Bellevue Healthcare Fraud Defense Lawyers

Is your Bellevue healthcare practice or medical business facing an audit or investigation? Our federal healthcare fraud defense lawyers can use their centuries of high-level experience to protect you. To put our career defense attorneys and former federal prosecutors on your side, call 888-680-1745 or request a free case assessment online now.

Healthcare providers in Bellevue are facing close scrutiny from federal authorities and “fee-for-service” audit contractors working with the Centers for Medicare and Medicaid Services (CMS). While federal program fraud and opioid diversion are currently top federal law enforcement priorities, all violations of the False Claims Act, Anti-Kickback Statute, Controlled Substances Act, and other statutes are likely to garner the federal government’s attention, and even unintentional violations can trigger recoupments, fines, and other penalties.

In many cases, however, healthcare providers are facing consequences that are far more severe. In cases of criminal healthcare fraud, physicians, pharmacists, and other providers in Bellevue can face years or decades of federal imprisonment. When their freedom is eventually restored, providers find themselves without a professional license, without a practice to which to return, and with a reputation that has been thoroughly and utterly destroyed.

Nick is extremely professional and knows what he is doing. He is also very kind as a person (unless he is in court!) I would recommend him to just about anyone if they need an amazing lawyer that is top notch and would frankly be scary to face in the court room. He will always do a great job representing his clients.... Thank you very much.read more
Anna P.
Anna P.
Nick is the absolute top expert in any federal case
Jeff C.
Jeff C.
Smart. Smarter. Nick.As a healthcare executive, I once ran into a litigation issue. I hired Nick and, literally, before I knew it the case was resolved in my favor. Nick has an incredible presence and every lawyer in the room knows that Nick will do exactly what he says. It was a mesmerizing experience to see Nick in... action! Very calm and determined, Nick is the absolute top litigator.read more
Whitney Bryant M.
Whitney Bryant M.
Nick has been a friend and trusted advisor for almost 10 years. As anyone just looking at his bio can tell, Nick is an outstanding attorney in highest demand across the country. All healthcare providers should hire attorney Nick Oberheiden!! You will not be disappointed.
Pamela M.
Pamela M.
Dr. Oberheiden has served as council and represented our company on several occasions, even during depositions, contract reviews and providing invaluable advice on multiple occasions that transpired into multilevel success in our business. He and his teams knowledge of both local, state and federal statues,... accompanied by their areas of expertise law regarding best asset protection, estate planning and wealth management solutions have provided both professional and personal growth for my companies, safeguarding them and protection my family’s name and legacy. I would recommend this firm and Dr. Nick Oberheiden without hesitation. I have no doubt that you will experience success with his council.read more
Corban M.
Corban M.
I have worked with Nick Oberheiden for over ten years on various litigation matters in and around New York City. Nick is an accomplished and seasoned lawyer and litigator---efficient, reliable, practical and, at the same time, highly academic. Nick will take the time necessary to understand a client's short- and... long-term goals, and tailor his representation and advice to work toward and achieve those ends. Nick is a zealous advocate for his client, and will never sacrifice his client's interests for a quick or easy resolution to a case. At the end of the day, Nick is a great person to know if you or your business is in need of a top litigator or defense attorney.read more
Brendan C.
Brendan C.
When I was faced with one of the most terrifying and unexpected situations in my life, I called Dr. Oberheiden. I had vetted other attorneys and came right back to him. His knowledge, expertise, and reassuring presence made the decision easy. Throughout my case, his level of communication was what I needed and... expected. He constantly updated me on the status and progress of my case and was able to “talk me off the ledge” when the stress of it all would set in. He is simply the best of the best...there’s not a question about it.read more
Scarlett L.
Scarlett L.
Nick is a superb lawyer with exceptional skills and a formidable personality. Nick works harder, he thinks smarter, and he delivers faster than any lawyer you will ever find. Good, better, Nick!
Jacqueline S.
Jacqueline S.
1st class service. Atty. Iberheiden and Atty. Lynette Byrd were always available for us during the whole process of our Home Health Audit. Thank you so much!
Ed O.
Ed O.
I am a healthcare compliance consultant with almost 25 years of experience. The one advice I have for anyone seeking a lawyer with unbeatable healthcare law experience is to hire attorney Nick Oberheiden. For the past 8 years, I have worked with Nick on a variety of healthcare matters—from DEA compliance to DOL... supervisory rules to setting up PT and pain management clinics. I have never once seen a client not being 100% intrigued by Nick’s proven expertise in the field of healthcare structuring and compliance.Dr. S.T.read more
RAFT C.
RAFT C.
Nick Oberheiden is a spectacular lawyer, a true life saver. Nick is simply the very best!
Michael P
Michael P
Nick Oberheiden is the absolute best federal litigation attorney. Nick gives you the immediate comfort of feeling 100% protected. He is polite, respectful— and extremely compelling. His legal strategy turned out to be brilliant.
Marshall M
Marshall M
Great firm, with a great firm record of experienced healthcare and litigation attorneys.
Chris A.
Chris A.

Do Not Let an Audit or Investigation End Your Practice and Threaten Your Freedom

While these risks are very real, the outcome of a federal healthcare fraud audit or investigation is not a foregone conclusion. If you are facing an audit or investigation, you can affect the outcome. Our record proves it, and our attorneys can use their experience to help you avoid unnecessary consequences.

What is Oberheiden P.C.?

Oberheiden, P.C. is a federal defense law firm that represents healthcare providers nationwide in audits, investigations, and civil and criminal enforcement matters. With a team of highly-experienced in-house senior attorneys and a nationwide network of lawyers who all have extensive experience in the area of federal defense, we provide strategic and effective representation that is guided by our results in prior cases. We have seen what works, and we know when, why, and how the U.S. Department of Justice (DOJ) decides to prosecute. If your Bellevue healthcare business or medical practice is being audited or targeted in a federal fraud investigation, we can protect you.

Put our highly experienced team on your side

Dr. Nick Oberheiden
Dr. Nick Oberheiden

Founder

Attorney-at-Law

John W. Sellers
John W. Sellers

Former Senior Trial Attorney
U.S. Department of Justice

Local Counsel

Joanne Fine DeLena
Joanne Fine DeLena

Former Assistant U.S. Attorney

Local Counsel

Joe Brown
Joe Brown

Former U.S. Attorney & Former District Attorney

Local Trial & Defense Counsel

Amanda Marshall
Amanda Marshall

Former U.S. Attorney

Local Counsel

Aaron L. Wiley
Aaron L. Wiley

Former Federal Prosecutor

Local Counsel

Roger Bach
Roger Bach

Former Special Agent (OIG)

Gamal Abdel-Hafiz
Gamal Abdel-Hafiz

Former Supervisory Special Agent (FBI)

Chris Quick
Chris Quick

Former Special Agent (FBI & IRS-CI)

Kevin M. Sheridan
Kevin M. Sheridan

Former Special Agent (FBI)

Ray Yuen
Ray Yuen

Former Supervisory Special Agent (FBI)

Dennis A. Wichern
Dennis A. Wichern

Former Special Agent-in-Charge (DEA)

Why Choose Oberheiden P.C. in Bellevue?

If you are facing a MAC, RAC, UPIC, or ZPIC audit, if you have been contacted by CMS or the DOJ, or if your business or practice is being targeted by any other federal agency or task force in Bellevue, why should you choose Oberheiden P.C. for healthcare fraud defense?

1. We Provide Nationwide Federal Defense

Our healthcare fraud defense practice is nationwide in scope. This allows us to pick up on federal law enforcement trends, keep pace with the federal government’s new law enforcement initiatives, and effectively represent clients who may be accused of participating in nationwide healthcare fraud “conspiracies.” We have the attorneys and resources to handle cases that are confined to Bellevue and that cross state lines, and we know how to efficiently handle high-risk and large-scale cases without letting the federal government fully take the reins.

2. We Focus on Healthcare Fraud Defense

A significant portion of our practice is devoted to federal healthcare fraud defense. Many of our attorneys’ backgrounds are in this area (including founding attorney Dr. Nick Oberheiden), and our federal defense team includes several former DOJ attorneys who previously prosecuted healthcare fraud cases on behalf of the federal government. We understand the unique complexity of these cases, and we also understand the extreme risks involved. We use our vast knowledge of federal healthcare laws and program billing regulations to our clients’ advantage.

3. Our Team Includes Several Former Healthcare Fraud Prosecutors and Investigators

Wouldn’t it be nice to know what federal authorities are thinking? At Oberheiden P.C., we can tell you—definitively. This is because in addition to our former DOJ prosecutors, we also employ the services of several former federal agents with the Office of Inspector General (OIG), Federal Bureau of Investigation (FBI), Internal Revenue Service (IRS), and other agencies. We offer our clients decades worth of insights gained from working directly for the agencies that are accusing them of healthcare fraud.

4. Our Practice Focuses on Pre-Charge Resolution

While it is important to know that your defense lawyers are prepared to defend you at trial if necessary, it is far more important to know that your lawyers are doing everything possible to prevent your case from going to trial. At Oberheiden P.C., we emphasize pre-trial resolution. We promptly intervene in our clients’ audits and investigations, and we work diligently to convince auditors, investigators, and prosecutors that our clients’ practices do not warrant further scrutiny. If we can prevent charges from being filed, you can get back to business as usual.

5. Our Results (and Our Clients) Speak for Themselves

We have resolved the majority of our clients’ audits and investigations without civil or criminal charges being filed, and to date not a single client of Oberheiden P.C. has faced False Claims Act liability as a result of a healthcare fraud investigation in which we have been involved. Our clients also routinely provide testimonials thanking our attorneys for defending them effectively. In short, our results and our clients speak for themselves, and we are proud to let them do so.

Are you accused of a federal crime?

Don't delay. Learn about your rights.

Call Dr. Nick Oberheiden now!

888-680-1745

What are the Differences Between an Audit and an Investigation?

There are two primary ways that CMS, the DOJ, the OIG, and other federal authorities seek recoupments and other penalties in cases of alleged healthcare fraud: audits and investigations. While audits and investigations are very different, the ultimate consequences can be the same, and both require an equally strategic and custom-tailored defense.

Healthcare Fraud Audits: Contractors Get Paid to Demand Recoupments

During a healthcare fraud audit, employees of a private government contractor review the provider’s program billing records for evidence of overbillings. These contractors receive additional compensation from CMS if they uncover improper payments from federal government programs; and, as a result, accusations of overbilling are extremely common. However, in our experience, they are also frequently unjustified, and disputing unfounded audit determinations before they become final is critical to avoiding the long and time-intensive audit appeals process.

Healthcare Fraud Investigations: Fighting Healthcare Fraud is a Top Federal Priority

During a federal healthcare fraud investigation, agents from the OIG, DOJ, and various other agencies work to collect the evidence required to substantiate allegations of healthcare fraud. Federal authorities have various investigative tools at their disposal, including informal requests for “interviews,” civil investigative demands (CIDs), and federal subpoenas. Healthcare fraud investigations often involve numerous agencies (or coordinated task forces, such as the Opioid Fraud and Abuse Detection Unit), and they can lead to charges for a variety of related and unrelated offenses.

Am I Facing Civil or Criminal Penalties?

In healthcare fraud audits, CMS contractors only have the authority to impose civil penalties. However, auditors have the authority (and often the obligation) to report providers to CMS and the DOJ when they uncover evidence of alleged fraud, and this can trigger a follow-on investigation. Investigations can be either civil or criminal in nature, and investigations that start out civil can transition into criminal inquiries. As a result, providers need to treat all audits and investigations with equal care, and they must engage experienced federal defense counsel in order to protect against being civilly or criminally charged with healthcare fraud.

What is “Healthcare Fraud”?

Of course, all of this begs the question: What exactly is “healthcare fraud”?

Allegations of federal healthcare fraud can take many different forms. While there are certain acts that are exclusively criminal in nature (i.e. taking part in a healthcare fraud “conspiracy”), many statutes include provisions for both civil and criminal enforcement. Examples of acts and practices that can be prosecuted as civil or criminal healthcare fraud include (but are not limited to):

  • – Fraudulently certifying medical necessity or certifying a patient for hospice or home health services
  • – Upcoding medical services or procedures in order to bill at a falsely-inflated rate
  • – Unbundling related medical services or procedures in order to bill at higher individual rates
  • – Billing for services not actually provided or procedures not actually performed (“phantom billing”)
  • – Billing Medicare, Medicaid, or another federal benefit program for non-existent patients (or “ghost patients”)
  • – Offering, soliciting, paying, or receiving unlawful referral fees in violation of the Anti-Kickback Statute
  • – Engaging in prohibited transactions relating to designated health services under the Stark Law
  • – Providing opioid pain medications without medical necessity or without performing a re-examination prior to refilling a prescription

Is Your Bellevue Healthcare Practice or Medical Business at Risk?

Our firm is actively representing several physicians, pharmacists, clinics, laboratories, telemedicine companies, durable medical equipment (DME) companies, and other clients in federal healthcare fraud audits and investigations. If your Bellevue practice or business is being targeted, call 888-680-1745 or contact us online now for a free and confidential case assessment.

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