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Atlanta Health Care Fraud Defense Lawyers

Our federal defense lawyers represent Atlanta health care providers and businesses in ZPIC, RAC, and MAC audits and all CMS, DEA, DOJ, and OIG matters.

Health care providers in Atlanta are increasingly finding themselves facing invasive, and potentially dangerous, audits and investigations. The same is true for other businesses in the health care industry, including durable medical equipment (DME) manufacturers, testing laboratories, and traditional and compounding pharmacies. If you have received an audit letter, subpoena, or civil investigative demand (CID), or if federal agents have shown up at your door to “ask some questions,” you need to speak with an experienced defense attorney as soon as possible.

Facing a federal health care audit or investigation is a serious matter – far more serious than most practitioners and business owners appreciate, at least initially. If auditors accuse you of overbilling Medicare, Medicaid, Tricare, the VA, or the DOL, or if federal prosecutors decide to pursue civil or criminal charges, you could be at risk for recoupments, treble damages, fines, program exclusion, and even federal imprisonment.

A Team of Proven Health Care Fraud Defense Lawyers Representing Clients in Atlanta, GA

 

Oberheiden, P.C. is a team of federal health care fraud defense lawyers who represent providers, practitioners, businesses, and business owners in high-stakes federal matters. Our team also includes several non-lawyer consultants and experts who specialize in various areas of federal health care law compliance. When we are engaged as defense counsel, we intervene promptly in our client’s audit or investigation, take any emergency action necessary, and work closely with our client to execute a tailored defense strategy focused on obtaining a favorable result as quickly as possible.

If you are in the federal government’s crosshairs, or if your business or practice has been singled out for an audit, you don’t have time to waste. In order to avoid severe consequences, you need to act right away. With our attorneys’ extensive experience on both sides of federal health care fraud audits and investigations, we can take immediate action to protect your business or practice. We can turn the tables in your favor, and we can use the law to your advantage.

 

Here’s Why Atlanta Health Care Providers and Business Owners Trust Oberheiden, P.C.

 

1. We Focus Our Practice on Federal Health Care Fraud Defense.

Unlike most other firms, we focus our practice on federal health care fraud defense. Defending against federal charges is very different from defending against state charges, and federal health care law is a beast of its own. Several of our lawyers previously served as health care fraud prosecutors with the U.S. Attorney’s Office and the U.S. Department of Justice (DOJ), and our consultants include a former Special Agent with the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) and a former Special Agent-in-Charge with the Drug Enforcement Administration (DEA). 

2. We have Extensive Relevant Experience.

Together, our attorneys have centuries of experience in federal health care fraud matters. This includes MAC, RAC, and ZPIC audits; DEA, DOJ, OIG, and other federal agency investigations; and, civil and criminal trials and appeals. We also represent health care providers nationwide with regard to health care compliance, and to date not a single client of ours has faced liability under the federal False Claims Act. When you choose Oberheiden, P.C., you are choosing a team of attorneys and consultants who have successfully worked with thousands of health care providers across the country. 

3. We are a Team of Senior Attorneys and Experts.

Also unlike most other firms, our defense team is comprised entirely of senior attorneys and experts. We do not employ any junior associates or paralegals, so you can feel confident knowing that all aspects of your case will be handled by a senior member of our team. Our attorneys and consultants routinely work together to establish defenses, test theories, and strategize about our clients’ cases, so you will truly have decades of experience on your side. 

4. We have a Proven Track Record of Success.

From avoiding recoupments and pre-payment review in ZPIC audits to defending clients against multiple criminal charges in federal district court, we have a proven track record of success in all aspects of federal health care fraud defense representation. While our attorneys have represented clients in more than 500 criminal trials, we have resolved the vast majority of our clients’ health care fraud audits and investigations without charges being filed. 

5. We Prioritize Our Clients 24/7.

Our clients are our priority, and not just from 9:00am to 5:00pm. Our attorneys and consultants are available to our clients by phone, text, and email 24/7, and we work round-the-clock when necessary to ensure that our clients’ interests are secure. As licensed practitioners and business owners ourselves, we understand what is at stake in your case; and, as experienced health care fraud defense lawyers, we know what it means for your business or practice to be put in jeopardy. We work tirelessly to protect our clients, whether that means relentlessly challenging auditors’ faulty methodologies or providing vigorous representation at trial.

Proven Health Care Fraud Defense Lawyers for Audits, Investigations, and Trials

 

Our defense lawyers represent clients in Atlanta who are being audited and investigated for all types of alleged health care law violations. We also represent clients who have been served with federal grand jury subpoenas and who are actively facing civil or criminal charges in federal district court. Contact us today for a free consultation to discuss your case involving:

Federal Health Care Program Audit (MAC, RAC, or ZPIC Audit)

Medicare Administrative Contractors (MACs), Recovery Audit Contractors (RACs), and Zone Program Integrity Contractors (ZPICs) are private entities that audit health care providers on behalf of the Centers for Medicare and Medicaid Services (CMS). Although an audit is not an investigation, and audit can lead to an investigation, and MACs, RACs, and ZPICs have broad authority to impose substantial penalties on providers they deem to be non-compliant. There are many ways to defend against unfavorable determinations during Medicare and Medicaid audits, and our attorneys can intervene in the process to ensure that you are not improperly accused of overbilling the federal government. 

Medicare, Medicaid, Tricare, VA, or DOL Billing Fraud Investigation

We represent physicians, pharmacists, clinics, laboratories, hospitals, durable medical equipment (DME) companies, and other clients in federal investigations involving all types of billing fraud allegations. We have successfully defended clients in CMS, DOJ, OIG, U.S. Department of Defense (DOD), U.S. Department of Labor (DOL), and other federal agency investigations involving allegations of: 

  • Billing for medically-unnecessary services
  • Upcoding and unbundling
  • Overbilling
  • Double-billing
  • Phantom billing
  • Falsifying records
  • Intentional and unintentional coding errors
  • Other billing and coding violations

DEA Audit or Investigation

DEA investigations can lead to loss of registration and other severe penalties under the Controlled Substances Act (CSA) and other statutes. We represent registered and unregistered health care providers in all DEA matters, including registration applications and denials, routine inspections, CSA compliance audits, and prescription drug fraud and opioid diversion investigations. 

Anti-Kickback Statute or Stark Law Investigation 

The Anti-Kickback Statute and Stark Law are among the most-important and least-understood federal laws that apply to program-participating health care providers and businesses. Under these statutes, virtually any payment of compensation in relation to the referral of a program beneficiary (i.e. Medicare or Medicaid patient) can trigger civil or criminal prosecution – unless a specific statutory exception or “safe harbor” applies. Our attorneys have extensive experience in Anti-Kickback Statute and Stark Law investigations, and we can help you defend your financial relationships with other practitioners and businesses.

Federal Grand Jury Subpoena

If you have received a federal grand jury subpoena, you need to seek legal representation immediately. While this does not necessarily mean that you are the target of a criminal investigation (at this point, you could merely be a witness in an investigation targeting another provider or business), you need to be extremely careful to avoid saying something that could get you into trouble. Our attorneys can advise you regarding what you need to do (and what mistakes you need to avoid), correspond with the U.S. Attorney’s Office on your behalf, and represent you in the courthouse on the date you are scheduled to appear before the grand jury. 

Civil or Criminal Health Care Fraud Charges

If you have already been indicted or had formal civil charges filed against you, our attorneys can fight to keep you out of prison and protect your right to practice. We have a proven track record of success in civil and criminal health care fraud cases across the country, and we have favorably resolved many of our clients’ cases prior to trial. 

 

Contact Oberheiden, P.C. about Your Health Care Fraud Matter in Atlanta, GA

Regardless of the current status of your audit, investigation, or case, the key to protecting yourself is to engage experienced defense counsel as soon as possible. To speak with one of our attorneys about your health care fraud matter in Atlanta, call 214-469-9009 or contact us online now. 

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