Brooklyn, New York Health Care Fraud Defense
Experienced Defense Attorneys for Health Care Fraud Investigations in Brooklyn
For health care providers in Brooklyn, New York, federal fraud investigations can lead to severe consequences. Not only are targeted providers at risk for incurring substantial financial penalties, but key personnel can face long-term incarceration, licensed practitioners can face license suspension or revocation, and providers can lose their right to participate in Medicare and other health benefit programs. Avoiding these consequences requires a strategic approach, and this starts with hiring experienced legal representation
Facing a Federal Health Care Fraud Investigation in Brooklyn, New York
At Oberheiden, P.C., we have decades of experience representing health providers in federal fraud investigations. With office locations across the country, including an office in New York City, we represent providers nationwide, and we have a proven record of success helping our clients avoid civil and criminal liability. Led by Dr. Nick Oberheiden, our health fraud defense team includes several former health fraud prosecutors with the U.S. Attorney’s Office, and the U.S. Department of Justice (DOJ). We rely heavily on this past prosecutorial experience to design and execute defense strategies tailored to the government’s priorities and our clients’ unique circumstances, and we take a comprehensive team approach that puts the full weight of our attorneys’ experience on each client’s side.
Federal health prosecutors are currently targeting physicians, pharmacists, hospices, hospitals, toxicology laboratories, and other providers in select regions around the country. This includes New York City. If you are a practitioner, administrator, or company executive in Brooklyn and your business or practice is under investigation, it is important that you seek legal representation as soon as possible. You can contact our firm 24/7 to schedule a free case assessment; and, if you choose to engage our health care fraud defense team, we will take action immediately to intervene in your investigation.
“Our companies have worked with firms all over the country within various specialties and now use [Oberheiden, P.C.] almost exclusively. [Dr. Nick Oberheiden] represented our companies in some federal law investigations. His guidance and expertise allowed us to continue to concentrate on our core business as he dealt with the complex legal issues.” – Satisfied Client“Relentless”
“It is very clear to me that Nick Oberheiden has a deep understanding of health law issues. Nick has been instrumental in managing and resolving many difficult legal matters. He is always relentlessly focused on the critical issues that matter most. Nick is very dedicated and . . . always displays a high degree of professionalism. I would not hesitate in recommending Nick for the most important of legal matters.” – Satisfied Client
Experience in All Health Care Fraud Matters
As Brooklyn health care fraud defense lawyers and former federal prosecutors, our attorneys have served as counsel in cases involving virtually all types of health fraud allegations. Our attorneys have worked with and defended clients against investigations involving the DOJ, the Medicare Fraud Strike Force, the Drug Enforcement Administration (DEA), the U.S. Department of Health & Human Services’ (DHHS) Office of Inspector General (OIG), and other federal agencies, and we have obtained successful resolutions in numerous cases involving Medicare, Medicaid, Tricare, and other health benefit programs. We routinely represent clients in Brooklyn, New York and nationwide in investigations involving:
- False Claims Act. Under the False Claims Act, it is unlawful to bill Medicare, Medicaid, Tricare, or any other health benefit program in non-compliance with the applicable billing regulations. The submission of “false or fraudulent” reimbursement claims can lead to severe penalties, including civil fines and recoupments, and, in criminal cases, long-term incarceration. Common allegations in False Claims Act investigations include billing and coding errors such as upcoding, unbundling, double-billing, phantom billing, and billing for services that are not medically necessary.
- Anti-Kickback Statute. The Anti-Kickback Statute is another law that provides for both civil and criminal penalties. If your business or practice is being investigated under the Anti-Kickback Statute, this means that government agents have reason to believe that you have unlawfully offered, solicited, paid, or received compensation for patient referrals.
- Stark Law. The Stark Law is similar to the Anti-Kickback Statute in that it targets unlawful referral fees; but, it is unique in that (i) it only applies to physicians and their related entities, and (ii) it only includes provisions for civil penalties. However, with civil monetary penalties of up to $15,000 for each unlawfully-referred service and the potential for health benefit program exclusion (in addition to other penalties), physicians facing Stark Law investigations must take action to protect themselves as early in the investigative process as possible.
- Prescription Drug Fraud. In October 2017, President Trump declared the nation’s opioid crises a public health emergency. Since then, prosecutors with the DOJ, DEA, and other agencies have been aggressively pursuing enforcement actions and criminal prosecutions against health care providers suspected of engaging in prescription drug fraud. Allegations of drug diversion, fraudulent prescriptions, failure to adhere to prescription requirements, and issuing medically-unnecessary prescriptions are all common, and providers targeted in these cases are often facing the maximum penalties available.
- Physician Certification Fraud. Physicians that certify patients for hospice and home care must take appropriate measures ensure that their certification practices are fully-compliant and meticulously documented. Hospices and home health agencies that rely on physician certifications must take care to ensure that their patients satisfy the necessary requirements and receive re-certifications on an ongoing basis. Even minor issues can lead to allegations of certification fraud; and, like other forms of health care fraud, physician certification fraud is a serious federal offense that carries severe civil and criminal penalties.
FAQs: Our Attorneys Answer Your Questions about Health Care Fraud Investigations
Q: Which federal agencies conduct health fraud investigations?
Many health care fraud investigations in Brooklyn, New York involve agents and prosecutors from the DOJ, the DEA, the OIG, and the Medicare Fraud Strike Force. These authorities are tasked with enforcing the nation’s health laws, and they have a mandate to vigorously pursue civil enforcement actions and criminal charges against health providers suspected of defrauding our nation’s health benefit programs. However, these are not the only federal authorities that conduct health care fraud investigations. We also regularly represent clients in investigations involving:
- Centers for Medicare and Medicaid Services (CMS)
- Federal Bureau of Investigation (FBI)
- Medicaid Fraud Control Units (MFCUs)
- S. Department of Defense (DOD)
- S. Department of Labor (DOL)
- Other agencies and task forces
Q: Do I need to cooperate with the federal agents who are conducting the investigation?
Understanding your obligations during a federal health fraud investigation requires knowledge of the specific details involved. Which agencies are involved in the investigation? Have you received a subpoena or civil investigative demand? Were you presented with a warrant? If you are not legally required to cooperate, is it in your best interests to do so (and, if so, to what extent)? These are all critical questions that our attorneys can help answer so that you can make informed decisions during your investigation.
Q: If I know that my business or practice has overbilled Medicare, am I required to disclose this to the government?
Health providers have various self-reporting obligations; and, if you have discovered a shortcoming in your business’s or practice’s compliance program that has resulted in overbilling Medicare or another health care benefit program, you may be required to disclose this to the government. However, there are specific procedures for self-reporting billing violations, and disclosing more than is required could have adverse consequences for your investigation. This is another area where experienced legal representation is critical, and where our health care fraud defense team can help you mitigate your liability as much as possible.
Q: How far back can the government review my business’s or practice’s billing records?
The “look-back” period for your investigation will depend on the specific statute (or statutes) under which your business or practice is being investigated; but, generally speaking, you can expect several years of program billings to be subjected to close scrutiny. For example, under Section 3731(b) of the False Claims Act, federal investigators can potentially review up to 10 years of billing records during an investigation.
Trusted Defense Lawyers for Brooklyn, New York Health Care Providers
Our team of Brooklyn health care fraud defense attorneys is the go-to legal resource for health care providers facing investigations in Brooklyn, New York and nationwide. If your business or practice is under investigation, or if you are concerned about a possible billing violation, we can take action quickly to mitigate the consequences, and we will pursue all available courses of action to help you avoid civil or criminal charges. When you cannot afford to wait – and you cannot afford to take chances – you need a legal team with proven results. Contact us today to find out why providers nationwide trust our attorneys to defend them.
To schedule a free case assessment at Oberheiden, P.C., please call (888) 519-4897 or contact us online. We are available seven days a week, and if we cannot respond immediately we will be in touch as soon as possible.