Forth Worth Health Care Fraud
Effective Federal Lawyers Defend FBI, DEA, and OIG Health Care Fraud Investigations in Fort Worth
Just like the rest of the country, Fort Worth is experiencing new heights of federal health care fraud investigations. The U.S. Attorney’s Office in Fort Worth and in Dallas, two important divisions of the Department of Justice for the Northern District of Texas, utilize specialized and highly trained federal agents to discover any form of wrongdoing amongst providers and health business owners. While focus of the investigations are violations of the Medicare and Medicaid laws, Stark Law, the False Claims Act, and the Anti-Kickback Statute, there is also a noticeable push to identify prescribers and corresponding pharmacies associated with high amounts of opioid prescriptions.
Oberheiden, P.C. Is a Defense Team of Former Justice Department Lawyers — Right Here in DFW, Texas
Oberheiden, P.C. understands health care audits and investigations. After all, many of our lawyers previously worked at the U.S. Attorney’s Office in Dallas, where they coordinated civil and criminal health care fraud, kickback investigations, Medicare fraud and CMS audits, and criminal health fraud trials.
Our DFW office covers:
- Former Health Care Prosecutors, Dallas-Fort Worth Office
- 1000 health care fraud investigations
- Dismissal of state and federal indictments
- 70 years of Department of Justice experience
Many of our attorneys previously supervised FBI, DEA, and OIG health care investigations at the Department of Justice in Dallas-Fort Worth and are perfectly familiar with the investigative techniques and effective defense strategies. We have obtained “No Civil, No Criminal Liability” outcomes for physicians, dentists, mental health providers, marketing companies, pharmacies, toxicology laboratories, home health agencies, hospice agencies, sober living groups, and many other health care clients in Dallas Fort Worth accused of fraud with respect to the following matters.
- Medicare Fraud
- Medicaid Fraud
- Stark Law (Physician Self-Referral Laws)
- False Claims Act
- Anti-Kickback Statute
- Controlled Substances Act
- Fraud Against Private Insurance Companies
- CMS and Medicare Audits
For many of our satisfied clients, we are among the best federal defense lawyers in the DFW area. We sure are the only law firm in North Texas with a concentration on health care fraud defense.
Visit our DFW office and call us immediately if you are concerned about a potential fraud allegation against you or your business. Let us take care of these concerns so that you can continue your business. As we have for so many other clients in Dallas, Fort Worth, and across the country — we will find a way to help you.
We Help Fort Worth Clients With the Following Audits and Fraud Investigations
North Texas, Dallas, and Fort Worth are declared centers of health fraud investigations. Nationwide there are only seven cities that receive special federal funds and that have specialized task forces to prosecute fraud in the health care industry. Dallas-Fort Worth is one them. The Medicare Fraud Strike Force is a combination of highly trained FBI and OIG agents, fraud investigators from the Medicaid Fraud Control Unit, and federal prosecutors specifically assigned to Medicare and Medicaid fraud cases. As a result, providers with high Medicare beneficiaries (e.g. home health care agencies, hospice agencies, DME companies, cardiologists, mental health programs etc.) must be more sensitive to CMS audits and fraud investigations than would be true outside of DFW.
- Medicare Audits & ZPIC Audits. What makes current audits for Medicare providers in For Worth and North Texas troublesome is the fact that the government nowadays pursues a data driven approach. That means, if you are a successful home health or hospice agency, or if you are a busier cardiologist than your competitor, that fact alone may lead to a patient chart production request. Having supervised many audits at the Department of Justice and the U.S. Attorney’s Office in Dallas Fort Worth, our attorneys have seen how mistakes in that first round of production can impact the entire case resolution. If you contact Oberheiden, P.C. with your health care audit, you will receive competent advice and we will make sure that your practice will not be referred to the U.S. Attorney’s Office. That said, we know that mistakes happen and that few practices and clinics are perfect. Our job is to analyze the mistakes, assess the error rate, and resolve the audit matter with the respective auditors.
- Illegal Physician “Self-Referrals”. Stark Law prohibits a physician to refer patients for certain types of services to entities, in which the physician has a financial interest. The most common application of Stark Law is a situation where a physician enters a joint venture with, for example, a toxicology laboratory or a pharmacy (or MRI, radiology center), and that physician nonetheless sends scripts and samples to that business without making sure that the business relationship is protected under one of the exceptions to Stark Law. Oberheiden, P.C.’s lawyers have a track record of convincing investigating agents from the Office of Inspector General and the Civil Division at the Department of Justice that an alleged violation can, in fact, be construed to fall into a protected arrangement category. Nick Oberheiden, for example, has argued Stark Law cases at the Department of Health and Human Services’ Washington D.C. headquarters and appeared before the Office of Inspector General throughout the United States, including in Washington D.C. Not one of his clients ended up needing to admit any civil or criminal liability.
- Prescription Drug Fraud & Opioid Investigations. Opioid investigations continue to dominate the attention of federal prosecutors. Internal medicine physicians, pain management physicians, family practitioners, and pharmacy owners in Fort Worth and surrounding communities must expect unprecedented enforcement, aggressive interventions, search warrants, and even federal arrests—if their practice involves the routine prescription or dispensing of Schedules I-III under the Controlled Substances Act. The government has instructed the U.S. Attorney’s Office in Fort Worth and all federal agencies to identify, monitor, and arrest all individuals deviating from the new government’s opioid policy standards. Whether you seek proactive compliance advice or whether you were notified about a case against you, Oberheiden, P.C. can help. Several of our attorneys previously supervised DEA and FBI agents and our track record involves a great number of success defense interventions on behalf of pharmacies and physicians. With client representations against opioid charges across the United States, we are at the forefront against this government movement, are familiar with the prosecutor’s strategy, and have the experts and expertise to challenge and defend. Please call us with your case as early as you can to make sure there is enough time to introduce vigorous defense strategies into the case.
- Medicare Fraud, Medicaid Fraud. Medicare Fraud and Medicaid Fraud are among the most charged offenses in Fort Worth health care investigations. Of particular focus are mental health providers, cardiologists, home health care agencies, hospice agencies, DME companies, and other Fort Worth medical providers with high numbers of federally funded program patients. The term Medicare fraud encompasses any violation of the Medicare program rules, in particular billing and kickback violations. Because most Medicare Fraud investigations are criminal in nature and pursued under a federal felony statute (18 U.S.C. 1347), caution is in order. If you or your business receive notice from the U.S. Attorney’s Office in Fort Worth or experience agents from the FBI or OIG trying to interview you or affiliates, you should immediately contact our health fraud defense attorneys. The sooner we can intervene and clarify the situation, the more likely it is that we can stop the investigation before it gets out of control. Call Oberheiden, P.C.. Let’s assess your situation and let’s find a way together to navigate you through this process.
- Illegal Kickbacks, Bribes, and Referral Fees. Fort Worth is known for an aggressive enforcement of the federal Anti-Kickback Statute (“AKS”). The AKS prohibits the offering, solicitation, payment, or receipt of any form of compensation for a patient referral. A classic application of the statute is when a physician or health care entity enters into a business development/marketing contract that establishes a percentage or commission payment structure. Federal law is very clear that commissions, percentage, and success fee payments to recruit Medicare, Medicaid, or Tricare patients is prohibited and constitutes a violation of the Anti-Kickback Statute, a federal criminal felony statute. Attorney Nick Oberheiden has frequently defended providers and health marketing groups against federal fraud allegations and he is available to explain how he avoided criminal charges in these representations.
The attorneys at Oberheiden, P.C. are available to discuss your situation in a free and confidential consultation, including on weekends. You will benefit from a reliable assessment from those lawyers previously in charge of DOJ, OIG, FBI, CMS, and DEA investigations. We are waiting for your call.
FAQs: What Providers in Fort Worth Need to Know about Health Care Fraud Investigations
Q: Who Are the Targets of Health Care Investigations in Fort Worth?
As stated, DFW is unique when it comes to health fraud enforcement because Dallas and Fort Worth are among the very few cities that were assigned to the Medicare Fraud Strike Force, a highly specialized federal enforcement group comprised of FBI agents and federal prosecutors. With that, Medicare providers in Dallas-Fort Worth are statistically more likely to be approached for audits or investigations than it is true in most other cities in the U.S. In general, the targets of health care fraud cases in Dallas Fort Worth are the owners of:
- Home Health & Hospice Agencies
- Physicians and Nurses Involved in Home Health Services
- Pharmacies & Compound Pharmacies
- Opioid Prescribing Physicians
- Toxicology & DNA Laboratories
Q: What Are Common Accusations in Home Health Care Investigations?
Fort Worth and Dallas are among the country’s most monitored cities when it comes to home health fraud investigations. Dallas-based Medicare Fraud Strike Force, an alliance of specially assigned agents and prosecutors, leads most of the home agency cases. From our involvement in many of these cases, we know that the government often claims that services were either not provided, not appropriately supervised by the medical doctor, or were based on referrals that are the results of illegal kickbacks. When it comes to these accusations of billing fraud, Medicare fraud, and kickbacks, it is absolutely critical to engage experienced lawyers as quickly as possible. The longer the government can explore its case without opposition, the more likely the initial suspicion of fraud will turn into a real investigation, and perhaps even criminal charges. Oberheiden, P.C.’s attorney Nick Oberheiden has substantial experience and can share with clients how he managed to avoid charges and to avoid jail time for our Texas clients.
Q: What Should I Do When I Receive an OIG Subpoena?
A popular way for the government to find out whether a company committed health care fraud is by way of issuing a federal subpoena from the Department of Health and Human Services (HHS) and the Office of Inspector General (OIG). The receiving individual or business is requested to produce certain documents, typically patient files and email/text communications, in addition to marketing and corporate information. If your business is targeted by OIG subpoena, you must understand that the handling of that subpoena will decide whether or not your case will be civil, criminal, or dismissed. Oberheiden, P.C. has substantial experience with OIG investigations. Not just did several of our attorneys previously oversee OIG cases in their roles at the U.S. Attorney’s Office and offer clients incredible insights from that angle; we have handled a large number of defense cases and concluded the investigation with no liability outcomes for our clients: toxicology labs, pharmacies, physician groups, marketing companies, and many more in OIG Stark Law, False Claims Act, and Medicare Fraud investigations. Call us today. Don’t let inexperienced counsel ruin your case.
Q: What Are the Penalties for Health Care Fraud in Fort Worth?
Health Care fraud can be both civil and criminal. The art of resolving health fraud is by having experienced attorneys assess the situation early to turn a criminal case into a civil case and a civil case into no monetary liability. In general terms, federal judges in the Northern District of Texas, which covers Fort Worth, apply criminal health care fraud statutes rather harsh. Whether the offense is an illegal kickback or billing fraud, the punishment range can rise up to 10 years per one count. However, rarely does it happen that there are not some signs of an investigation like a grand jury subpoena or interview requests by federal agents. The earlier a client contacts experienced health fraud defense lawyer, the less likely the case will result in criminal charges or liability. In light of the severe consequences of criminal fines, restitution, asset forfeiture, and possibly incarceration, you should not hesitate to begin your defense strategy as early as possible. Call our DFW office and ask us how we can help.
Q: When Should I Consult With a DFW Lawyer If I Believe that I Am Under Investigation?
It’s never too early but sometimes too late to speak with an experienced attorney about a possible case against you. Many investigations can be successfully intervened at an early stage when the government welcomes clarifying information to cease the matter. We often see how an investigation takes a course of its own because the client or the lawyer simply fails to recognize the need for effective communications with the U.S. Attorney’s Office. Oberheiden, P.C. is known for its proactive approach (and our high number of cases in which we drained the investigation before it got out of control). Please call us or visit our DFW office if you have questions or concerns about a health care matter. All consultations are free and confidential.
Q: Which Oberheiden, P.C. Lawyer Can Help Me?
One of the nice things about our firm is that every attorney on the team is qualified to help our clients in Fort Worth and throughout Texas. We do not use junior lawyers and the attorneys below are among those that you will be working with.
Contact Skilled Fort Worth Health Care Fraud Defense Attorneys Today
If you’re accused of health care fraud in Fort Worth or the surrounding area, contact Oberheiden, P.C. immediately to schedule a free and confidential consultation. We can help; reach out today.