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False Claims Act & Qui Tam Lawsuit Defense in California

If you’re named as a qui tam defendant or if you’re being investigated for violating the False Claims Act in California, you should call Oberheiden & McMurrey, LLP. The Oberheiden & McMurrey, LLP is a law firm serving the entire State of California. We have experience in representing clients who are named as defendants in qui tam lawsuits and who are being investigated by the federal government. We also have experience in other legal matters, including criminal defense. Oberheiden & McMurrey, LLP also helps clients with regulatory compliance issues. California clients benefit from being represented by a defense team headed by a former Chief Health Care Fraud Coordinator from the U.S. Attorney’s Office. Our legal team is comprised of attorneys with fantastic educational backgrounds from the nation’s best law schools. Additionally, several of our lawyers have former experience as federal prosecutors and senior trial attorneys. Oberheiden & McMurrey, LLP serves clients throughout the State of California.

California health care practitioners, facilities, entities, and related businesses face a serious risk. They have an increased chance of investigation by the federal government involving the False Claims Act. An allegation of this sort can cause you to receive civil or criminal charges. Oberheiden & McMurrey, LLP provides legal assistance to California health care practitioners, entire health care systems, and businesses in need of health care fraud defense counsel. Dr. Nick Oberheiden is a Harvard-trained negotiator and renowned health care fraud defense attorney. Dr. Oberheiden is the principal managing partner of the Oberheiden & McMurrey, LLP.

False Claims Act Violations in California

Doctors, nurses, other individual health care practitioners, health care entities, businesses, and facilities located or practicing in California have an exceptionally higher risk of being involved in a False Claims Act investigation than in the majority of the United States. California is one of nine areas with a large number of people who rely on federal health care program. This causes more claims to be filed. The increase in claims means that the Medicare Fraud Strike Force pays particular attention to the state.

The Medicare Fraud Strike Force is an investigative agency that amasses investigators and prosecutors from various federal agencies including the Department of Justice, the Department of Health and Human Services, the Office of Inspector General, the DEA, the FBI, and the IRS. Other agencies can also be involved. If you discover that you’re under investigation by the Medicare Fraud Strike Force, you should contact Oberheiden & McMurrey, LLP immediately. Initial consultations are confidential and free of charge.

Elements of the False Claims Act

The False Claims Act is a federal statute. It applies to any person, business, or organization that has a direct or indirect contract with and that will receive payment by the federal government for services or equipment. Any person, business, contractor, or organization that knowingly submits or causes the submission of one or more false claims for approval and payment by the federal government may face civil or criminal penalties.

The False Claims Act doesn’t require you to have actual knowledge of the filing of a false claim. Liability is created because you knew or should have known that the False Claims Act was being violated. Medical coding is one of the easiest ways to explain this concept. Recently, ICD-10 was introduced and implemented. If you outsource or hire someone to handle your coding and they use an obsolete code or the wrong code, you may be held legally liable. This is because you knew you were giving the work to someone else. It was your responsibility to ensure that they were using the appropriate codes.

Civil and Criminal Penalties Created by the False Claims Act

If you’re accused of violating the False Claims Act, you may be tried in civil or criminal court. If you’re unsure about the charges that you may be facing, you should call Oberheiden & McMurrey, LLP now. Once we are retained, we can help you get the answers that you need.

Civil penalties are imposed by civil court judges. Civil charges can have a major impact on your personal and professional life. You may be forced to deal with one or more of the following civil penalties:

  • Adjudged with treble damages (damages that are three times more than the amount that the claim is worth)
  • A fine of up to $11,000 per false claim
  • State disciplinary proceedings
  • Loss of your professional license
  • Loss of hospital privileges
  • You could be ordered to pay attorneys’ fees for the federal government

Criminal penalties are imposed by the criminal court. You may face one or more of the following:

  • Criminal indictment
  • Prison time
  • A fine of $250,000 per claim for individuals for federal felony convictions
  • A fine of $500,000 per claim for businesses for federal felony convictions
  • A fine of $100,000 per claim for individuals for a misdemeanor conviction
  • A fine of $200,000 per claim for businesses for a misdemeanor conviction

Qui Tam Lawsuits Filed in California

California False Claims Act investigations are usually prompted by a qui tam lawsuit that is filed against you. These lawsuits are supposed to be utilized to protect the federal government from fraud. Private citizens are encouraged to sue on behalf of the federal government to help it recoup money that was illegally paid out on fraudulent claims. If the lawsuit is successful, the plaintiff will receive a monetary reward. Qui tam is a Latin phrase that means ‘he who sues for the king and himself.’ What was implemented as a legal instrument to aid whistleblowers is now abused by spiteful former employees and competitors as a way to close down successful health care providers and businesses.

Qui tam lawsuits are filed in the federal court system. Which federal court will depend on where your practice, facility, or business operates in California. The plaintiff is referred to in the lawsuit as the ‘qui tam realtor.’ These lawsuits are sealed, with the exception of the unsealed copies provided to the presiding judge and appropriate federal investigators. False Claims Act investigations can be time consuming. The federal court will grant six month extensions to furnish the federal government with enough time to complete its investigation.

From the very outset of your case, you should have a health care fraud defense attorney. Your attorney can open a line of contact with the federal investigators and prosecutors on your behalf to determine what can be done to settle the matter. Settlement negotiations can also take a lot of time.

As the investigation continues, the federal government will subpoena your financial, billing, communication, and other pertinent records. Subpoenas may be issued by the FBI, the IRS, OIG, DEA, DOJ, and other federal agencies. After the federal government reviews your records it will decide if it wants to support or reject the case. If it rejects the qui tam lawsuit, the plaintiff has the option of continuing it. If they win against you, they are entitled to receive 30 percent of the recovered funds.

The Department of Justice must approve of supporting the qui tam lawsuit. If permission is given, this is known as government intervention. It is likely that the lawsuit will be amended to list additional charges such as violations of the the Anti-Kickback Act, the Truth in Negotiation Act, or the Physician Self-Referral Law. If you lose the qui tam suit, the plaintiff will receive 25 percent of the recovered funds as a reward.

Important Defense Principles

Oberheiden & McMurrey, LLP utilizes a remarkable mix of experience. Several of the lawyers who make up our health care Fraud Defense Team have experience as former senior federal prosecutors of health care fraud. Additionally, we are the premier attorneys of health care fraud defense. Our experience has led us to develop important defense principles that we employ in each and every case involving a violation of the False Claims Act.

Determining possible charges. Our first objective is to determine the nature of the potential charges that you face. Most violations of the False Claims Act in California don’t occur because someone had a plan to defraud the government. They happen because someone made an honest mistake. We get into immediate contact to determine how the investigation began, the existing exposure, and what our client can do to resolve the matter. We can generally get this information within just a few hours following our engagement.

Pertinent defense strategies for California qui tam lawsuits. Because most False Claims Act investigations start as a result of a qui tam lawsuit, we put together a pertinent defense strategy for our California clients. The main objective is to destroy the credibility of the case. We will scrutinize the facts, the evidence, and the plaintiff to prove to the federal government that the case does not deserve its support.

Negotiations. When the federal government alerts us that our clients will face civil damages, we start negotiating with the federal government. The goal is to agree to a settlement that is appropriate and favorable. To date, none of our clients have been forced to shut down their business or stop practicing medicine.

Oberheiden & McMurrey, LLP

Oberheiden & McMurrey, LLP has provided successful legal defenses nationwide for doctors; clinic owners; physician-owned entities; toxicology labs; DME companies; pharmacies; service management organizations; marketing companies that work in health care , clinics, hospitals; and many other health care related entities in relation to False Claims Act violations. We also assist defendants in qui tam lawsuits; Stark Law violations; Anti-Kickback statute violations; and with Medicare, Medicaid, Tricare, and Department of Labor investigations.

Our Track Record

The attorneys of Oberheiden & McMurrey, LLP have successfully defended physicians, practice owners, physician owned entities, toxicology laboratories, device companies, pharmacies, service management organizations, health care marketing companies, hospitals, and many others in False Claims Act, qui tam lawsuits, Stark Law, Anti-Kickback, Medicare, Medicaid, Tricare, and DOL investigations.

  • False Claims Act Investigation (Pharmacy)   Result: No Liability.
  • False Claims Act Investigation (Pharmacy)   Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)   Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)   Result: No Liability.
  • False Claims Act Investigation (Laboratory Group)   Result: No Liability.
  • False Claims Act Investigation (Physician)   Result: No Liability.
  • False Claims Act Investigation (Physician)   Result: No Liability.
  • False Claims Act Investigation (DME Company)   Result: No Liability.
  • False Claims Act Investigation (MSO)   Result: No Liability.
  • False Claims Act Investigation (MSO)   Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)   Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)   Result: No Liability.
  • False Claims Act Investigation (Physician Syndication)   Result: No Liability.
  • False Claims Act Investigation (Device Company)   Result: No Liability.
  • False Claims Act Investigation (Health Care Service Provider)   Result: No Liability.

Call us at Oberheiden & McMurrey, LLP now and ask to speak with our Health Care Fraud Defense Team about your case. Initial consultations are confidential and free.

False Claims Act Defense Lawyers Serving California

Nick OberheidenDr. Nick Oberheiden has represented clients in qui tam lawsuits, False Claims Act investigations, Medicare fraud investigations, Tricare fraud investigations, Stark Law violations, and anti-kickback proceedings before virtually all federal agencies including, but not limited to, the Office of Inspector General (OIG), the Department of Health and Human Services (HHS), the Department of Defense (DOD), the Department of Justice (DOJ), and the Department of Labor (DOL). Dr. Oberheiden is trained in negotiations by Harvard Law School and holds a Juris Doctor from the University of California, Los Angeles, as well as a Ph.D. in law.

Lynette ByrdLynette S. Byrd is a former Assistant United States Attorney (AUSA). Detroit clients greatly benefit from Ms. Byrd’s previous experience with the Department of Justice, where she prosecuted health care fraud, Anti-Kickback violations, violations of the False Claims Act, and Stark Law violations on behalf of the United States. Ms. Byrd has immense experience with health care law enforcement, and she regularly argues federal matters for her clients.

Don’t wait. We’re available now to discuss your case. Call us, email us, or use our contact form.

800-810-0259
Including Weekends
Oberheiden & McMurrey, LLP
Serving the State of California and Surrounding Areas
www.federal-lawyer.com
This information has been prepared for informational purposes only and does not constitute legal advice. This information may constitute attorney advertising in some jurisdictions. Reading of this information does not create an attorney-client relationship. Prior results do not guarantee similar future outcomes. Oberheiden & McMurrey, LLP is a Texas LLP with headquarters in Dallas. Mr. Oberheiden limits his practice to federal law.

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