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How To Avoid Criminal Penalties For Medicare Fraud In Houston

Categories: Criminal Law & Process

Criminal Charges

Criminal Defense Attorneys Fighting Medicare Fraud Charges for Professionals in the Houston Area

Oberheiden & McMurrey, LLP
Former Prosecutors & Defense CounselEffective Defense Strategies for:
Physicians, Business Owners, Marketers, Health Care Providers, Home Health & Hospice Agencies, DME Companies, Laboratories, Pharmacies, and Hospitals.Call Attorney Dr. Nick Oberheiden Directly: (214) 469-9009

Recognize the Authorities

The Medicare and Medicaid programs are regulated by federal laws and regulations.  Enforcement of the federal Medicare laws is handled by two executive departments – the Department of Justice (DOJ) and the Department of Health and Health and Human Services (HHS).  Generally, the DOJ is in charge of handling criminal matters, while HHS handles civil matters.

Recently, the DOJ and HHS have begun collaborating their enforcement efforts to prevent, detect, investigate and prosecute Medicare fraud through the creation of joint agency task forces.  In 2009, DOJ and HHS jointly established the Health Care Fraud Prevention and Enforcement Action Team (HEAT), a national program dedicated to enforcing federal health care regulations.  HEAT supervises localized joint agency task forces called Medicare Fraud Strike Forces.  Medical Fraud Strike Forces combine federal law enforcement efforts with state and local law enforcement efforts for the purpose of weeding out health care fraud in specific geographical regions.  To date, nine United States cities have received Medicare Fraud Strike Forces, including Houston.  The cities who received the Task Forces were designated as Medicare Fraud “hot spots” by federal authorities.

Understand the Potential Liability

Due to Houston’s designation as a Medicare fraud hot spot and its receipt of a Medicare Fraud Task Force, Medicare fraud investigations in Houston are steeply rising.  Houston medical providers, business owners, and other participants in the Houston medical industry are at an increased risk of being investigate for Medicare fraud and potentially receiving criminal charges for Medicare fraud.

Anyone involved in the Houston medical industry needs to be aware of the potential risks they face for criminal Medicare fraud charges.  Once a person or business comes under investigation for Medicare fraud, government prosecutors have enormous discretion over whether they bring charges and what types of charges they may impose.  The penalties for Medicare fraud range from administrative sanctions, such as exclusion from participating in federal health care programs, to civil fines, to criminal penalties such as prison time or probation.  The more medical industry participants know about the potential penalties they face, the better they can prepare to combat those penalties.

Criminal Penalties

For Houston medical providers, the biggest threat they face as a result of a Medicare fraud investigation is criminal convictions.  Not only will a criminal conviction harm their personal and professional reputation, it will also threaten their freedom and livelihood.  Criminal convictions for Medicare fraud carry life altering penalties, such as a maximum of 10 years in prison for each count of Medicare, which may be enhanced up to life in prison if the fraud results in injury or death to patient.  Most criminal sentences for Medicare fraud also include steep criminal fines and recoupment of monies improperly received from Medicare.

Civil Penalties

In lieu of, or in addition to, criminal charges, a person convicted of Medicare fraud may face hefty civil money parties for the same fraudulent activities.  Prosecutors are more and more seeking both criminal and civil penalties for the same health care fraud violations, sometime seeking criminal penalties against the owner of a business and civil penalties against the business itself.  Civil fines for Medicare fraud can be thousands of dollars for each count of alleged Medicare fraud, in addition to treble damages, legal fees, court costs, and exclusion from participation in federal health care programs.

Rely on Experienced Health Care Defense Attorneys

Houston area medical providers facing investigation for Medicare fraud should contact an experienced health care fraud attorney immediately once they learn of the investigation.  The easiest and most effective way to avoid criminal charges as a result of a Medicare fraud investigation is to hire an attorney early on in the investigation.  An attorney who understands the health care laws and has experience with health care fraud investigations will be able to assess the nature of the investigation and predict the potential liabilities the provider is facing.  Since health care fraud cases are generally brought in federal court, the right attorney should be well versed in federal court procedure and customs.

The Oberheiden & McMurrey, LLP offers effective defense strategies to Houston medical providers.  Our lawyers have a comprehensive understanding of federal health care laws and a depth of experience handling health care fraud investigations.  Our experience as former prosecutors at the U.S. Attorney’s Office permits us to quickly understand what the government is looking for during an investigation, and we know how to communicate with government officials to present our clients in the best possible light throughout the investigation.  We also use our firsthand understanding of health care prosecutions to develop sophisticated strategies to undermine the case against our clients.

One strategy that our attorneys have used to help our clients defeat criminal health care fraud charges is to demonstrate that our clients did not intend to commit health care fraud.  To commit health care fraud, a person must intend to defraud the government; merely making an inadvertent mistake that causes a violation of health care laws does not amount to health care fraud.  Therefore, a prosecutor must prove – beyond a reasonable doubt – that the accused actually intended to commit fraud in order to convict that person of health care fraud.  We take a close look at all of the facts in our clients’ cases and determine where and how the mistakes were made in order to undermine the prosecutor’s ability to prove our clients intended to commit fraud.

Our Success Stories

Oberheiden & McMurrey, LLP has a long history of success representing providers and businesses in Texas against a variety of health care fraud charges, including Stark Law violations, Anti-Kickback Law violations, and False Claims Act violations.  We have successfully defended health care fraud investigations conducted by the Federal Bureau of Investigation (FBI), the Drug Enforcement Administration (DEA), the Department of Justice (DOJ), the Department of Defense (DOD), the Department of Labor (DOL), the Office of Inspector General (OIG), the Internal Revenue Service (IRS), the Medicaid Fraud Control Unit (MFCU), HEAT, and other task forces.Oberheiden & McMurrey, LLP has a proven track record of achieving successful outcomes for our clients, including the following recent examples:

Medicare Fraud:

  • Successful Defense of a Health Care Business against an Investigation by the Department of Justice and the U.S. Attorney’s Office for Alleged Medicare Fraud.
    Result: No Liability.
  • Successful Defense of a Health Care Business against an Investigation by the Department of Health and Human Services for Alleged Medicare Fraud.
    Result: No Liability.
  • Successful Defense of a Health Care Business against an Investigation by the Office of Inspector General and the FBI for Alleged Medicare Fraud.
    Result: No Liability.
  • Successful Defense of a Marketing Company against an Investigation by the Office of Inspector General and the U.S. Attorney’s Office for Alleged Medicare Fraud.
    Result: No Liability.
  • Successful Defense of Physician Syndication against an Investigation by the Office of Inspector General and the FBI for Alleged Medicare Fraud.
    Result: No Liability.
  • Successful Defense of a Toxicology Laboratory against an Investigation by the Office of Inspector General for Alleged Medicare Fraud.
    Result: No Liability.
  • Successful Defense of a Toxicology Laboratory against an Investigation by the Office of Inspector General and the FBI for Alleged Medicare Fraud.
    Result: No Liability.
  • Successful Defense of a Physician against an Investigation by the Office of Inspector General for Alleged Medicare Fraud.
    Result: No Liability.

Free Consultation

If you are a Houston doctor or health care professional facing investigation for Medicare fraud, you should contact legal counsel immediately.  The experienced health care fraud defense attorneys at Oberheiden & McMurrey, LLP are available seven days a week, including weekends, to speak with you about your case.

Oberheiden & McMurrey, LLP
Compliance – Litigation – Defense
800-810-0259
Serving Houston, Texas and Surrounding Areas
www.federal-lawyer.com
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