Defending PGX Laboratories Against Medicare Fraud Charges

Specializing in healthcare fraud defense, Oberheiden & McMurrey, LLP has a proven track record of successfully defending laboratories, physicians, and medical service providers against allegations of Medicare fraud.  Led by Dr. Nick Oberheiden, a nationally recognized healthcare fraud defense attorney, our team of attorneys utilizes their experience on both sides of prosecutions to achieve the best possible outcome for laboratories facing investigation for Medicare fraud.

PGX Medicare Fraud

Medicare fraud occurs when an individual or entity takes advantage of the Medicare program by receiving or making payments for medical services in violation of healthcare regulations.  Medicare fraud charges may be civil or criminal, and they may result from violation of one or more of several statutes, including the False Claims Act, the Anti-Kickback Statute, the Physician Self-Referral Laws (Stark Law), the Social Security Act, or the U.S. Criminal Code.  Among laboratories, including PGX laboratories, Medicare fraud often involves the laboratory improperly compensating physicians for patient referrals or the laboratory submitting inaccurate bills to Medicare.

Defending Medicare Fraud Charges

Lack of Evidence. All defendants are innocent until proven guilty, and the prosecutors bear the heavy burden of proving a defendant’s guilt beyond a reasonable doubt.  In the case of defendants accused of Medicare fraud, the prosecution’s burden includes demonstrating that the defendant intended to commit the fraudulent conduct.  At Oberheiden & McMurrey, LLP, we routinely defeat allegations of Medicare fraud by demonstrating that the prosecution has failed to present sufficient evidence that our client committed the alleged fraud.  We regularly achieve the following outcomes for our clients:

• Case Dismissed
• Avoidance of Criminal Charges
• License Maintained
• Civil Fine, No Criminal Plea
• Misdemeanor, No Felony
• No Jail Time

Lack of Intent.  Through our years of experience with the healthcare industry, we understand how and why innocent mistakes may happen through human or organizational error.  We have seen how laboratories, concerned with servicing patients or distracted by the demands of running a business, have inadvertently run afoul of the labyrinthine web of healthcare regulations.  Common causes of such mistakes include:

• Unqualified Staff
• Supervision Errors
• Delegation & Outsourcing
• Structural Deficits
• Organizational Mistakes
• Human Error
• Lack of Oversight and Overwhelmed Supervisors
• Lack of Compliance Program
• Constantly Changing Rules

Armed with this knowledge, we have helped many laboratories defeat charges of Medicare fraud by proving to investigators and juries that our clients lacked the requisite criminal intent to commit fraud.  The laboratories we represent do not have to make plea deals or accept charges of fraud merely for negligently overseeing the operations of their businesses.

Experienced Medicare Fraud Defense Attorneys

Comprised of former healthcare prosecutors and experienced healthcare defense attorneys, Oberheiden & McMurrey, LLP protects laboratories, medical services providers, and physicians nationwide against charges of Medicare fraud, including fraudulent billing practices or violations of anti-kickback laws.

• Nick Oberheiden is a Harvard-trained and internationally educated healthcare fraud defense attorney. Nick has successfully represented healthcare executives, business owners, public officials, physicians, and lawyers in high profile prosecutions, scores of political corruption, government investigations, and media campaigns, including 60 Minutes. He is most known for stopping federal investigations before criminal charges can be filed. In addition to his healthcare defense practice, Nick leads internal investigations, implements corporate compliance programs, and teaches U.S. criminal law and federal litigation in the United States and abroad.

• Attorney Lynette S. Byrd focuses her practice on civil and criminal litigation, Medicare and insurance audits, and general advice and counseling in health care law. She is a former Assistant United States Attorney with years of substantial trial experience under her belt who merges excellent litigation skills with profound understanding of the law.