Miami Healthcare Fraud Defense Attorneys
Miami healthcare providers are often the target of high-stakes healthcare fraud investigations that can jeopardize their practice and potentially ruin their careers. If you suspect that you are under investigation, you need our experienced Miami healthcare fraud defense attorneys of Oberheiden, P.C.
Healthcare providers are currently being targeted for possible violations of healthcare laws and regulations. Aggressive prosecutors and authorities from the Department of Justice, Federal Bureau of Investigation, Medicare Fraud Strike Force, Health and Human Services Office of Inspector General, and Healthcare Fraud Unit launch extensive investigations into local healthcare providers whom they suspect of myriad healthcare law violations.
Miami is home to one of nine cities with an established federal healthcare fraud task force. Investigators are constantly looking for providers who have violated federal statutes. When you are confronting charges brought by this task force or other federal agencies, it is critical that you seek legal assistance from a criminal defense lawyer who is experienced in healthcare fraud defense.
Oberheiden, P.C. offers healthcare fraud defense for medical providers, businesses, and entities that have found themselves targeted by federal agencies. Our Miami, Florida healthcare fraud defense attorneys offer over 100 years of combined legal experience that they put to use to quickly design a legal defense that is customized to your particular situation.
What Is Healthcare Fraud?
Healthcare fraud involves submitting false or misleading information in order to receive healthcare benefits or payments for them. Healthcare fraud can be brought under a variety of federal or state statutes, which further define the crime and the potential penalties.
Federal Healthcare Fraud Charges
One common statute that federal prosecutors use in healthcare fraud cases is 18 U.S.C. § 1347. This law defines healthcare fraud as the knowing and willful execution or attempt to execute a scheme to defraud any healthcare benefit program or to falsely obtain any benefit of a healthcare program.
To secure a conviction under this law, the federal prosecutor must prove the following legal elements by proof beyond a reasonable doubt:
- The defendant knowingly and willfully executed or attempted to execute a scheme to defraud a healthcare benefit program or falsely obtained a benefit of a healthcare program.
- The defendant made false statements that related to a material fact.
- The defendant acted in a willful manner and intended to defraud the healthcare benefit program.
- The defendant’s actions were in connection with the delivery of healthcare benefits, items, services, or the payment for them.
The potential penalty for conviction of this offense is up to ten years imprisonment along with additional fines.
There are many other statutes that federal prosecutors can use to charge individuals and entities with healthcare fraud. Federal authorities may use the following laws to prosecute Miami healthcare providers:
- False Claims Act – This law is designed to protect the federal government from being overcharged for goods or services, including reimbursements from Medicare. The False Claims Act allows federal authorities to charge violations per each false claim that can result in significant penalties to healthcare providers and possible exclusion from further billing to the program. Additionally, it provides rewards for whistleblowers, which may motivate reports from anonymous sources.
- Anti-Kickback Statute – The Anti-Kickback Statute makes it illegal for an individual to pay or receive anything of value in exchange for referrals to Medicare and other government healthcare programs.
- Stark Law – The Stark Law prohibits doctors from referring Medicare patients to entities in which the doctor or an immediate family member has an ownership or investment interest.
- Controlled Substances Act – The Drug Enforcement Agency is responsible for investigating potential criminal violations of drug laws, including monitoring physicians for writing prescriptions for unnecessary medication or selling prescriptions.
State Healthcare Fraud Charges
Many instances of healthcare fraud may be prosecuted simultaneously at the state and federal level. Several healthcare programs are based on both federal and state law. For example, Medicaid is a program that is run by the state and federal government. Therefore, a person may be charged with both state and federal charges for Medicaid violations.
Florida law defines healthcare fraud as making a misrepresentation or intentionally deceiving a healthcare program, knowing that the deception results in an unauthorized benefit to the individual or a third party. Most forms of healthcare fraud in the state are considered third-degree felonies.
Types of Healthcare Fraud
There are several activities that can rise to the level of healthcare fraud, including the following:
- Billing for services not rendered
- Fraudulent billing for a non-patient
- Billing for more hours than those rendered
- Duplicate billing
- Illegal fee sharing
- Billing for unnecessary services
- Falsification of credentials
- False cost reports
- Accepting kickbacks
- Illegal prescribing of medications
- Nurses ordering medications without the approval of the physician
- Counterfeit prescriptions
- Theft or sale of patient medications
- Forging prescriptions
If you have been charged with one of these offenses or another healthcare fraud violation, it is imperative that you retain a skilled Miami healthcare fraud defense lawyer who will quickly get to work on your case. Oberheiden, P.C., is available 24/7. Our Miami healthcare fraud defense lawyers can schedule a confidential consultation during which one of our seasoned healthcare fraud defense lawyers will discuss your situation with you and explain how we can help.
Why You Should Choose the Miami Healthcare Fraud Defense Attorney at Oberheiden, P.C., for Your Defense
When extreme penalties are at stake (such as possible imprisonment, the loss of a medical license, and the possibility of being ordered to pay exorbitant fines), it is important that you engage a federal defense law firm as soon as possible. Clients throughout Miami, Florida, and the rest of the country choose the experienced and proven Miami healthcare fraud defense lawyer at Oberheiden P.C., for the following reasons:
- Experience – Our firm has handled thousands of cases involving healthcare fraud defense. Some of our healthcare fraud lawyers are former federal prosecutors who know how the other side works and what holes they may have in their case. Our team leverages over a century’s worth of legal experience in healthcare fraud defense in complex and high-stakes cases involving federal criminal charges.
- Robust track record – We have a proven track record of securing favorable outcomes and have even convinced prosecutors to drop criminal charges against our clients. Our Miami healthcare fraud defense attorneys have helped many clients avoid federal indictments by providing early intervention in their case. We have often been able to stop federal investigations in their tracks long before charges are filed. Additionally, we have prevented many defendants from having to serve any prison time. Every client whom we have represented who was subject to a False Claims Act investigation has not been held criminally or civilly liable. Also, we have negotiated significant civil penalties to nominal amounts. We implement proven strategies that have garnered favorable outcomes for former clients.
- Focus – Federal task forces and authorities devote extensive resources to healthcare fraud investigations and prosecutions. It is important that you mount a strong defense against these charges. Your attorney will focus on your case and employ proven strategies to defend you against serious charges. We have the knowledge and experience to lodge a strong defense on your behalf.
- Customized legal representation – Our experienced attorneys know that every case is unique. We will create a customized defense strategy, commencing with an effective and aggressive defense from the start. We will explore all options about how we can resolve your case with a favorable outcome, including providing assistance to prosecutors in another case in exchange for dropping charges against you. Our skilled Miami healthcare fraud defense attorneys can also try to broker a favorable plea agreement that may help avoid prison time, such as seeking probation or alternatives to incarceration. We understand that your future and your freedom are at stake, and we will work tirelessly on your case.
- Ready for a courtroom battle – Our attorneys can advise you on whether early resolution is in your best interest or if it is preferable to proceed to trial. Our attorneys have represented clients in many trials and supervised many others. Our Miami healthcare fraud defense lawyers are recognized for their aggressive trial practice.
Frequently Asked Questions
Which government agencies prosecute healthcare fraud?
There are several federal government agencies responsible for prosecuting healthcare fraud, including:
- Centers for Medicare and Medicaid Services (CMS)
- Department of Defense (DOD)
- Department of Health and Human Services (HHS)
- Department of Justice (DOJ)
- Department of Labor (DOL)
- Drug Enforcement Administration (DEA)
- Federal Bureau of Investigation (FBI)
- Office of Inspector General (OIG)
While some of these agencies specialize in healthcare fraud, others maintain a focus on law enforcement in more of a general sense. Depending on the nature of the alleged violation, how it was reported, and whether criminal liability is anticipated, charges may be brought by any of these agencies. No matter which federal agency is investigating your practice or business, it is imperative to contact a dedicated Miami federal healthcare fraud defense attorney as soon as you learn you are at the center of a federal healthcare fraud investigation.
Can healthcare fraud result in criminal charges?
Yes, there are several statutes that allow for federal prosecutors to pursue criminal charges based on allegations of healthcare fraud. Some statutes, such as the False Claims Act, allow for both civil or criminal penalties, depending on the circumstances. The general rule is that criminal liability does not attach to a provider’s negligent actions—as opposed to intentional misconduct. However, there is often a fine line between the two. Therefore, it is in your best interest to contact an experienced Miami, Florida federal healthcare fraud defense attorney to learn more about the allegations if you are under investigation for healthcare fraud.
When should I reach out to a Miami federal healthcare fraud defense attorney?
In a federal healthcare fraud investigation, the sooner you reach out to a Miami, FL federal healthcare fraud defense attorney, the more options your attorney will have to help avoid the most severe consequences of the investigation. Typically, an attorney’s early involvement in an investigation can help clear up any misunderstandings and, more importantly, prevent the subject from making any critical errors when speaking with investigators. In many instances, federal investigators rely on statements made by a subject during the course of the investigation. The last thing you want is to speak with investigators thinking you are helping your situation, but end up putting yourself in the middle of the investigation. If you are under investigation for federal healthcare fraud, do not wait to contact a lawyer. Reach out to an experienced Florida federal healthcare fraud defense lawyer today.
When are physician kickbacks not allowed?
Kickbacks and referral fees are common in the medical industry. However, there are several instances in which a referral arrangement can run afoul of federal healthcare fraud laws. For example, the Eliminating Kickback in Recovery Act forbids accepting or paying kickbacks for referrals to recovery homes, clinical treatment facilities, or laboratories. The Anti-Kickback Statute forbids paying or receiving anything of value for referring a patient whose medical bills are being covered by a federally funded program. Lastly, the Stark Law imposes civil liability on providers who refer patients to another practice that they have a financial interest in. Therefore, while nothing forbids referral arrangements, practitioners should consult with a Miami, FL federal healthcare fraud defense attorney to make sure that an arrangement is permissible.
Speak with our Miami Healthcare Fraud Defense Lawyers Today
If your Miami healthcare business, practice, or organization is currently under investigation, please call Oberheiden, P.C., to schedule an initial consultation with a skilled Miami healthcare fraud defense attorney. Our team can immediately get started on your case to mount an aggressive defense or help you create a compliance program. We have over 100 years of combined experience in defending clients against charges that can result in imprisonment, significant monetary fines, and damage to their reputations. Call our Miami healthcare fraud defense lawyers today at 888-680-1745 or contact us online to schedule your confidential consultation.
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