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Phoenix Healthcare Fraud Defense Attorneys

If you’re a healthcare provider or if you own a healthcare practice or business that is active in Phoenix, Arizona or the surrounding areas, you’re at risk for being investigated for fraud. If you’re facing an allegation of healthcare fraud, call Oberheiden, P.C. We have extensive legal experience in healthcare fraud defense, Medicare and Tricare audits, protection of assets, compliance programs, jury trials, fraud allegation defense, qui tam defense, OIG and grand jury subpoenas, criminal defense, and internal investigations. Our team of Phoenix Healthcare Fraud Defense Lawyers includes such talent as a former Chief Healthcare Fraud Coordinator for the U.S. Attorney’s Office, several former healthcare fraud prosecutors, and elite former lead prosecutors of the Medicare Fraud Strike Force. We serve clients in Phoenix as well as the rest of the state of Arizona.

You have legal options. Call the Oberheiden, P.C. and ask to speak with a Phoenix healthcare fraud defense lawyer. The call is free and confidential.

Phoenix, Arizona Is Constantly Monitored by the Federal Government

Phoenix, Arizona is one of nine regions in the United States that is constantly monitored by the Medicare Fraud Strike Force, an agency of the federal government. The Medicare Fraud Strike Force is a team of prosecutors and investigators from multiple federal agencies. Often, members of this team work with the Department of Justice, Department of Health and Human Services, Office of Inspector General, and the Federal Bureau of Investigation. However, other federal agencies often have representatives who are part of this team.

Phoenix and the surrounding areas are constantly monitored because of the number of citizens in the area who rely on a federal healthcare program. The large amount of recipients increase the number of claims filed with the federal government by healthcare providers and businesses for reimbursement. This increase in claims causes the federal government to watch the area closer because they believe that there will be an increase in the number of fraudulent claims filed. During 2016, the Department of Justice released a statement that revealed that they had investigated around 300 cases of healthcare fraud. Individual providers were the center of 80 of those investigations. The rest of the cases centered on a healthcare entity or business. The agency stated that they recovered more than $900 million in fraudulently paid out claims.

Phoenix Healthcare Fraud Defense Attorneys

What Is Healthcare Fraud?

Federal healthcare fraud is the attempt to receive reimbursement for medical equipment or services from a federal healthcare program such as Medicaid, Medicare, Tricare, or federal workers’ compensation. It is the filing of one or more false claims and includes a violation of at least one of the following laws:

  • The Anti-Kickback Statute. Federal healthcare law outright prohibits kickbacks in exchange for referrals. Any individual (including doctors, marketing representatives, and business owners) is subject to prosecution for violating the Anti-Kickback statute for offering or providing payment or other valuables in exchange for patient referrals.
  • Stark Law. Stark Law, also known as the Self-Referral Law, prohibits doctors from referring patients to specific 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. Note, however, that there are statutory exceptions to this law.
  • False Claims Act. If you submit a claim to Medicare or any other federal healthcare program, you are required by law to abide by the False Claims Act. If the claim submitted to the federal government is discovered to be inaccurate, the federal government will likely launch an investigation into your billing practices under the criminal provisions of the False Claims Act.
  • Prescription Fraud. The federal government pays special attention to practices that have an unusually high number of narcotic prescriptions. If you are suspected of running a “pill mill,” you are at a high risk of being investigated for insurance fraud and for violating DEA dispensing rules.
  • Billing Fraud. The federal government is persistent about investigating the up-coding of claims. Up-coding means that the next higher code is used for a service when the billing is done. The federal government is also prone to investigating phantom billing (billing for services that were not provided), billing for patients who do not exist (referred to as ghost patients), and billing for equipment or services that are deemed not medically necessary.
  • Certification Errors. The home care and hospice industry is frequently a practice that the federal government chooses to maintain a close eye on. The most common accusations include fraudulent certification.

Our aggressive Phoenix healthcare fraud defense attorney has a successful track record in helping our clients avoid criminal charges. If you’re being investigated by the federal government for healthcare fraud in Phoenix, Arizona or the surrounding areas, call Oberheiden, P.C. now. Your initial call is free and confidential.

This is Why You Are in Good Hands

Fantastic lawyer - so dependable. We've worked with Nick for over 4 years and he is the best at what he does.
Denver F.
Denver F.
Attorney Lynette Byrd was so kind and helpful with my case. I would highly recommend her legal services.
Marcel L.
Marcel L.
Nick Oberheiden is an excellent attorney. He is hardworking, smart and intelligent.He takes a proactive approah on cases. He has dedicated team of former federal lawyers and investigators that are available to get results on cases. I recommend him highly.
Chris Q
Chris Q
Dr. Nick is acutely aware of the intricacies and subtleties of the relevant legal issues, and he is also gifted at explaining the issues in simple, easy-to-understand language. He has an outstanding rapport with the prosecutors - a critical talent for an Attorney trying to prevent prosecution or minimize criminal... exposure of his clients. He is a master of multi-tasking, so you can be rest assured that he is always up-to-date with your representation. I believe that his European background allows him to view the totality of your case from an extra “dimension,” which allows him to craft exceedingly effective strategies and proffers. His caring and empathetic attitude goes a long way in helping you to keep up your spirits through the process. I could not have hoped for a better outcome. I unreservedly recommend him - he is a true Master of the trade!read more
M R
M R
When your freedom, family, or fortune are at stake - it's best you meet Nick Oberheiden. Respected by the judges, his peers, colleagues, and clients - Nick is known to get results. Putting his keen intellect aside, one cannot help but appreciate his genuine desire to protect his clients and prevail. His cell number... is in my phone for good reason. And if I ever need him, I know he'll be there - ready to win.read more
Michael D. W.
Michael D. W.
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Civil and Criminal Penalties of Healthcare Fraud

Healthcare fraud in Phoenix can result in civil or criminal charges. Both courts have their own set of penalties that they may levy against you if you are found guilty. In civil court, you could be ordered to repay the claims, you could be denied reimbursement on future claims, and you could be excluded from filing claims with federal healthcare programs in the future. You may also be called in front of the state disciplinary board. You could lose your license and your hospital privileges.

Criminal penalties include more than a criminal record. You could be ordered to pay hefty fines that cost you hundreds of thousands of dollars, even if you’re only found guilty of a misdemeanor. You could receive a federal prison sentence:

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

Phoenix clients often ask us about the worst-case scenario for fraud allegations. The worst-case scenario involves criminal charges or getting a prison sentence. Whether you will face either of those depends on factors such as the severity of any injury suffered by the patient, whether the prosecutor is interested in pursuing criminal charges, and the reason why the investigation was started.

Oberheiden, P.C. provides legal defense strategies for Phoenix area providers, entities, and businesses in fraud defense cases. Our Phoenix healthcare fraud defense lawyers use their experience as former healthcare prosecutors and as defense lawyers to develop strategic legal defenses for clients. If you’re being investigated for, call us right away. The call is free and confidential.

How to Tell If the Investigation Against You Is Criminal

Healthcare fraud investigations in Phoenix, Arizona and the surrounding areas can be civil or criminal. They can even start off as civil and become criminal. This is why it is important to immediately contact Oberheiden, P.C. right away if you are being investigated.

Being contacted by a prosecutor isn’t a good indicator that the investigation against you is criminal. Federal agencies that have prosecutors have civil and criminal branches. That’s why you cannot rely on this. Signs of a criminal investigation into healthcare fraud include search warrants, seizure warrants, arrest warrants, target letters, contact from a federal criminal prosecutor, involvement from the IRS, or the receipt of a grand jury subpoena.

Developing Healthcare Fraud Defenses in Phoenix

Oberheiden, P.C. is a healthcare fraud defense firm providing legal advocacy to individual providers, entire healthcare systems, and healthcare businesses in Phoenix, Arizona and the surrounding areas. We’ve handled hundreds of cases during our time as a firm. Several of our Phoenix healthcare fraud defense attorneys have previous experience as healthcare auditors and fraud prosecutors with the Department of Justice and with the Medicare Fraud Strike Force. We use our combined experience to benefit our clients. This combined experience has led us to develop strategic healthcare fraud defenses that we use with our Phoenix clients.

Immediate contact with federal investigators. Our main priority is to help you avoid criminal charges. From our experience, we’ve learned that one of the most efficient ways that we can do this is to immediately contact federal investigators on behalf of clients. This reduces the amount of time that the federal government has to investigate you without an interruption. Immediately after we are retained, we contact federal investigators to get answers to the most important questions:

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

We are often able to get the answers to those questions within just hours after we are retained.

Evaluating the legal standards. The federal government must meet a high legal standard to show that you committed a crime and that you also acted with criminal intent. We evaluate the evidence and the legal standards in each case. Often, the federal government will point to billing inaccuracies to say that you committed a crime. Yet, we’ve found that these inaccuracies occur not because of fraud, but because of a mistake. While these mistakes should certainly be addressed and corrected, they shouldn’t cause you to face criminal penalties. Mistakes often occur when health practices or businesses grow quickly or because someone makes a mistake. The most common mistakes that cause these allegations include the use of unqualified workers, delegation errors, outsourcing errors, lack of oversight, insufficient supervision, and the frequently changing laws and rules.

Developing strategic defenses for each case. Oberheiden, P.C. reviews each case and develops strategic legal defenses for our Phoenix clients. This may also include reviewing and utilizing the applicable statutory loopholes and exceptions. For example, the Stark Law involves medical necessity certifications. Where applicable, we will point to these exceptions to either mitigate or entirely resolve a healthcare fraud case.

Preserving your professional reputation. Fraud allegations can hurt your professional reputation. It’s one of the main concerns of our clients. Our lawyers will look for the right opportunities to correct any misinformation given to the public by the media. We also address slanderous comments.

If you’re under investigation for healthcare fraud in Phoenix, Arizona or the surrounding area, call our Phoenix healthcare fraud defense lawyers at Oberheiden, P.C. now. The call is free and confidential.

Are you accused of a federal crime?

Don’t delay. Learn about your rights.

Call Dr. Nick Oberheiden now!

888-680-1745

Our Track Record

The commitment of Oberheiden, P.C. is to avoid criminal charges and to shield our client’s medical business from government intrusion. Our team of former healthcare prosecutors and experienced defense attorneys have a distinguished history of protecting business owners, executives, lawyers, physicians, hospitals, laboratories, pharmacies, home care entities, and many other healthcare organizations against any form of alleged healthcare 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 Healthcare 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 Healthcare Marketing Group Against an Investigation by the Office of Inspector General for Alleged Healthcare 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 Healthcare 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.

A Phoenix Healthcare Fraud Defense Attorney Answers Your Questions

Why Are Phoenix Doctors Targeted?

Arizona doctors are targeted more than ever after the Department of Justice announced to fight the national opioid crisis by prosecuting and arresting prescribing physicians. Family doctors, internal medicine specialists, pain doctors, psychiatrists, rheumatologists and veterinarians must recognize that healthcare fraud and violations of the Controlled Substances Act (opioid prescriptions) are top federal law enforcement priorities. Any Phoenix physician who has regularly prescribed narcotics or Xanax or similar drugs should immediately consult with an experienced Phoenix federal criminal defense attorney for a comprehensive risk assessment. Hundreds of doctors have been recently arrested–– don’t be the next one.

What Are Common Healthcare Fraud Charges in Phoenix, Arizona?

The most common healthcare fraud offenses that agents from the Office of Inspector General, the Department of Health and Human Services, and the FBI investigates in Arizona are Medicare fraud, Medicaid fraud, violations of the Controlled Substances Act, opioid and drug diversion offenses, Stark Law issues, and violations of the Anti-Kickback Statute. If your business is under investigation for any of these offenses or if you need reliable advice, you should call Nick to find out what to do and what defenses may exist to, for example, resolve home health certification (Form 485) or kickback allegations.

What Penalties Could Physicians Face in Opioid Investigations?

 

Prescription fraud is classified as “drug dealing” and subject to the Controlled Substances Act at 21 U.S.C. 841, 846. If inadequately represented, physicians found guilty of prescription abuse may lose their medical license, DEA privileges, and may face up to 10 years in federal prison. If you are a physician in Phoenix, Arizona or neighboring towns and have dispensed controlled substances, you should not wait but reach out to DEA federal criminal defense attorney Nick Oberheiden.


Healthcare Fraud Defense Lawyers Serving Phoenix, Arizona

Attorney Nick Oberheiden, an attorney handling healthcare fraud cases in Phoenix.Nick Oberheiden is a healthcare fraud defense attorney. Dr. Oberheiden has successfully represented healthcare 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 healthcare 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.

 

Our Phoenix healthcare fraud defense attorneys are available every day of the year. You can call us directly or complete our contact form.

888-680-1745
Including Weekends Oberheiden, P.C.
Serving Phoenix, Arizona 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, P.C. is a Texas PC with headquarters in Dallas. Mr. Oberheiden limits his practice to federal law.

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Why Clients Trust Oberheiden P.C.

  • 1,000+ Cases Handled
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  • Experienced Trial Attorneys
  • Former Department of Justice Trial Attorneys
  • Former Federal Prosecutors, U.S. Attorney’s Office
  • Former Agents from FBI, OIG, DEA
  • Cases Handled in 48 States
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