What is Hospice Fraud?
Several branches of the government have begun to scrutinize the practice of hospice care centers and its compliance with Medicare rules, certification procedures, and billing policies. The attorneys of Oberheiden & McMurrey, LLP have been involved in a number of hospice care investigations and offer our clients valuable government insights as well as the experience of healthcare fraud defense attorneys. Hospice Fraud does not exist as an offense per se and most investigations against hospice businesses arise either under the False Claims Act or as a criminal Medicare Fraud matter pursuant to 18 U.S.C. 1347, the general healthcare fraud statute. According to the provisions of the statute, a person may face up to 10 years per count if the government can show that the person knowingly and willfully participated in or attempted a scheme to defraud a government healthcare program, such as Medicare, and up to 20 years if the fraud resulted in serious bodily injury to the patient.
Oberheiden & McMurrey, LLP has a track record of convincing the government in healthcare fraud cases that errors, to the extent they occurred, arose out of negligence and not knowingly and willfully to justify criminal prosecution.
Avoiding Criminal Charges in Hospice Cases
The U.S. Constitution sets out a high burden to prove that someone violated criminal law. In order to be found guilty of a healthcare offense, the government must prove—beyond a reasonable doubt—that the defendant willfully and knowingly defrauded the government. In our experience, that burden is very hard to meet and the attorneys of Oberheiden & McMurrey, LLP have demonstrated in case after case that deviations from the law resulted from negligence and did not occur knowingly or willfully. Our attorneys put the high constitutional standard to the test and we fight to avoid criminal charges and to maintain a professional’s license.
The reason for our success is simple. We have observed that most situations that have led to investigations, and even prosecutions, in home health and hospice care cases are results of mistakes and human errors, not because the owners of a hospice wanted to criminally defraud the government. Rapid growth of the business, unreliable staff, unqualified billers mixed with delegation, outsourcing, and lack of appropriate oversight may cause the hospice business to be in default of the law— allowing Oberheiden & McMurrey, LLP to remind the government that negligence is not punishable by criminal penalties.
Oberheiden & McMurrey, LLP has significant experience with healthcare fraud investigations. Home health and hospice care clients that engage our firm will notice that we listen to your side of the story because your story is key to our defense strategy. We will conduct a careful analysis of your business to prove that the origin of potential mistakes stems from lack of oversight and neglectfulness. Our attorneys are utmost familiar with certification and re-certification determinations, medical necessity, conditions of coverage, and plan of care requirements.
Oberheiden & McMurrey, LLP has successfully defended business owners, physicians, and companies in Medicare Fraud, Medicaid Fraud, Tricare Fraud, Stark Law, and Anti-Kickback investigations across the United States. If you are a business owner, physician, or employee of a hospice care center that is accused of healthcare fraud, you should immediately seek legal advice. The experienced attorneys of Oberheiden & McMurrey, LLP offer free and confidential consultations and are interested in assessing your situation. Call now to discuss your case and find out what we can do for you.