Tampa, Florida Healthcare Fraud Defense Lawyers
Tampa healthcare providers are at risk for being targeted in federal investigations. If you have received a target letter, subpoena, or any other form of contact from the U.S. Department of Justice (DOJ), Drug Enforcement Administration (DEA), Internal Revenue Service (IRS), Office of Inspector General (OIG), or another federal law enforcement agency, call 888-680-1745 now for a free and confidential case assessment.When facing a federal healthcare fraud investigation, executing a proactive defense strategy is the key to mitigating the risk of civil charges or a criminal indictment and the potential for prosecution in federal district court. These investigations can move quickly. And by the time that you discover your healthcare practice or business is being targeted, the government has already begun building its case against you. To stop federal agents and prosecutors in their tracks, you need to intervene in the investigation as soon as possible. This means hiring experienced legal representation. At Oberheiden, P.C., we routinely represent clients in Tampa, throughout Florida, and nationwide in federal healthcare fraud investigations. Our attorneys have handled thousands of investigations, and they have centuries of combined experience as defense attorneys and former prosecutors with the U.S. Department of Justice (DOJ). If you are being targeted by the DOJ, Drug Enforcement Administration (DEA), Internal Revenue Service (IRS), Office of Inspector General (OIG), or another federal law enforcement agency, this is the type of experience you need on your side. We are available 24/7 and our attorneys can act immediately on your behalf, if necessary. So call 888-680-1745 now to discuss your case in confidence.
Understanding What It Means to Be Accused of “Healthcare Fraud”What does it mean to be accused of healthcare fraud? In the context of a federal investigation, it means that the government has reason to believe that you (or someone else within your practice or business) may have improperly billed Medicare, Medicaid, Tricare, or the Department of Labor (DOL). It may also mean they suspect that you have unlawfully used program-reimbursed funds to pay referral fees or other improper forms of compensation. Specific allegations can range from upcoding or unbundling services (which is commonly the result of honest human error by billing administrators) to improperly prescribing opioid medications (which is often a matter of medical judgment). As a result, in order to defend against the government’s investigation effectively, you need to discern the specific allegations against you. Defending against allegations of billing violations is very different from defending against allegations of prescription drug fraud. You also need to know whether the government’s investigation is civil or criminal in nature. This is because the nature of the investigation determines both (i) the full scope of the defenses you have available, and (ii) the potential penalties that are on the table. When you engage our federal healthcare fraud defense team to represent you, uncovering the scope and nature of the government’s investigation will be our first priority. We will quickly intervene in the investigation on your behalf, and we will use our extensive experience and deep knowledge of the federal healthcare system to determine your potential exposure. Armed with this information, we can quickly craft a custom-tailored defense strategy and we can begin executing this strategy immediately in order to try to prevent charges from being filed. Additionally, if the investigation is currently civil in nature, we can work to keep it this way so that federal prison time is not on the table.
Federal Statutes Used to Investigate and Prosecute Healthcare Fraud
1. The False Claims ActUnder the False Claims Act (FCA), it is unlawful to submit any “false or fraudulent” claim for reimbursement to Medicare, Medicaid, Tricare, or the DOL. This includes the intentional or unintentional submission of an inaccurate request for payment. In civil cases (involving unintentional violations), potential penalties include recoupments, treble damages (three times the government’s actual losses), civil monetary penalties, and program exclusion. In criminal cases (involving intentional violations), potential penalties include fines and up to five years in prison for each individual offense.
2. The Anti-Kickback StatuteThe Anti-Kickback Statute (AKS) applies to rebates, referral fees, and other forms of “remuneration” paid out of federally-reimbursed program funds. It applies to providers and other entities and individuals who offer, solicit, pay, or receive unlawful remuneration. And similar to the False Claims Act, it includes provisions for both civil and criminal penalties.
3. The Stark LawThe Stark Law also prohibits the payment of referral fees, but it applies exclusively to physicians and their related entities. Also unlike the Anti-Kickback Statute, the Stark Law is exclusively civil in nature. The Stark Law applies to referrals fees paid in connection with the provision of “designated health services,” which include:
- Clinical laboratory services
- Physical therapy services
- Occupational therapy services
- Outpatient speech-language pathology services
- Radiology and certain other imaging services
- Radiation therapy services and supplies
- Durable medical equipment and supplies
- Parenteral and enteral nutrients, equipment, and supplies
- Prosthetics, orthotics, and prosthetic devices and supplies
- Home health services
- Outpatient prescription drugs
- Inpatient and outpatient hospital services
4. The Controlled Substances ActThe Controlled Substances Act imposes criminal penalties for prescription drug fraud, including the issuance of unnecessary prescriptions, the improper filling of prescriptions, and prescription drug diversion. Providers charged under the Controlled Substances Act can face criminal penalties. And even if a violation does not rise to the level of a federal crime, it can still result in the loss of your DEA registration.
5. The Federal Healthcare Fraud StatuteThe healthcare fraud statute, 18 U.S.C. 1347, makes it a criminal offense to, “knowingly and willfully execute, or attempt to execute, a scheme . . . to defraud any healthcare benefit program . . . [or to obtain] money or property owned by, or under the custody or control of, any healthcare benefit program [by false pretenses].” Most violations of 18 U.S.C. 1347 carry a maximum prison sentence of 10 years. However, violations resulting in serious bodily injury carry a maximum sentence of 20 years, and violations resulting in death carry the potential for life behind bars.
6. Other Federal Criminal StatutesThere are a number of other federal statutes that can come into play in criminal healthcare fraud investigations as well. Due to the breadth of these statutes, providers will often be at risk for facing multiple counts simply by virtue of engaging in a fraudulent healthcare-related transaction (and under the criminal conspiracy statute, it is not even necessary to submit a false or fraudulent claim in order to face charges). Common charges in criminal healthcare fraud cases include:
- 18 U.S.C. 371 (criminal conspiracy)
- 18 U.S.C. 1028A (identity theft)
- 18 U.S.C. 1341 (mail fraud)
- 18 U.S.C. 1343 (wire fraud)
- 18 U.S.C. 1344 (bank fraud)
- 18 U.S.C. 1357 (money laundering)
- 21 U.S.C. 841 (distribution of controlled substances)
- 26 U.S.C. 7206 (tax fraud)
Is Your Tampa Healthcare Business or Practice Under Investigation? Here Are Five Reasons to Put Oberheiden, P.C.’s Federal Healthcare Fraud Defense Team on Your Side.If you need legal representation for an investigation involving the DOJ, DEA, IRS, OIG, or any other agency or task force in Tampa, here are five reasons to choose the federal defense lawyers at Oberheiden, P.C.:
- We Have Extensive Experience in Federal Healthcare Fraud Investigations. Our attorneys have represented clients in federal healthcare fraud investigations across the country.
- We Will Work with You, One-on-One, to Develop a Comprehensive and Custom-Tailored Defense Strategy. Our senior attorneys work with clients personally and in-depth in order to craft defense strategies that are designed to succeed under the specific facts at hand.
- We Will Work Diligently to Resolve Your Investigation Without Charges Being Filed. In every case, our goal is to fully protect our client by terminating the government’s investigation without charges being filed.
- We Will Make Ourselves Available to You 24/7. When our clients need us, we answer the call. You can expect to reach our federal healthcare fraud defense team 24/7.
- If Necessary, We Will Use our Federal Trial Experience to Fight for You in Court. Many of our healthcare fraud lawyers are seasoned litigators, and we do not back down when it is in our clients’ best interests to go to trial.