Fayetteville Health Care Fraud Defense Attorneys
Decisive Health Care Fraud Defense Attorneys Representing Fayetteville, Arkansas Providers in Audits, Investigations, and Prosecutions
Health care providers in Fayetteville, Arkansas and other cities around the nation are facing increased scrutiny from federal authorities. Due to the high cost of fraud schemes targeting Medicare, Medicaid, Tricare, and other government benefit programs, senior officials at multiple agencies throughout the government have been tasked with taking an aggressive approach to stopping waste and abuse.
While this means that many fraud artists and organized crime syndicates are being taken down, it also means that legitimate providers are being targeted in audits and investigations as well. Today, these audits and investigations are routine occurrences for physicians, pharmacists, hospitals, hospices, home health care providers, durable medical equipment (DME) companies, and others in the Fayetteville, AR area. With the government’s focus on stopping waste and abuse, even simple human errors have the potential to lead to severe consequences, and even the suggestion of intentional overbilling can result in a criminal investigation.
About Oberheiden, P.C.
Oberheiden, P.C. is a team of experienced Fayetteville health care fraud defense attorneys and former federal prosecutors who represent health providers and related entities in federal fraud matters. We bring decades of experience to representing clients in audits and investigations, and we have a proven track record of vigorously protecting our clients’ interests at trial. If your business or practice is being targeted by the government, prompt intervention is critical. We can take immediate action to protect you, and our team of attorneys will work closely with you and your key personnel in order to execute a defense strategy designed to secure the best possible result as quickly as possible.
“Trustworthy attorney who also understands the compliance, legal and business aspects of our group”
“Our companies have worked with firms all over the country within various specialties and now use [Oberheiden, P.C.] almost exclusively. Nick represented our companies in some federal law investigations. His guidance and expertise allowed us to continue to concentrate on our core business as he dealt with the complex legal issues.” – Satisfied Client“The very best!”
“I hired Nick Oberheiden and Oberheiden, P.C. to defend me in a criminal health care matter. From the first moment I met with Nick[,] my wife and I knew that he [would provide] the help I need[ed]. And yes, Nick got me out of trouble. No charges. Case Dismissed.” – Satisfied Client
Fayetteville, Arkansas Health Care Companies are Being Targeted in Federal Fraud Investigations
Due to its location and the number of providers in the area, Fayetteville, AR has become a prime target in the federal government’s fight against health care fraud. Federal authorities such as the U.S. Department of Justice (DOJ), and the U.S. Department of Health & Human Services’ (DHHS) Office of Inspector General (OIG) rely heavily on data analytics to identify potential “hot spots” for Medicare, Medicaid, and Tricare fraud and abuse. When the data suggest that providers in a particular region of the country are receiving program reimbursements at a disproportionate rate, these authorities will focus their enforcement efforts in that region, and it is not uncommon for numerous providers to suddenly find themselves the targets of federal investigations.
Recent developments indicate that Fayetteville, AR health providers are currently in the DOJ’s and OIG’s crosshairs. Our attorneys are prepared to represent local health entities, licensed professionals, and company executives and board members in cases involving allegations of:
- False and Fraudulent Claims. The False Claims Act (FCA) imposes civil and criminal penalties for the submission of “false and fraudulent” claims to Medicare, Medicaid, Tricare, and other government benefit programs. This includes reimbursement claims that are intentionally overstated as well as those that are inaccurate (or “false”) due to simple human error. If someone within your business or practice made a mistake, we will tailor our defense strategy to helping you avoid potential criminal liability.
- Illegal Kickbacks, Bribes, and Referral Fees. The Anti-Kickback Statute is another law that includes both civil and criminal penal provisions. This law prohibits the offering, solicitation, payment, or receipt of any form of compensation for a patient referral when the compensation comes directly or indirectly from a federal health benefit program. The Anti-Kickback Statute’s prohibitions are broad, but it contains numerous “safe harbors” as well. We have a deep understanding of the Anti-Kickback Statute and we can use its protections to your advantage.
- Illegal Physician “Self-Referrals”. Under the federal Stark Law, it is illegal for physicians to refer patients to “related” entities for financial benefit. The entities that receive illegal “self-referrals” can face penalties under the Stark Law as well. We have extensive experience in Stark Law matters, and we can use our experience to protect your business or practice.
- Prescription Drug Fraud. The DOJ, the Drug Enforcement Administration (DEA), and other federal agencies are also specifically targeting providers suspected of having any involvement in the dispensing or administration of illegal prescriptions. With the current administration’s prioritization of the fight against opioid abuse and dependence, providers in Fayetteville, AR who deal in prescription narcotics are particularly susceptible to federal inquiry.
- Billing and Coding Fraud. Intentional and unintentional billing errors (also known as “coding fraud”) are frequently the focus of federal health care fraud investigations as well. We routinely represent providers that are facing allegations of upcoding, phantom billing, double-billing, billing for medically-unnecessary services, and other forms of billing and coding fraud.
- Fraudulent Physician Certifications. Hospices, home health agencies, and physicians that certify patients for hospice or home care are increasingly facing investigations targeting allegations of fraudulent certifications. Our attorneys have represented numerous hospices, home health agencies, and physicians in these types of cases, and we have had significant success helping our clients overcome misguided accusations.
Q&A with Health Care Fraud Defense Attorney Nick Oberheiden, PhD
Q: I just learned that my practice is being investigated. 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 fraud depend on the specific statute (or statutes) at issue. Most cases involve allegations under the False Claims Act. In a civil case under the FCA, the penalties can include recoupments, treble (triple) damages, fines, program exclusion, and other financial penalties. 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 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: How do I know what statutes I am accused of violating and whether my case is civil or criminal?
Surprisingly to many Fayetteville-area providers, this is not as straightforward as it seems. It is not always easy to discern the scope or nature of the government’s investigation. When our attorneys get involved in your case, one of our first steps will be to make contact with the investigators and prosecutors involved in order to obtain the specifics of the allegations against you.
Strategic Defense for Health Care Providers in Fayetteville, Arkansas
At Oberheiden, P.C., we take a strategic approach to every case that utilizes our attorneys’ decades of experience as federal prosecutors and in private practice. Even though it may be your business that is under investigation, your professional reputation and license could be at stake, and minimizing the potential consequences requires careful attention to the unique details of your particular case.
Our strategic approach to defending health providers in Fayetteville, AR 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.
- Doing everything possible to preserve your professional reputation and resolve the investigation without your business or practice being put in jeopardy.
Schedule a Confidential Case Evaluation With an Experienced Fayetteville Health Care Fraud Defense Attorney
Our team of Fayetteville health care fraud defense attorneys is available to begin working on your case immediately. To speak with our attorneys in confidence, please call (214) 692-2171 or request a free case evaluation online now.