

The Oberheiden Law Group has provided legal advocacy for clients all over the nation. Call us right away if you’re being investigated for health care fraud defense. The call is free and confidential.

Our Track Record

The commitment of the Oberheiden Law Group 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 St. Louis
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 by emailing us directly.

800-810-0259
Including Weekends
Oberheiden Law Group, PLLC
Serving St. Louis, Missouri 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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