Brian Kuester
Former U.S. Attorney
Lynette Byrd
Former Assistant
U.S. Attorney
John Sellers
Former DOJ
U.S. Attorney
Joe Brown
Former U.S. Attorney
(Local Counsel)
Dr. Nick Oberheiden
Attorney & Founder
U.S. Department of Justice (DOJ) Targets Podiatrists for Alleged Foot Bath Schemes
The U.S. Department of Justice (DOJ) has recently targeted multiple podiatrists suspected of defrauding Medicare and other healthcare benefit programs. Each case has involved allegations of operating an unlawful “foot bath scheme” with medically unnecessary treatments that are not eligible for reimbursement. It seems that podiatrists are now squarely within...
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CMS and DOJ Target Healthcare Providers Offering Sanexas Pain Management and Treatment Services
The Centers for Medicare and Medicaid Services (CMS) and U.S. Department of Justice (DOJ) are targeting healthcare providers that offer Sanexas pain management and treatment services to their patients. Targeted healthcare providers face substantial risks—including the risk of recoupment liability, Medicare exclusion, criminal fines, and even federal imprisonment in some...
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Possible Statutory Violations for Medicare Billing Fraud Involving Amniotic Fluid Injections
Fraudulent Billing for Amniotic Injections "Fraudulent billing" is a broad term referring to a healthcare provider’s fraudulent requests for reimbursement that are submitted to Medicare, Medicaid, or any other government healthcare benefit program. Allegations for fraudulent billings can be investigated and prosecuted as civil or criminal offenses under various statutes...
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Medicare Audits and Fraud Investigations for Amniotic Fluid Injection Billings and How to Respond
What are Amniotic Fluid Injections? Amniotic fluid injections are amniotic cells that are injected into damaged tissues to help them recover and regrow. Their purpose is to reduce inflammation of the damaged tissue, cut down the individual’s recovery time, and regenerate tissue. These injections are prescribed for patients suffering from...
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How CGX Laboratories Can Be Compliant
Medicare began providing coverage for genetic cancer screening (CGX) in 2018. While this was a positive development for testing laboratories, some labs that have been billing Medicare for CGX have run into compliance issues. If your testing laboratory bills Medicare for CGX, this article provides an overview of what you...
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Alzheimer’s Testing Compliance
According to the National Institutes of Health (NIH), it is estimated that more than 5.5 million Americans may suffer from Alzheimer’s disease. Among other things, this means that diagnosing and treating seniors with Alzheimer’s disease presents a significant opportunity for neurologists, psychiatrists, geriatricians, and other healthcare providers to help people...
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Continuous Glucose Monitoring (CGM) Medicare Compliance
In 2018, the Centers for Medicare and Medicaid Services (CMS) expanded Medicare coverage for continuous glucose monitoring (CGM). While this is good news for program beneficiaries who need CGM, billing compliance has proven to be a challenge for many pharmacies and other healthcare providers. When continuous glucose monitoring (CGM) was...
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Federal CGX and PGX Investigations
Oberheiden P.C. Represents Laboratories, Distributors, and Business Owners in CGX and PGX Investigations Nationwide Are you worried about current PGX and CGX investigations? Did one of your former business partners get raided or indicted? Did the FBI or agents from the Office of Inspector General (OIG) stop by to interview...
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Penalties in Home Health Medicare Fraud
Medicare Fraud Defense Attorneys Available Now Everyone knows how dangerous it is to mess with Medicare billing. Few, however, are aware what actual penalties and consequences Medicare fraud allegations can trigger. Of all industries, owners of home healthcare centers are disproportionately high exposed to audits, investigations, and even criminal charges....
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Is It Legal to Purchase Medicare Leads?
This summary, co-written by former DOJ healthcare fraud prosecutors, attempts to answer a question of increasing importance: under what circumstances is it legal to purchase patient leads? What is the difference between a raw and a qualified lead—and why does it matter? What is the Justice Department’s position on the...
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