Grand Prairie/Arlington Health Care Fraud Defense
What You Need to Know About FBI, DEA, and OIG Health Care Fraud Defense in Grand Prairie & Arlington
Federal agents and prosecutors with the Federal Bureau of Investigation (FBI), the Drug Enforcement Administration (DEA), the U.S. Department of Justice (DOJ), and other law enforcement authorities have significantly expanded their prosecutions of health care providers and businesses in Grand Prairie & Arlington. Almost no day goes by without new arrests, take downs, and grand jury investigations involving alleged Medicare Fraud, commercial insurance fraud, Anti-Kickback violations, Department of Labor and Workers Compensation, opioid-related violations of the Controlled Substances Act and the federal False Claims Act. You need federal Arlington/Grand Prairie health care fraud defense attorneys.
Have the Former Justice Department Lawyers from Oberheiden, P.C. Handle Your Federal Case in Grand Prairie & Arlington
Dallas-based Oberheiden, P.C. has successfully defended clients in complex health investigations and government prosecutions involving Medicare Fraud, Medicaid Fraud, Tricare Fraud, False Claims Act, Qui Tam Defense, Stark Law Violations, and Physician Self-Referral Prohibitions across the country, including in Grand Prairie & Arlington.
- More than 1,000 health care fraud investigations
- More than 1,000 grand jury investigations
- Dismissal of state and federal indictments
- 500 criminal trials
- 70 years of Department of Justice experience
While there are many great law firms in the Dallas Fort Worth area, there is no firm that focuses its practices on health care fraud defense like we do. We are lead counsel throughout Texas defending physicians (e.g. internal medicine and pain management), mental health providers, dentists, psychologists, psychiatrists, health marketers, and a large variety of health related businesses.
Many of our attorneys previously supervised FBI, DEA, and OIG health care investigations at the Department of Justice and understand the process and how to challenge and defend the government’s case. We are:
- Former Department of Justice Attorneys
- Former Health Care Fraud Prosecutors, U.S. Attorney’s Office (Dallas)
- Former Chief Prosecutor, Health Care Fraud, U.S. Attorney’s Office
- Former Assistant United States Attorneys
- Federal Litigation & Trial Lawyers
Our lawyers have successfully represented health care clients against alleged violations of the Controlled Substances Act, Medicare Fraud, Medicaid Fraud, the Anti-Kickback Statute, and fraud of private insurance plans. Call us immediately if you are concerned about your role or if you are under investigation. As we have for others, we will find a way to help you.
Health Care Fraud Investigations in Grand Prairie & Arlington
Our attorneys have noticed a significant increase of investigations involving the Federal Bureau of Investigation, the Office of Inspector General, and the Drug Enforcement Administration throughout Texas.
- Medicare Audits & ZPIC Audits. Home health care, hospice agency, cardiology providers and many other medical clinics with traditionally high numbers of Medicare beneficiaries contact us to handle their CMS audit. Former Department of Justice health lawyers on our team will be able to competently walk you through the process of an audit and, most importantly, make sure that the government is not and will not become interested in asking for more files or referring your case to the U.S. Attorney’s Office in Dallas and Fort Worth.
- Texas False Claims Act & Whistleblower Defense. Many Texas health providers are shocked to find out one day that their former employee or business partner stands behind a federal lawsuit alleging violations of the False Claims Act (FCA). Under the FCA, any submission of a false claim (e.g. use of a wrong code or accidental billing for services not provided) constitutes a federal violation. Intent is not needed. What makes the FCA so appealing to former employees and the reporting to government agencies so rewarding for them is the fact that the FCA contains a whistleblower provision; if a former employees reports fraud and the government agrees with the allegations and forces a recoupment, the whistleblower will receive approximately 20% of that recovery as a reward for reporting fraud. Oberheiden, P.C. routinely assists businesses in the health care (and other industries) to defend against such allegations. Attorney Nick Oberheiden has successfully defended False Claims Act and whistleblower cases at U.S. Attorney’s Offices across the nation, at the Department of Justice, before the Department of Health and Human Services and the Office of Inspector General Washington D.C. headquarters.
- Illegal Physician “Self-Referrals”. Stark Law prohibits a physician to refer patients for certain types of services to entities, in which the physician has a financial interest. The most common application of Stark Law is a situation where a physician enters a joint venture with, for example, a toxicology laboratory or a pharmacy (or MRI, radiology center), and that physician nonetheless sends scripts and samples to that business without making sure that the business relationship is protected under one of the exceptions to Stark Law. Oberheiden, P.C.’s lawyers have a track record of convincing investigating agents from the Office of Inspector General and the Civil Division at the Department of Justice that an alleged violation can, in fact, be construed to fall into a protected arrangement category. Nick Oberheiden, for example, has argued Stark Law cases at the Department of Health and Human Services’ Washington D.C. headquarters and appeared before the Office of Inspector General throughout the United States, including in Washington D.C. Not one of his clients ended up needing to admit any civil or criminal liability.
- Prescription Drug Fraud & Opioid Investigations. Opioid investigations continue to dominate the attention of federal prosecutors. Internal medicine physicians, pain management physicians, family practitioners, and pharmacy owners in Grand Prairie & Arlington and surrounding communities must expect unprecedented enforcement, aggressive interventions, search warrants, and even federal arrests—if their practice involves the routine prescription or dispensing of Schedules I-III under the Controlled Substances Act. The government has instructed the U.S. Attorney’s Office in Grand Prairie & Arlington and all federal agencies to identify, monitor, and arrest all individuals deviating from the new government’s opioid policy standards. Whether you seek proactive compliance advice or whether you were notified about a case against you, Oberheiden, P.C. can help. Several of our lawyers previously supervised DEA and FBI agents and our track record involves a great number of success defense interventions on behalf of pharmacies and physicians. With client representations against opioid charges across the United States, we are at the forefront against this government movement, are familiar with the prosecutor’s strategy, and have the experts and expertise to challenge and defend. Please call us with your case as early as you can to make sure there is enough time to introduce vigorous defense strategies into the case.
- Medicare Fraud, Medicaid Fraud. Medicare Fraud and Medicaid Fraud are among the most charged offenses in Grand Prairie & Arlington health care investigations. Of particular focus are mental health providers, cardiologists, home health care agencies, hospice agencies, DME companies, and other Grand Prairie & Arlington medical providers with high numbers of federally funded program patients. The term Medicare fraud encompasses any violation of the Medicare program rules, in particular billing and kickback violations. Because most Medicare Fraud investigations are criminal in nature and pursued under a federal felony statute (18 U.S.C. 1347), caution is in order. If you or your business receive notice from the U.S. Attorney’s Office in North Texas, the Medicaid Fraud Control Unit, or experience agents from the FBI or OIG trying to interview you or affiliates, you should immediately contact our health fraud defense attorneys. The sooner we can intervene and clarify the situation, the more likely it is that we can stop the investigation before it gets out of control. Call Oberheiden, P.C.. Let’s assess your situation and let’s find a way together to navigate you through this process.
- Illegal Kickbacks, Bribes, and Referral Fees. North Texas is known for an aggressive enforcement of the federal Anti-Kickback Statute (“AKS”). The AKS prohibits the offering, solicitation, payment, or receipt of any form of compensation for a patient referral. A classic application of the statute is when a physician or health care entity enters into a business development/marketing contract that establishes a percentage or commission payment structure. Federal law is very clear that commissions, percentage, and success fee payments to recruit Medicare, Medicaid, or Tricare patients is prohibited and constitutes a violation of the Anti-Kickback Statute, a federal criminal felony statute. Attorney Nick Oberheiden has frequently defended providers and health marketing groups against federal fraud allegations and he is available to explain how he avoided criminal charges in these representations.
The attorneys at Oberheiden, P.C. are available to discuss your situation in a free and confidential consultation, including on weekends. You will benefit from a reliable assessment from those lawyers previously in charge of DOJ, OIG, FBI, CMS, and DEA investigations. We are waiting for your call.
FAQs: What Providers in Grand Prairie & Arlington Need to Know about Health Care Fraud Investigations
Q: What types of health care providers are being targeted in Texas?
With the government’s rigid position on pain medication prescriptions and, more generally, health care fraud, all members of the Grand Prairie & Arlington medical community should diligently assess whether they want to be, could be, or will be next — or whether they take effective measures now to avoid future problems. Compliance is key, but thinking about compliance and meaning to be compliant is just not enough. The main targets of current Grand Prairie & Arlington health fraud investigations are:
- Pharmacies & Compound Pharmacies
- Opioid Prescribing Physicians
- Toxicology & DNA Laboratories
- Home Health & Hospice Agencies
- Hospitals & Surgery Centers
- Drug Rehabilitation Centers
Q: What are some examples of billing and coding errors that can initiative federal health care fraud investigations in Grand Prairie & Arlington?
If your health practice is being accused of submitting false claims, billing for medically unnecessary services, up-coding, double-billing, or billing for services not actually rendered, you should immediately contact Oberheiden, P.C. to avoid civil or criminal prosecution.
Q: What should I do when I receive an OIG Subpoena?
The Office of Inspector General (OIG) and the Department of Health and Human Services (HHS) are the CMS and Medicare enforcement arms within the Department of Justice. If your business receives an OIG subpoena, either by first class mail or by service through agents, you need to understand that the government is investigating your practice for possible civil or criminal health care fraud. Sometimes the subpoena will say the nature of the investigation (e.g. possible Medicare Fraud, Anti-Kickback Statute), but it will be the job of skilled lawyers to vet whether it is a civil or criminal matter and how to successfully defend the business. Oberheiden, P.C.’s lawyers have in former times issued and supervised OIG subpoenas and OIG investigations as Department of Justice federal health fraud prosecutors and, as defense lawyers in private practice, successfully resolved OIG cases virtually across the United States. If you receive an OIG subpoena, don’t experiment. Don’t let inexperienced lawyers simply produce the items that are being asked for. Call us today and let’s make sure your case will not end up in the hands of a criminal prosecutor.
Q: What are some examples of practices that can lead to allegations of prescription drug fraud?
As stated, drug diversion, prescription fraud, and pill mill operations are important columns of current Department of Justice investigations. The FBI, together with the DEA and other agencies, were instructed to identify doctors, patients, and pharmacies with high or unusual Schedules I-III. Problematic with this data-driven approach is that the analysis does not take into important factors into consideration, such as the fact that some physicians are simply busier (and prescribe more!) than some patients may have exhausted conventional and interventional medicine and can only be treated with pain medicine to mitigate their suffering. Further, DEA agents will examine strict compliance with prescription formalities and look for mistakes with respect to the doctor’s signature and authorization and the level of medical examination prior to approving a controlled substance.
Q: What are the penalties for health care fraud?
Health care fraud can result in civil and criminal fines, but also criminal convictions and incarceration. Anyone accused, whether rightfully or wrongfully, of health care fraud must understand that there is no time for mistakes or inexperience when it comes to avoiding charges. Whether your practice receives a grand jury subpoena or federal agents trying to interview you, the sooner you get lawyers on board that understand this area of law, lawyers with experience, reputation, and a presentable track record, the greater the likelihood of resolution. As one of the only firms nationwide, Oberheiden, P.C. dedicates almost its entire practice to defending health fraud allegations and charges. No matter where you and your Texas business are in this process and no matter what the status of the investigation is, there is no hopeless case for us. While most criminal health care fraud violations involve the possibility of felony charges and incarceration of up to 10 years per count, our attorneys have proven again and again how to avoid charges, how to completely defend charges, how to favorably resolve investigations, how to obtain probation, and how to avoid jail or prison time.
Q: What steps can I take to protect my business or practice now that I am aware of the government’s investigation?
If your business or practice is being targeted in a civil or criminal health care fraud investigation, opioid investigation, you should contact Oberheiden, P.C. to discuss various compliance techniques that have proven to mitigate or eliminate criminal intent in past cases.
Why Grand Prairie & Arlington Clients Select Oberheiden, P.C.
Health care fraud charges, no matter how absurd they may be, are not the time to experiment. Too much is on the line and a simple mistake can turn a civil case into a criminal matter and a criminal matter into an indictment. Clients that come to our firm know that they don’t need to worry about that.
Oberheiden, P.C. is local and experienced. Decades of experience from health enforcement positions at the Department of Justice and from establishing a track record in private practice allow us to competently and efficiently advise and guide individual and corporate clients through all and any health care law related audit, investigation, prosecution, or trial.
- We Have Concluded a Large Number of Criminal Fraud Investigations (Medicare Fraud, Tricare Fraud, Anti-Kickback Cases) Resulting in No Client Liability
- We Have Avoided Civil Liability in a Large Number of False Claims Act, Qui Tam, and Whistleblower Cases Representing Physicians, Physician Groups, Toxicology Laboratories, Pharmacies, and Hospitals
- We Are One Team and Everyone on that Team Works Towards One Outcome: No Civil and No Criminal Charges for Our Clients
Are You Being Investigated for Health Care Fraud in Grand Prairie or Arlington? Call Our Trusted Federal Defense Lawyers Today
When it comes to protecting and defending your license, livelihood, and your freedom, you simply cannot experiment. If you are under investigation or have important questions about health care fraud, Medicare fraud, Medicaid fraud, prescription policies, drug investigations, or the Anti-Kickback Statute, advice from the best DUI defense attorney in Grand Prairie & Arlington may not be what you need. Our strategic approach to defending health providers in Grand Prairie & Arlington and Texas includes:
- Making immediate contact with the investigators and prosecutors involved in your case in order to intervene in the investigation and collect the key information we need to formulate a tailored defense strategy.
- Evaluating the legal standards that apply based on the nature of the government’s investigation and the unique aspects of your business or practice.
- Exploring all possible defenses to the government’s allegations, including statutory exceptions and safe harbors, factual arguments, and constitutional protections.
- Doing everything possible to preserve your professional reputation and resolve the investigation without your business or practice being put in jeopardy.
- Trial expertise. Where needed, we are ready to challenge the government in court. With more than 500 criminal cases handled, Oberheiden, P.C. is highly capable of bringing in former Department of Justice Trial Attorneys, former state and federal prosecutors with significant courtroom expertise.
Our Grand Prairie/Arlington health care fraud defense team is available to begin working on your case immediately. To speak with our attorneys in confidence, please call 214-469-9009, visit our DFW office at 5728 LBJ, Suite 250 in Dallas, Texas 75240 or request a free case evaluation online now.