Experienced Health Care Fraud Defense Attorneys Representing Physicians in Opioid Fraud Prosecutions
Former DOJ-Prosecutors & Experienced Counsel
Pain management physicians are under attack. The Drug Enforcement Administration (DEA) and other law enforcement agencies have dramatically increased their investigations of high volume pain drug prescribers. By virtue of their specialty, pain management physicians and psychiatrists are among the top targets of the “Opioid Fraud and Abuse Detection Unit,” a special unit of federal agents and prosecutors tasked to arrest and prosecute operators of so-called pill mills.
Almost no day goes by without new arrests of medical providers and pain management staff members. Doctors in Pittsburgh, Philadelphia, Boston, New York, Dallas, Houston, Detroit, Shearman, New Orleans, Denver, Las Vegas, Los Angeles, and many more cities across the United States are currently charged with intentional violations of the Controlled Substances Act, in particular Title 21 U.S.C. Section 841, which renders unlawful prescription practices a federal felony.
In this climate of raids, arrests, and prosecutions, guidance from experienced federal attorneys can make the difference between a safe medical practice and years of incarceration.
About Oberheiden, P.C.
Oberheiden, P.C. is a team of experienced defense attorneys and former federal prosecutors who represent health care providers and business owners in federal health care fraud matters. We bring decades of experience to representing clients in audits and investigations. On top, we have a proven track record of vigorously protecting our clients’ interests at trial.
Our experience includes:
- More than 70 years of Department of Justice experience
- Avoided criminal charges in hundreds of healthcare cases
- Handled more than 1,000 healthcare investigations
- Conducted more than 500 criminal trials
- Dismissal of state and federal indictments
Oberheiden, P.C. does not use junior lawyers or associates. All clients have direct access to experienced lawyers with specific backgrounds in healthcare fraud defense and healthcare compliance cases.
If your practice is being targeted by the government, prompt intervention is critical. We can take immediate action to protect you, and our attorneys will work closely with you and your trusted staff to establish and execute a comprehensive defense and protection strategy.
What Are the Allegations in Prescription Fraud Investigations?
Simply put, all prescription fraud prosecutions have in common that the government accuses medical provider to dispense controlled substances without a legitimate medical purpose and contrary to customary medical standards.
Specifically, 21 Code of Federal Regulations Section 1306.04 provides the following limitations to prescriptions issued under the Controlled Substances Act:
“[A] prescription for a controlled substance to be effective must be issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice. The responsibility for the proper prescribing and dispensing of controlled substances is upon the prescribing practitioner, but a corresponding responsibility rests with the pharmacist who fills the prescription.”
Of particular focus are those drugs that fall under the Controlled Substances Act Schedule II and Schedule III, in particular narcotic drugs involving oxycodone and acetaminophen such as OxyContin, Perocet, Percocet, Percodan, Endocet, Roxicet, Roxilox, Tylox, MS Contin, Docusate Sodium, Zanaflex, Colace, Motrin and similar brands.
- Casual Schedule I, II, III Prescription Policies
- Lack of Appropriate Physical Examination
- Delegation of Medical Duties to Administrative Staff
- Insufficient Monitoring, Enforcement of Drug Usage
- Financial Arrangement with Pharmacy
Auditors and investigators focus on doctor offices that see a high percentage of narcotic patients, patients that receive pain drugs from multiple doctors, as well as offices that accept cash payments in exchange for prescription refills. Undercover agents, appearing as regular patients, visit physician offices to record and film the extent of physical examinations and prescription counseling as part of their evidence gathering for insufficient compliance with the Controlled Substances Act.
Most clients are completely shocked to hear that they are accused of running a pill mill. In fact, many clients are seasoned physicians with extensive training in pain management and addiction behavior that have spent enormous time and resources ensuring rigid compliance with all applicable healthcare regulations. Simply put, many patients suffer from chronic pain and display severe symptoms of physical discomfort. To many of these patients, medication management is about the only treatment option left, when surgeries and interventional pain procedures are exhausted.
If you are accused of running a pill mill or if you were charged with prescription fraud, you must understand that while the allegations are serious, experienced defense attorneys can and will identify valid defenses.
Oberheiden, P.C. has the resources and the experience to help you. Many of our attorneys previously supervised healthcare investigations at the Department of Justice and they have in intimate understanding of how the government builds a case and what to do against it.
What Are the Criminal Charges?
The government is aggressively prosecuting physicians and other prescribers of narcotic medication alleging violations of a plethora of federal criminal statutes. According to recent criminal complaints and indictments, the following offenses are among the most frequently used charges brought in connection with narcotic diversion, prescription fraud, and alleged pill mill operations.
- Controlled Substances Act: 21 U.S.C. 841(a)(1) makes it a felony to knowingly and intentionally distribute or dispense a controlled substance other than in the usual course of professional practice and for a legitimate medical purpose. 21 U.S.C. 846 makes it a crime to attempt or conspire with others to violate Section 841(a)(1).
- Healthcare Fraud: Pursuant to 18 U.S.C. § 1347, a person is guilty of health care fraud if the Government proves beyond a reasonable doubt that the person:
- Knowingly and willfully executes, or attempts to execute, a scheme or artifice
- To defraud any health care benefit program or obtain, by means, of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any health care benefit program
- In connection with the delivery of or payment for health care benefits, items, or services.
- Mail Fraud. It is a federal felony to mail anything through the United States Postal Service or a private commercial carrier for the purpose of carrying out any scheme to defraud. A scheme to defraud includes any type of scheme to take someone’s money or property with false or fraudulent promises.
Pursuant to 18 U.S.C. § 1341, a person is guilty of mail fraud if the Government proves beyond a reasonable doubt that the person uses the mail (United States Postal Service or commercial carrier) in the foreseeable furtherance of a scheme to defraud involving material deception with the intent to deprive another of either money or property.
The former federal prosecutors and attorneys of Oberheiden, P.C. are available to discuss your case. Don’t let the situation get out of control, and don’t let the government build a criminal case against you. Call us today and let us identify your options.
What Can Happen If the Government Targets Your Practice?
The consequences of being a government target can be devastating. Penalties for prescription fraud, healthcare fraud, mail fraud, wire fraud, money laundering, and violations of the Controlled Substances Act range from zero to twenty years and more in prison, loss of medical privileges and licenses, and criminal fines. Without a proper defense strategy, defendants must expect all of the following consequences.
- Raid of Medical Offices
- Execution of Search and Arrest Warrant
- Asset Forfeiture
- Asset Seizure
- Medical License Revocation
- Exclusion from Insurance Plans
Worse, if the case goes out of hand and the government brings charges against you, you will find yourself in the middle of a federal criminal case with your livelihood and your freedom being at serious risk.
- Criminal Felony Charges
- Incarceration in Federal Prison
- Civil and Criminal Fines
Resignation is not an option. Our strategic approach to defending health care providers involves:
- Making immediate contact with the investigators and prosecutors involved in your case in order to intervene in the investigation and collect the key information we need to formulate a tailored defense strategy.
- Evaluating the legal standards that apply based on the nature of the government’s investigation and the unique aspects of your business or practice.
- Exploring all possible defenses to the government’s allegations, including statutory exceptions and safe harbors, factual arguments, and Constitutional protections.
- Being ready to fight the allegations in court.
Oberheiden, P.C. offers clients decades of specific experience with healthcare matters. Choose from among former top prosecutors and dedicated defense counsel. Criminal defense in healthcare matters is not an area to experiment with. Any mistake can cost you your license and your freedom.
Why Do Clients Choose Oberheiden, P.C.?
1. Our Healthcare Trial Experience
We offer clients decades of healthcare defense experience, decades of insights from healthcare enforcement positions within the Department of Justice, more than 1,000 healthcare fraud investigations under our belts, and a litigation experience exceeding more than 500 criminal trials and more than 1,000 grand jury proceedings. All our clients are represented by senior attorneys. We do not use junior lawyers, associates, or paralegals. If you need protection against unjust charges, the former federal prosecutors of Oberheiden, P.C. are your logical first choice.
2. Our Results
Our track record is hard to match. We have avoided criminal charges in healthcare fraud investigations in a large amount of cases for clients from across the United States. We took many of these cases from other lawyers and turned the case around. We have turned targets of federal healthcare fraud investigations into witnesses, we have turned criminal cases into civil fines, and we have shown our full force and expertise in meetings at U.S. Attorney’s Offices and within the country’s courtrooms. We have saved our clients imprisonment obtaining probation outcomes and, in extremely tough cases, we have mitigated decades of jail time to only few years.
3. Our Team
Just like the government works in a team of agents and lawyers, we offer clients a defense team comprised of experienced and talented attorneys. At Oberheiden, P.C., the attorneys in our Health Care Practice Group work together to accomplish the best results for our clients.
The former federal prosecutors and attorneys of Oberheiden, P.C. are available to discuss your case. Find out how experienced prosecutors and defense attorneys assess your situation and what advice they offer to clear your reputation and to protect your license. Calls are free and confidential.
FAQs — Narcotic Diversion & Opioid Prescriptions
Q: I Just Learned that My Practice is Under Investigation. What Do I Need to Know?
If your practice is under investigation, the most important thing you need to know is that an investigation is not a sentence. You are innocent until proven otherwise, and there is a long road ahead before prosecutors can seek civil or criminal penalties against you.
With this in mind, your focus needs to be on your defense strategy. Facing a federal investigation is a serious matter, and you want to resolve the investigation as soon as possible. I encourage you to contact Oberheiden, P.C. so that our health care fraud defense team can start working on your case immediately.
Q: What Are the Penalties for Federal Health Care Fraud?
The penalties for federal health care fraud depend on the specific statute (or statutes) at issue. In a criminal case, the penalties can include:
- Hundreds of thousands of dollars in fines
- Up to 10 years of federal imprisonment for each count of health care fraud
- Up to 20 years of federal imprisonment for each count involving serious bodily injury to a patient
- A life sentence for health care fraud resulting in a patient fatality
Q: Is It Even Worth Fighting?
Yes, absolutely. Resignation is not an option. The government has the burden of proof that you intentionally violated the law. We will pressure the government to meet that heavy burden and introduce decades of negotiation and healthcare law experience.
Q: What Outcome Can I Expect?
In every case, our goal is to resolve our client’s investigation without charges being filed. Oftentimes, closing an investigation favorably is a matter of making prosecutors understand that any apparent violations are in fact compliant with the practice of medicine and the law.
Q: What Are Defenses to Health Care Fraud?
Few people violate the law intentionally, but good people can still make mistakes. We all make mistakes. Our job as your lawyer is to hear your side of the story and to persuade the government that while mistakes might have occurred, these mistakes were the results of staff errors and organizational deficiencies—not as a result of a willful and deliberate conspiracy to defraud the government. As we learn more about your situation, we will be able to identify all of the defenses you have available. Good lawyers listen to their clients and hear their side of the story. Each client story offers defenses and avenues to improve a client’s situation. So, let’s talk. We are curious to hear about your case.
Q: When Should I Seek Legal Representation?
The primary benefit of seeking legal representation during your investigation is to avoid criminal charges. We want to resolve your case as quickly as possible, and this means terminating the investigation before fines and prison time are on the table. By seeking legal representation early, you put yourself into a position to better control the case and its outcome because you have interrupted the government and you are able to present your side of the story to eliminate potential misperceptions.
Compliance – Litigation – Defense