Dallas Healthcare Fraud Defense Lawyers

Oberheiden, P.C.
5728 Lyndon B Johnson Fwy #250, Dallas, TX 75240
888-680-1745

Oberheiden, P.C. is a healthcare law defense firm with significant experience in the areas of regulatory compliance, corporate structuring, litigation, government investigations, and criminal defense. Among our attorneys are the former Chief Healthcare Fraud Coordinator at the U.S. Attorney’s Office, former senior Department of Justice trial attorneys, former lead prosecutors of the elite Medicare Fraud Strike Force, and other talented attorneys with years of relevant experience and education from the country’s best schools such as Harvard Law School and Yale Law School. Our Dallas healthcare fraud defense lawyers serve clients in Dallas, TX as well as throughout surrounding areas in Texas.

Oberheiden, P.C. defends Dallas clients against healthcare fraud allegations. Dr. Nick Oberheiden, a healthcare fraud defense lawyer, leads our Healthcare Fraud Defense Team.

Our dedicated team has experience with OIG and Grand Jury subpoenas, Medicare and Tricare audits, defense of fraud allegations, internal investigations, implementation of compliance programs, qui tam defense strategies, asset protection, criminal defense, and jury trials.

If you’re facing allegations of healthcare fraud or any of the other areas listed above, call us immediately. We’re available 7 days a week.

Healthcare Fraud in Dallas

There are nine areas in the United States where the federal government established specialized tasks forces to surveil, investigate, and prosecute Medicare fraud. Dallas is one of those nine areas. Healthcare practitioners and businesses should be aware that government prosecution is becoming more aggressive and frequent in this community compared to many others. These investigations are initiated by the Healthcare Fraud Prevention and Enforcement Team (HEAT). HEAT is a federal task force that is composed of prosecutors from the Department of Justice (DOJ), Department of Health and Human Services (HHS), the Office of Inspector General (OIG), and the Federal Bureau of Investigation (FBI) along with many other government agencies.

Healthcare Fraud Explained

Federal healthcare fraud is the attempt to receive government funding through programs such as Medicare, Medicaid, Tricare, or federal workers’ compensation (DOL) through false and fraudulent information. It can take many different forms.

  • Anti-Kickback Violations. Compensation in exchange for referrals is prohibited by healthcare laws. Any person – physicians, marketers, business owners – are subject to healthcare fraud prosecution for receiving monetary payment or offers in exchange for a patient referral.
  • Stark Law. If a physician (or family member) has a compensation arrangement with any health services entities or practice, they may not, under law, refer patients to those facilities – unless one of the statutory exceptions applies.
  • False Claims Act Violations. The False Claims Act applies to any submission made to Medicare. If a bill is submitted that is incorrect, even if unintentional, the statutes’ heavy-handed civil penalties may kick in. The government can investigate incorrect billing under the criminal provisions of the False Claims Act.
  • Prescription Fraud. Physician practices with unusually high volumes of narcotic prescriptions are inspected by the government. Doctors who are under the suspicion of handing out unnecessary narcotic prescriptions may be investigated for insurance fraud and violations of DEA dispensing rules.
  • Billing Fraud. Up-coding or billing code use for higher than the service level provided, phantom-billing (services not provided), billing ghost patients, and billing for services deemed medically unnecessary will be investigated by the government.
  • Certification Errors. Investigations of the health and hospice industry have been intensified by the government. The main allegation is that some physicians and nurses are fraudulently certifying the medical services needed, despite the patient not being homebound (home health) or not terminally ill (hospice).

Penalties

Healthcare fraud is a serious offense and the penalties can range from civil recoupment requests, non-payment of claims, and program exclusion to criminal prosecution, fines, and even incarceration. The general crime-fraud statute at 18 U.S.C. 1347 provides:

  • Up to 10 years in prison for each count of healthcare fraud.
  • Up to 20 years in prison, if the fraud resulted in serious bodily injury.
  • Life in prison if the fraud resulted in the patient’s death.

How you may be prosecuted for healthcare fraud and whether you will receive a prison sentence is largely dependent upon all of the factors involved in your case, whether the prosecutor is interested in taking the case, and what the government believes was your primary motivating factor for committing the alleged fraud.

Because Oberheiden, P.C. has former experience as healthcare fraud prosecutors and because of our work as defense attorneys, we have a unique blend of experience and a distinct track record of helping our clients avoid criminal prosecution. If you’re being investigated or if you want to speak with us about the facts involved in your case, contact Oberheiden, P.C. right away. We’re available 7 days a week. The call is free and it’s confidential.

When Is Healthcare Fraud Criminal?

Healthcare fraud cases can be both civil and criminal. In many healthcare investigations, it is often unclear how a case will be prosecuted. The U.S. Attorney’s Office is divided into a civil and a criminal division that employs federal prosecutors to work in both divisions. The fact that a prosecutor is leading the investigation is not enough of an indication that a case is criminal. This applies to federal agents, as well. Contact from an OIG or FBI agent does not automatically mean that they are making an inquiry about a criminal case. Many agents investigate civil matters.

The determination of the nature of a case can initially depend on a skillful interpretation of the requests made in an OIG subpoena, the tone of the inquiry, or the underlying allegations. There are some indications that would suggest a criminal prosecution rather than a civil matter – warrants, seizure warrants, arrest warrants, issuance of target letters, the involvement of criminal prosecutors, the involvement of the IRS, or the issuance of grand jury subpoenas.

If you’re a Dallas, Texas healthcare provider, facility, or business and you’re being investigated and aren’t sure if it is criminal or civil, please call us now. We’ve represented entire healthcare systems, executives, healthcare practices, individual providers, and other healthcare industry organizations. If you’ve received contact from the DOJ, the DOD, FBI, DEA, OIG, Medicaid Fraud Control Unit, Dallas or Texas law enforcement, or the IRS, don’t wait. Call us now.

Defending Healthcare Fraud in Dallas, Texas

Oberheiden, P.C. has many healthcare fraud defense lawyers who handled healthcare audits and fraud investigations as former employees of the Department of Justice. They are a valuable part of our team and can offer their insights and experience with our Dallas clients. Their insights and experience are part of the reason why we’re able to provide strategic, custom defenses for our clients.

  • Immediate Defense. During an investigation, our number one goal is to help our Dallas clients avoid criminal charges. We believe in intervening as early as possible. This allows us time to make an impact on the investigation. When you retain our criminal defense firm, we will work to protect your rights, freedom, and livelihood. We can answer the most pressing questions you may have in regards to your case: What is the case about? What is the purpose of the investigation? How long will it take? What is the likely outcome?
  • No Criminal Intent. The U.S. Constitution requires the government to prove criminal intent beyond a reasonable doubt. Many prosecutors will attempt to claim that inaccuracies in billing records are evidence of a defendant’s intent. We know that innocent mistakes happen. Innocent mistakes do not equate to fraudulent intent. We can demonstrate that misinformation in billing records can be the result of organizational or human error and not fraudulent intent. We know that unqualified staff, delegation and outsourcing errors, lack of oversight, and insufficient supervision can lead to errors. The constantly changing healthcare system and billing rules can contribute to billing errors, but they should not lead criminal liability.
  • Applicable Legal Defenses. Oberheiden, P.C. has healthcare law experience to introduce applicable defenses and statutory loopholes to defend our clients. For example, we have won many cases by demonstrating how exceptions in the Stark Law and in medical necessity certifications apply to our clients, and either mitigate or entirely nullify the government’s fraud case.
  • Protecting Your Reputation as a Healthcare Provider. Unfounded allegations of fraud in Dallas, Texas go far beyond establishing legal strategies and defense plans against government investigations. Many of our clients are equally concerned about their reputation and their perception in the public. The media has the power to ruin someone’s reputation or to ignite rumors about wrongdoings. Our healthcare fraud defense lawyers routinely intervene upon slanderous reporting. We can obtain news spots and opportunities to correct and rectify errors by educating the audience about the truth.

Oberheiden, P.C. – Dallas Healthcare Fraud Defense Firm

The commitment of Oberheiden, P.C. is to avoid criminal charges and to shield our client’s medical business from government intrusion. Our team of former healthcare prosecutors and experienced healthcare fraud defense attorneys have a distinguished history of protecting business owners, executives, lawyers, physicians, hospitals, laboratories, pharmacies, healthcare entities, and many other healthcare organizations against any form of alleged healthcare fraud. Here are some recent examples of our case outcomes.

  • Representation of a pharmacy investigated by the Department of Defense and the Office of Inspector General for Tricare fraud.
    Result: No civil or criminal liability.
  • Representation of a marketing group investigated by the Department of Defense and the Office of Inspector General for Tricare fraud.
    Result: No civil or criminal liability.
  • Representation of physicians investigated by the Department of Defense and the Office of Inspector General for Tricare fraud.
    Result: No civil or criminal liability.
  • Representation of laboratory against an investigation by the Department of Justice and the U.S. Attorney’s Office for Alleged Medicare fraud.
    Result: No civil or criminal liability.
  • Representation of laboratory against an investigation by the Department of Health and Human Services and the U.S. Attorney’s Office for Alleged Medicare fraud.
    Result: No civil or criminal liability.
  • Representation of laboratory against an investigation by the Department of Justice and the U.S. Attorney’s Office for alleged Tricare fraud.
    Result: No civil or criminal liability.
  • Representation of a healthcare services company against an investigation by the Office of Inspector General, the Department of Justice, and the Department of Health and Human Services for alleged False Claims Act and Stark Law violations.
    Result: No civil or criminal liability.
  • Representation of a healthcare marketing group against an investigation by the Office of Inspector General for alleged healthcare fraud.
    Result: No civil or criminal liability.
  • Representation of a physician against an investigation by the Department of Health and Human Services and the U.S. Attorney’s Office for alleged Medicare fraud, Stark Law Violations, and Anti-Kickbacks.
    Result: No civil or criminal liability.
  • Representation of Laboratory against an Investigation by the Department of Justice and the Office of Inspector General for Alleged False Claims Act and Medicare violations.
    Result: No civil or criminal liability.
  • Representation of Physician Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud and False Claims Act violations.
    Result: No civil or criminal liability.
  • Representation of Physician Investigated by the Office of Inspector General for Medicaid Fraud and Stark Law violations.
    Result: No civil or criminal liability.
  • Representation of Healthcare Organization Investigated by the Department of Justice and the Office of Inspector General for Medicare fraud.
    Result: No civil or criminal liability.
  • Representation of Physician Group Investigated by the Department of Justice and the Office of Inspector General for Medicare Fraud, Stark Law Violations, and False Claims Act violations.
    Result: No civil or criminal liability.
  • Representation of Physician Group Investigated by the Department of Health and Human Services and the Office of Inspector General for False Claims Act violations.
    Result: No civil or criminal liability.
  • Representation of a Physician Investigated by the Department of Defense and the Office of Inspector General for Tricare fraud.
    Result: No civil or criminal liability.
  • Representation of Pharmacy Investigated by the Department of Justice and the Office of Inspector General for Department of Labor Program Fraud.
    Result: No civil or criminal liability.
 

Call us today and speak to one of our experienced attorneys directly. We are available to discuss your situation in a free and confidential call, including on weekends.

888-680-1745
Including Weekends
Oberheiden, P.C.Serving: Allen, Arlington, Balch Springs, Bedford, Burleson, Carrollton, Cedar Hill, Cleburne, Colleyville, Coppell, Denton, DeSoto, Duncanville, Euless, Farmers Branch, Flower Mound, Fort Worth, Frisco, Garland, Grand Prairie, Grapevine, Greenville, Haltom City, Hurst, Irving, Keller, Lancaster, Lewisville, Little Elm, Mansfield, McKinney, Mesquite, North Richland Hills, Plano, Richardson, Rockwall, Rowlett, Sachse, Southlake, The Colony, Waxahachie, Weatherford, Wylie
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, P.C. is a Texas LLP with headquarters in Dallas. Dr. Oberheiden limits his practice to federal law.

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