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What California Medical Providers Should Know About Medicare Fraud

Categories: Health Care Law

medicare fraud

Comprised of former Assistant United States Attorneys and veteran federal defense attorneys, Oberheiden & McMurrey, LLP represents doctors, business owners, and other professionals within the healthcare industry facing investigation or prosecution for Medicare fraud.  Throughout the country, and especially in California, we help clients when faced with allegations of Medicare fraud, anti-kickback violations, improper billing procedures, and other healthcare fraud.

Medicare Fraud Investigations in California

California is a major focal point for Medicare fraud investigations.  The United States Department of Justice (DOJ) has designated Los Angeles as a hot spot for Medicare fraud, and Los Angeles is one of just nine cities in the country to receive a local Medicare Fraud Strike Force, which is a collaborative effort by the DOJ and the Department of Health and Human Services (HHS) that works with local state and federal law enforcement agents to prevent, detect, and investigate Medicare fraud in the region.   The Medicare Fraud Strike Force is overseen by the Health Care Fraud Prevention and Enforcement Action Team (HEAT), another joint effort of DOJ and HHS to combat Medicare fraud on a national scale.  The establishment of the Medicare Fraud Strike Force in Los Angeles reflects increasing enforcement action throughout the state and has resulted in a drastic increase in statewide Medicare fraud investigations and prosecutions.  Therefore, if you are a doctor or other medical professional practicing in California, you should be aware of the increasing scrutiny of the federal government as it monitors for fraudulent activity.

Not Every Mistake Constitutes Healthcare Fraud

Federal healthcare laws and regulations are complicated, confusing, and constantly changing.  Therefore, it is easy to see how a business or practitioner could unintentionally violate one or more rules without even realizing that a violation had occurred.  In fact, in our experience as healthcare defense attorneys, we often see well-meaning physicians and business owners facing scrutiny as the result of human or clerical error, lack of organizational oversight, or inexperienced employees.  Innocent mistakes do not constitute healthcare fraud and should not lead to criminal liability; to be guilty of healthcare fraud, one must engage in fraudulent activity intentionally.  So, for example, a company or doctor does not commit Medicare fraud merely by making a mistake on an invoice that is submitted to Medicare.

At Oberheiden & McMurrey, LLP, we understand that innocent mistakes aren’t Medicare fraud.  We have helped many clients avoid Medicare fraud charges simply by demonstrating to investigators that suspicious activity was in fact the result of mistakes or misunderstandings and not intentional fraud.  Call Oberheiden & McMurrey, LLP today to speak with one of our attorneys about your investigation.

California Medicare Fraud Defense Attorneys Are Available to Answer Your Questions

If you are under investigation for Medicare Fraud or have been contacted by federal investigators regarding a healthcare fraud investigation, you likely have questions about the investigation and your potential exposure to civil or criminal charges.  Oberheiden & McMurrey, LLP is available to speak with you about your case in a free and confidential consultation.  As former healthcare prosecutors and Medicare Fraud Strike Force leaders, we understand both sides of the investigative process and can explain it to you.

  • Nick Oberheiden, Founder
  • Lynette S. Byrd, Fmr. Assistant United States Attorney, Healthcare Fraud (U.S. Attorney’s Office)
Oberheiden & McMurrey, LLP
Compliance – Litigation – Defense
(800) 810-0259
(310) 873-8140
(714) 294-2000
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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