Ohio Hospice Fraud Attorneys

Oberheiden, P.C. is a healthcare law firm with expertise in regulatory compliance, litigation, civil and criminal government inspections, corporate structures, and criminal defense. Our healthcare Fraud Defense Team consists of talented Ohio hospice fraud attorneys with years of experience and education from the nation’s best law schools, including Yale and Harvard. Our attorneys serve clients in Ohio and the surrounding area.

If you are under investigation for home healthcare or hospice fraud in Ohio, call Oberheiden, P.C. to speak with a member of our Healthcare Fraud Defense Team. Initial calls are free and confidential.

Ohio Is Closely Followed by Federal Authorities

Ohio is constantly monitored by the federal government’s Medicare Fraud Strike Force, one of nine areas in the nation. This team consists of investigators and prosecutors from multiple agencies. Its job is to monitor, investigate, and prosecute healthcare fraud, including home healthcare and hospice fraud.

Home Healthcare and Hospice Fraud in Ohio

Oberheiden, P.C. provides legal counsel for Ohio area hospice providers, home healthcare agencies, business owners, and health care providers. We have experience in:
Corporate compliance, internal investigations, Medicare audits, recoupment questions and requests, and 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 and prescription fraud

• Certifications involving medical necessity
• Billing inaccuracies
• Overbilling
• Overuse of services
• Overuse of equipment
• RAC audits
• ZPIC audits
• IRS investigations

Oberheiden, P.C. works with the National Association for Home Care and Hospice (NAHC), the National Hospice and Palliative Care Organization (NHPCO), the National Center for Assisted Living (NCAL), and other related programs. Our Ohio hospice fraud attorneys understand the extensive certification and re-certification requirements, verifying clinical status, respite care requirements, homebound assessments, medical necessity certification, and plan of care regulations.

Civil and Criminal Penalties of Home Healthcare and Hospice Fraud in Ohio

Health care fraud conviction is serious. You could be charged in civil or criminal court. Civil penalties of health care fraud cases can include:

• Civil fines of up to $11,000 per false claim,
• Recoupment of claims,
• Future exclusion from federal healthcare 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.

If you’re found guilty of incorrectly prescribing medications, improper supervision, or completing false medical necessity certifications, you could be excluded from all federal healthcare programs, payment of claims rejected, and loss of your professional license.

The Three Traits of the Best Ohio Hospice Fraud Attorneys

If you’re being looked at for alleged health care fraud in Ohio, you need a defense lawyer with the knowledge and talent to help. Allegations of fraud can ruin your life and career. Choosing the right defense attorney can increase your chances of defeating such allegations. As you consider your options, look for the following traits:

• Demonstrated knowledge of rules and regulations related to home health and hospice care. You don’t have time to explain billing, coding, and certification rules to a lawyer who doesn’t have this knowledge.
• A successful record of resolving healthcare audits and healthcare fraud cases. An attorney should have a proven history of successfully managing complex healthcare fraud cases involving various federal agencies, such as the OIG, DOJ, HHS, and IRS.
• Experienced litigators and trial lawyers. Federal prosecutors will know your defense lawyer and if he/she has a good reputation for success. Ask each lawyer you interview how many healthcare fraud trials they’ve managed. Of those, how many resulted in neither civil, nor criminal judgments against their clients?

Established Home Healthcare and Hospice Fraud Defenses

The Ohio hospice fraud lawyers of Oberheiden, P.C. have experience with hundreds of healthcare fraud cases. Our lawyers have experience in healthcare auditing. In addition, some of our attorneys were former federal healthcare fraud agents and prosecutors. We use a set of successful defenses for home healthcare and hospice fraud clients in the Ohio area.

Immediate legal advocacy. Once the process is under way, don’t wait to get legal counsel. The longer the federal government investigates, the more likely you will face criminal charges. Once retained, we promptly begin our work for you. We contact federal prosecutors right away to answer several important questions. We can usually get answers to these questions within 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 cases in Ohio begin because of a mistake made by an individual or because of poor business decisions. Very few come about because someone planned to commit fraud. The most common errors we’ve seen include using unqualified or overwhelmed staff, negligence, supervision errors, and unfamiliarity with constantly changing rules. Our court system acknowledges that sometimes good people make mistakes. While these mistakes should be corrected, they should not lead to criminal penalties. The federal government must prove that you committed a crime. In addition, they must prove that you did so intending to commit the crime. The high burden of “proof beyond a reasonable doubt” is not easily reached in such instances. Our Ohio hospice lawyers study the federal government’s evidence to determine if it meets that standard. We aim to prove that our clients made a mistake but did not act with criminal intent.

Showing that certifications were appropriate. Most Ohio inquiries for home health or hospice care include an allegation that the owner or healthcare provider did not correctly certify or re-certify medical necessity. Oberheiden, P.C. uses legal exceptions and delegations to these rules to prove that your actions were proper. The federal government is aware of these exceptions, but does not always note them in its complaint or arguments. Oberheiden, P.C. uses industry experts and our trial experience to provide an easy legal explanation to a judge or jury about rules governing medical necessity.

We work to protect your professional reputation. A common concern of our clients is their professional standing. You have worked hard to establish your reputation. Something as small as an allegation could be detrimental. A damaged reputation can destroy a business or career. Oberheiden, P.C. is committed to defending you both inside and outside the courtroom. If the media reports a biased story or slanders our client, we address the issue and look for chances to correct the errors. Our goal is to protect the professional reputation that you have worked so hard to build.

We are available every day of the year. You can call or email us directly, or complete our contact form.