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Health Care Fraud Defense

Federal Attorneys Who Have Proven How to Defend Health Care Fraud

Audits & Investigations | Whistleblower Defense Strategies | Grand Jury Subpoenas & CIDs | FBI, HHS, OIG Investigations | Search Warrant Defense | Indictments | Criminal Defense & Trials | Corporate Compliance | Internal Investigations

Successfully Protected Healthcare Clients in 45+ States | 214-469-9009

Are you being punished for your success? You have worked very hard to build your business. You have contributed to your community, and you have helped to improve quality patient care. You never had criminal intent. Your employees and vendors have a job because of you. You pay high taxes so that everyone else can benefit. And now comes the government and threatens to jeopardize everything you have accomplished? Isn’t it true that the government really wants to punish you for being more successful than others? Well, we think so. That’s why we have put together the A-Team of Federal Defense for you.

  • We Don’t Surrender, We Fix.
  • Top Trial Team: No Junior Lawyers, No Paralegals
  • Former FBI, Former DOJ Staff, Former U.S. Attorney
  • 95% Success Rate: 45 States (1,000+ Cases)

Call Dr. Nick Oberheiden If You Had No Intent to Do Anything Wrong | 214-469-9009

Are you seeking a life saver? Imagine you have a heart attack. Would you call a dentist or a cardiologist? Probably a cardiologist, someone that has the specific background and the experience to fix the problem. Let’s be honest. A federal investigation is like a heart attack. Everything is on the line. If you or your practice are accused of healthcare fraud, you simply cannot afford to experiment. You need a cardiologist, a life-saver, to make sure that your business, your good name, and your freedom are protected.

You are at the right firm. Meet Attorney Dr. Nick Oberheiden. Nick has represented clients all over the country and demonstrated that healthcare fraud allegations are fixable. In fact, Nick has avoided civil liabilities and criminal charges in many hundreds of healthcare audits and FBI/OIG investigations, whistleblower cases, grand jury and CID proceedings, FBI interview requests, and even search warrants. No stranger to the court room, Nick and his team have dismissed indictments, obtained acquittals, and secured probation even in multi-million-dollar fraud cases. This is what clients have said about Nick publicly.

  • “Brilliant Strategy”
  • “A True Life Saver”
  • “Federal Litigation Superstar”

Proven strategy and personal experience will  determine your outcome. To see how personal our service is, just text or call Dr. Oberheiden. Get a free and confidential consultation from Nick directly, including on weekends.

Central Intake Contact for Dr. Nick Oberheiden | 214-469-9009

How We Are Different

There truly is no firm like Oberheiden P.C. What makes us different compared to any firm you may find online is the experience of our team and the proven results. Some lawyers will tell you that they can help you when in fact they might experiment with your freedom; other lawyers may understand healthcare laws, but they have never argued a case in court or made a compelling defense presentation in a room filled with FBI agents and federal prosecutors. Well, that’s what WE do every day: WE don’t experiment, WE don’t surrender. We fight, we fix, we resolve, we litigate healthcare fraud accusations.

  • Covering Los Angeles, Miami, New York, Washington D.C., Houston, Dallas, and many more cities with local presence of experienced partner-level federal defense lawyers
  • Former FBI Agents (also OIG, IRS, DEA, DOJ Special Agents)
  • Former High-Ranking Federal Prosecutors

Find out for yourself. Get the relief that allows you to focus on your business while we take care of your case. Call us today. We are confident that 10 minutes with us will save you hours spent with lawyers that don’t even understand your industry, billing/coding, or where you first need to explain healthcare laws. Don’t waste your time. When you call Dr. Nick Oberheiden and his team, you will see why so many clients before you have trusted us when their financials, their good name, and their freedom was under attack.

How Our Experienced Health Care Fraud Defense Attorneys Have Resolved Healthcare Fraud Cases

Most healthcare fraud cases are based on the theory that a medical provider or a healthcare business (lab, pharmacy, hospital, home health agency) submitted fraudulent billing claims to Medicare, Medicaid, Tricare, or a commercial insurance company. Because billing mistakes are not uncommon in an industry known for its regulatory complexity, for the government to be involved, the alleged fraud must be widespread, systematic, and financially significant. In this context, billing errors are financially significant if the received reimbursement exceeds tens or even hundreds of thousands of dollars. “Fraud” is a fairly undefined term and in most cases the government will allege that a healthcare service lacked medical necessity, was outside the accepted standards of care (e.g. excessive testing), was billed too high, or was billed for but not provided.

Oberheiden P.C. has proven that each of these scenarios is fixable. The sooner we get involved, the easier it is to resolve the matter. | 214-469-9009

You will know that you are under investigation if you or your business receives a healthcare audit request, a CID (Civil Investigative Demand), a subpoena from the Department of Health and Human Services (HHS) Office of Inspector General (OIG), a Grand Jury Subpoena from the Department of Justice (DOJ), or, if the case is already advanced, if your business experiences a federal search warrant or an indictment. An experienced attorney will understand the nuances of each of these scenarios and tailor a specific defense strategy.

Federal Health Care Fraud (18 U.S.C. 1347)

  • United States v. Client: Client was indicted for Medicare Fraud. The damage amount was $ 7m. Nick obtained probation for his client.
  • United States v. Client: Client was indicted for Medicare Fraud. The damage amount was $ 3m. Nick obtained probation for his client.
  • United States v. Client: Client was indicted for Medicaid Fraud. The damage amount exceeded $ 1m. Nick obtained probation for his client.
  • See 100+ more examples of Oberheiden P.C. healthcare fraud cases here.

Anti-Kickback Law (42 U.S.C. 1320a-7b)

One of the most common allegations in healthcare fraud investigations are so-called kickbacks. Unlike most other industries, healthcare laws prohibit certain types of referral incentives to protect the integrity and independence of a physician’s professional judgment. Even though virtually anything of value may qualify as a kickback (not just straight payments, but also indirectly through physician distributions in MSOs or medical directorship agreements etc.), most kickback cases are surprisingly defendable. A successful client defense requires two attorney skillsets: a superb healthcare law understanding as well as the ability to lead tough negotiations through compelling arguments. The following are just a few representative examples of how Oberheiden P.C. has successfully defended civil and criminal kickback cases across the entire country.

  • United States v. Client: Federal kickback investigation against spine surgeon. No civil or criminal liability.
  • United States v. Client: FBI investigation against Client. No civil or criminal liability.
  • United States v. Client: Dismissed.
  • See 100+ more Anti-Kickback examples of Oberheiden P.C. cases here.

False Claims Act (18 U.S.C. 287)

Most False Claims Act cases originate as whistleblower cases. That is, someone, often a former employee or a competitor, reports alleged fraud to the government by filing a lawsuit in an effort to later collect a reward. Targets of these whistleblower cases often find out about the existence of an investigation when they receive a Civil Investigative Demand (CID) or another form of a government subpoena (e.g. OIG subpoena) requesting documents and corporate information. The absolute priority in all False Claims Act defense cases is to make sure that the investigation does not turn into a criminal case—that is something Oberheiden P.C. has accomplished in every single whistleblower case. By the same token, Oberheiden P.C. has successfully protected the financial stability of its clients by dismissing or favorably settling False Claims Act cases (e.g. in Los Angeles, in Florida, in Houston, in Philadelphia, in Dallas, in Portland, in Ohio etc.).

  • United States v. Client: OIG investigation against laboratory. Our defense resulted in no civil and no criminal liability for our client. Case dismissed, no liability.
  • United States v. Client: OIG/FBI kickback investigation against marketing company. Our defense resulted in no civil and no criminal liability for our client. Case dismissed, no liability.
  • United States v. Client: FCA investigation against physician practice. Our defense resulted in no civil and no criminal liability for our client. Case dismissed, no liability.
  • See 100+ more False Claims Act defense examples of Oberheiden P.C. here.

Aggravated Identity Theft

Aggravated identity theft is a good illustration to understand how important it is to be represented by trusted, experienced healthcare fraud defense attorneys. Recently, the Justice Department started to add aggravated identity theft to healthcare fraud indictments. Each count contains a mandatory two-year imprisonment. That means, probation is not an option. Oberheiden P.C. saw this trend quickly, and has successfully argued why aggravated identity theft is simply not applicable in the case—and saved clients from years of unnecessary prison time. Again, don’t gamble with your future. Call Oberheiden P.C. today.

  • United States v. Client: We avoided aggravated identity theft charges for our client and were able to stop the investigation against our client in its entirety. No charges.
  • United States v. Client: OIG/FBI kickback investigation against marketing company. Our defense resulted in no civil and no criminal liability for our client. Case dismissed.
  • United States v. Client: FCA investigation against physician practice. Our defense resulted in no civil and no criminal liability for our client. Case dismissed.
  • See 100+ more examples of how Oberheiden P.C. defended federal felonies here.

Federal Conspiracy (18 U.S.C. 1349)

Many federal healthcare fraud cases are brought as a conspiracy. The government essentially claims that multiple people have contributed something to the overall success of a fraud scheme. Let’s take the example of a marketer (M), a doctor (D), and a pharmacy (P). If a M unlawfully incentivizes D to send referrals to the pharmacy (“kickbacks”), then all three individuals may be charged by way of a conspiracy: the marketer for bribing, the doctor for accepting the bribe, and the pharmacy for billing claims that were based on a kickback. Oberheiden P.C. knows how to break that chain. We have successfully defended against hundreds of conspiracy charges, call us now to see how we did it!

  • United States v. Client: We avoided aggravated identity theft charges for our client and were able to stop the investigation against our client in its entirety. No charges.
  • United States v. Client: OIG/FBI kickback investigation against marketing company. Our defense resulted in no civil and no criminal liability for our client. Case dismissed.
  • United States v. Client: FCA investigation against physician practice. Our defense resulted in no civil and no criminal liability for our client. Case dismissed.
  • See 100+ more examples of how Oberheiden P.C. avoided or defended federal conspiracy charges here.

Our Pledge to You

  • No Associate or Junior Lawyer Will Work on Your Case
  • You Will Speak
  • You Will Benefit from Our Experience and Reputation

Our Federal Defense Lawyers Represent Clients in Federal Health Care Fraud Cases Nationwide – Including all CMS, DEA, DOJ, and OIG Matters

Regardless of your role within the health care industry, facing federal fraud allegations is an extremely serious matter. If federal agents are targeting your business or practice based upon allegations of Medicare, Medicaid, Tricare, or Department of Labor (DOL) fraud, failing to defend yourself effectively could result in exposure to significant civil or criminal penalties.

Federal health care fraud allegations can take a variety of different forms, and federal prosecutors can pursue civil and criminal charges under a multitude of federal statutes. As a result, when facing a federal health care fraud investigation, a critical early step is to determine the scope and nature of the allegations against you. Are you being accused of overbilling Medicaid or Tricare? Are you being accused of using Medicare-reimbursed funds to pay “kickbacks” or referral fees? Are you being accused of improperly prescribing, dispensing, or billing for opioid medications? Until you know why you are being targeted, you simply have no way of asserting an effective defense.

At Oberheiden, P.C., a significant portion of our practice is devoted to defending clients in federal health care fraud matters. When you engage our federal defense team to represent you, our attorneys will work to quickly get to the bottom of the government’s investigation. To find out why you are being targeted and what penalties are on the table, call 888-519-4897 for a free and confidential case assessment from one of our senior health care fraud defense lawyers.

Why Choose Oberheiden, P.C. for Federal Health Care Fraud Defense

Our firm is comprised entirely of attorneys who are highly-experienced in federal civil and criminal matters, and many of our attorneys have well over a decade of experience in federal health care fraud defense. This includes founding attorney Dr. Nick Oberheiden, who is recognized nationwide for his results in civil and criminal health care fraud investigations, as well as several former senior prosecutors and trial attorneys with the U.S. Department of Justice (DOJ).

With centuries of combined experience in high-level federal matters, including more than 70 years of experience as DOJ prosecutors and trial lawyers, our attorneys have handled federal health care fraud cases involving all relevant federal agencies. This includes assisting in and defending against investigations and prosecutions conducted by the Department of Justice, Centers for Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Office of Inspector General (OIG) of the Department of Health and Human Services (DHHS), and other agencies ranging from the Federal Bureau of Investigation (FBI) to the Internal Revenue Service (IRS). Our attorneys have been on both sides of cases involving all relevant statutes and sources of regulatory authority, and we have avoided charges and won trials in cases involving virtually all health care fraud allegations prosecuted under federal law.

If you or your business or practice is being targeted by federal authorities, this is the type of experience you need on your side. You need attorneys who can not only level the playing field, but who can tip the scales in your favor. With our attorneys’ vast federal defense experience and in-depth knowledge of the legal and medical principles involved in federal health care fraud investigations, we have become go-to defense counsel for health care providers and medical industry businesses across the country.

This is Why You Are in Good Hands

I found Dr. Nick Oberheiden online and the moment I spoke with him, I knew he is a true federal law expert. Nick outlined a defense strategy that was so thought through and so out of this world--and he executed and delivered like I would never have imagined. Nick is unbelievably good!! Nick is the very best of the best lawyers. Hire Nick if you want a classy, smart, and extremely successful lawyer.read more
David Lo
David L.
Nick is extremely professional and knows what he is doing. He is also very kind as a person (unless he is in court!) I would recommend him to just about anyone if they need an amazing lawyer that is top notch and would frankly be scary to face in the court room. He will always do a great job representing his clients. Thank you very much.read more
Anna Pham
Anna P.
Nick is the absolute top expert in any federal case
Jeff Crilley
Jeff C.
Extremely successful attorney with brilliant litigation skills.
Shannon Faulk
Shannon F.
Smart. Smarter. Nick. As a healthcare executive, I once ran into a litigation issue. I hired Nick and, literally, before I knew it the case was resolved in my favor. Nick has an incredible presence and every lawyer in the room knows that Nick will do exactly what he says. It was a mesmerizing experience to see Nick in action! Very calm and determined, Nick is the absolute top litigator.read more
Whitney Bryant Milam
Whitney Bryant M.
Nick has been a friend and trusted advisor for almost 10 years. As anyone just looking at his bio can tell, Nick is an outstanding attorney in highest demand across the country. All healthcare providers should hire attorney Nick Oberheiden!! You will not be disappointed.
Pamela mulrooney
Pamela M.
I have never witnessed a lawyer with such uncompromising client commitment, integrity, and dedication. On weekends, at night, in the morning— Nick is always there for his clients, constantly identifying solutions, no matter how complex the situation. The only question I have after all these years of knowing Nick: Does he ever sleep?read more
Laura Driscoll
Laura D.
Dr. Oberheiden has served as council and represented our company on several occasions, even during depositions, contract reviews and providing invaluable advice on multiple occasions that transpired into multilevel success in our business. He and his teams knowledge of both local, state and federal statues, accompanied by their areas of expertise law regarding best asset protection, estate planning and wealth management solutions have provided both professional and personal growth for my companies, safeguarding them and protection my family’s name and legacy. I would recommend this firm and Dr. Nick Oberheiden without hesitation. I have no doubt that you will experience success with his council.read more
Corban Milam
Corban M.
I have worked with Nick Oberheiden for over ten years on various litigation matters in and around New York City. Nick is an accomplished and seasoned lawyer and litigator---efficient, reliable, practical and, at the same time, highly academic. Nick will take the time necessary to understand a client's short- and long-term goals, and tailor his representation and advice to work toward and achieve those ends. Nick is a zealous advocate for his client, and will never sacrifice his client's interests for a quick or easy resolution to a case. At the end of the day, Nick is a great person to know if you or your business is in need of a top litigator or defense attorney.read more
Brendan Carosi
Brendan C.
When I was faced with one of the most terrifying and unexpected situations in my life, I called Dr. Oberheiden. I had vetted other attorneys and came right back to him. His knowledge, expertise, and reassuring presence made the decision easy. Throughout my case, his level of communication was what I needed and expected. He constantly updated me on the status and progress of my case and was able to “talk me off the ledge” when the stress of it all would set in. He is simply the best of the best...there’s not a question about it.read more
Angela Lee
Angela L.
Nick is a superb lawyer with exceptional skills and a formidable personality. Nick works harder, he thinks smarter, and he delivers faster than any lawyer you will ever find. Good, better, Nick!
Jacqueline Singleton
Jacqueline S.
1st class service. Atty. Iberheiden and Atty. Lynette Byrd were always available for us during the whole process of our Home Health Audit. Thank you so much!
Ed Orosa
Ed O.
I am a healthcare compliance consultant with almost 25 years of experience. The one advice I have for anyone seeking a lawyer with unbeatable healthcare law experience is to hire attorney Nick Oberheiden. For the past 8 years, I have worked with Nick on a variety of healthcare matters—from DEA compliance to DOL supervisory rules to setting up PT and pain management clinics. I have never once seen a client not being 100% intrigued by Nick’s proven expertise in the field of healthcare structuring and compliance. Dr. S.T.read more
Raft Consultants
Raft C.
Nick Oberheiden is a spectacular lawyer, a true life saver. Nick is simply the very best!
Michael P
Michael P
Nick Oberheiden is the absolute best federal litigation attorney. Nick gives you the immediate comfort of feeling 100% protected. He is polite, respectful— and extremely compelling. His legal strategy turned out to be brilliant.
Marshall M
Marshall M
Great firm, with a great firm record of experienced healthcare and litigation attorneys.
Chris Anderson
Chris A.
Great attorney who will fight to protect your rights. I would recommend Nick to any friend or family member.
Gerrid Smith
Gerrid S.

When you choose Oberheiden, P.C. for your federal health care fraud matter:

  • We will begin working on your defense immediately. With our attorneys’ experience representing health care providers and medical industry businesses across the country, we have cultivated a body of knowledge that allows us to get to work on our clients’ cases immediately. Unlike other firms, we do not need time to get up to speed on the legal and medical issues involved.
  • We will work diligently to secure an efficient and discrete resolution. In today’s world, even unproven allegations can have devastating consequences for a business or practice. Our attorneys understand these types of concerns, and we will work to secure a discrete and favorable outcome as efficiently as possible.
  • We will promptly assess your risk. By immediately intervening in the government’s investigation, we can quickly discern the allegations against you, including the volume of these allegations and whether they are civil or criminal in nature.
  • We will be fully prepared if your case goes to trial. If your only option is to go to court, we will be fully prepared to represent you at trial when the time comes. Our attorneys have handled hundreds of civil and criminal trials in federal jurisdictions nationwide
  • We will help you and your team make informed decisions. When facing a federal health care fraud investigation, there are several critical mistakes you need to avoid. Our attorneys will walk you through everything you need to know and train your staff so that you can effectively aid in your defense.

Put our highly experienced team on your side

Dr. Nick Oberheiden
Dr. Nick Oberheiden

Attorney-at-Law & Founder

Amanda Marshall
Amanda Marshall

Former U.S. Attorney

Local Counsel

Lynette S. Byrd
Lynette S. Byrd

Former Federal Prosecutor

Partner

Aaron L. Wiley
Aaron L. Wiley

Former Federal Prosecutor

Local Counsel

Subodh Chandra
Subodh Chandra

Former Federal Prosecutor

Local Counsel

R. Brandon Johnson
R. Brandon Johnson

Former Federal Prosecutor

Local Counsel

Roger Bach
Roger Bach
(Non-Lawyer)

Former Special Agent, OIG

Dennis A. Wichern
Dennis A. Wichern
(Non-Lawyer)

Former Special Agent-in-Charge

Chris Anderson
Chris Anderson
(Non-Lawyer)

Compliance Consultant

Beverly Gibson
Beverly Gibson
(Non-Lawyer)

Compliance Auditor

Joe Lewis
Joe Lewis
(Non-Lawyer)

Pharmacy Compliance

Valerie Rivera
Valerie Rivera
(Non-Lawyer)

Private Investigator

More about Our Federal Health Care Fraud Defense Practice

Cases We Handle

We represent individuals and businesses in civil and criminal health care fraud matters nationwide. This includes representing licensed professionals, practice and business owners, facility administrators, clinics, laboratories, hospitals, hospices, home health agencies, and other clients in audits, investigations, and prosecutions in all 50 states. With a significant portion of our practice devoted to federal health care fraud defense, we routinely represent clients facing allegations such as:

  • Overbilling Medicare, Medicaid, Tricare, or the DOL
  • Improperly prescribing, dispensing, or diverting opioid medications
  • Billing for services not provided (so-called “phantom billing”)
  • Improper practices related to physician certifications or patient election statements
  • Billing for services that were not medically-necessary
  • Falsifying patient records or test results
  • Double-billing federal benefit programs and/or a private health insurer
  • Offering or accepting illegal kickbacks, bribes, or referral fees
  • Billing and coding violations (including “upcoding” and “unbundling”)
  • Attempt or conspiracy to commit health care fraud

Are you accused of a federal crime?

Don’t delay. Learn about your rights.

Call Dr. Nick Oberheiden now!

(310) 873-8140

Available nights and weekends

Proven Results at All Stages of Federal Health Care Fraud Prosecution

If you have been contacted by federal agents or auditors working with CMS, it is important that you seek legal representation promptly. While going to trial on federal charges is a very real possibility, it is also possible that you could resolve your case short of trial – and potentially without charges ever being filed. In fact, we have resolved the vast majority of our clients’ cases at the investigative stage; and, to date, we have avoided prosecution in every False Claims Act investigation we have handled.

1. Fee-For-Service Contractor Audits (MAC, RAC, ZPIC)

Fee-for-service contractors working with CMS audit Medicare-participating health care providers on a regular basis. Unfortunately, these auditors have a financial incentive to find violations, and they often lack the up-to-date and in-depth knowledge required in order to accurately assess providers’ compliance with the Medicare billing regulations. We regularly represent providers in audits and appeals involving Medicare Administrative Contractors (MACs), Recovery Audit Contractors (RACs), Zone Program Integrity Contractors (ZPICs), and other CMS fee-for-service audit contractors.

2. Federal Investigations

Federal health care fraud investigations can be civil or criminal in nature, and they can involve agents from CMS, DEA, DOJ, FBI, IRS, OIG, and various other agencies and task forces. The majority of our federal heath care fraud defense practice involves representing clients at the investigative stage, and we have protected the majority of our clients against any civil or criminal liability.

3. Grand Jury Proceedings

If you have been served with a grand jury subpoena, you do not have any time to waste. Federal prosecutors are pursing criminal charges, and an indictment will put your case on the path toward trial. We have extensive experience representing clients in federal grand jury proceedings, from challenging subpoenas to providing advice and representation in the courthouse.

4. Pre-Trial Practice and Plea Deal Negotiations

Once an indictment or civil charges have been issued, there will still be a significant amount of time before your case goes to trial. While many firms use this time exclusively for trial preparation, we use it as an opportunity to continue to fight for a favorable pre-trial resolution. From having indictments dismissed to negotiating plea deals that protect our clients’ practices and keep them out of prison, we utilize a variety of aggressive pre-trial defense strategies to protect our clients from the possibility of a “guilty” verdict at trial.

5. Trials and Sentencing

At the federal level, trial on the merits and sentencing are separate proceedings. Each requires a different approach, and our attorneys have extensive experience on both sides of federal health care fraud trials. We can use this experience to protect you, whether that means convincing the jury that the government has not met its burden of proof or arguing for a sentence below what is called for under the Federal Sentencing Guidelines.

6. Appeals

In addition to handling civil and criminal health care fraud cases at the trial level, we also represent clients on appeal. Our defense team includes highly-experienced appellate attorneys who are licensed to practice before multiple U.S. Circuit Courts of Appeal.

Potential Consequences of a Federal Health Care Fraud Audit or Investigation

The potential consequences of a federal health care fraud audit or investigation vary depending upon the type of fraud alleged and the number of violations of which you are being accused. In all cases, however, the consequences can be severe, and some practitioners and business owners will face business-threatening and life-altering consequences as a result of the government’s inquiry. Depending on the circumstances involved, the consequences of being targeted for health care fraud can include:

  • Recoupments – Providers and businesses accused of overbilling Medicare, Medicaid, Tricare, or the DOL will be required to repay all overbilled amounts and may be subjected to pre-payment review going forward.
  • Program Exclusion – Civil and criminal health care fraud violations can result in exclusion from Medicare, Medicaid, Tricare, and DOL program participation.
  • Treble (Triple) Damages – In addition to recoupments, providers and businesses will also generally be required to pay treble damages, or three times the government’s actual losses.
  • Licensing and/or Registration Consequences – Health care fraud offenses can result in loss of DEA registration and trigger disciplinary action by state licensing boards.
  • Civil or Criminal Fines – Civil and criminal health care fraud offenses also carry steep fines, with fines often applying on a “per-claim” basis.
  • Federal Imprisonment – In criminal health care fraud cases, practitioners and business owners can face the potential for years, or even decades, of federal imprisonment.
  • Civil or Criminal Fines – Civil and criminal health care fraud offenses also carry steep fines, with fines often applying on a “per-claim” basis.
  • Costs and Attorneys’ Fees – Providers and businesses found guilty of health care fraud may also be required to pay the government’s cost of prosecution.

Speak with a Federal Health Care Fraud Defense Lawyer at Oberheiden, P.C.

If you are being targeted by federal authorities, contact us for your free and confidential initial case assessment. To speak with a member of our federal health care fraud defense team as soon as possible, call 888-519-4897 or tell us how to reach you online now.

Your Health Care Fraud Defense Team

Potential Consequences of a Federal Health Care Fraud Audit or Investigation

The potential consequences of a federal health care fraud audit or investigation vary depending upon the type of fraud alleged and the number of violations of which you are being accused. In all cases, however, the consequences can be severe, and some practitioners and business owners will face business-threatening and life-altering consequences as a result of the government’s inquiry. Depending on the circumstances involved, the consequences of being targeted for health care fraud can include:

  • Recoupments – Providers and businesses accused of overbilling Medicare, Medicaid, Tricare, or the DOL will be required to repay all overbilled amounts and may be subjected to pre-payment review going forward.
  • Program Exclusion – Civil and criminal health care fraud violations can result in exclusion from Medicare, Medicaid, Tricare, and DOL program participation.
  • Treble (Triple) Damages – In addition to recoupments, providers and businesses will also generally be required to pay treble damages, or three times the government’s actual losses.
  • Licensing and/or Registration Consequences – Health care fraud offenses can result in loss of DEA registration and trigger disciplinary action by state licensing boards.
  • Civil or Criminal Fines – Civil and criminal health care fraud offenses also carry steep fines, with fines often applying on a “per-claim” basis.
  • Federal Imprisonment – In criminal health care fraud cases, practitioners and business owners can face the potential for years, or even decades, of federal imprisonment.
  • Civil or Criminal Fines – Civil and criminal health care fraud offenses also carry steep fines, with fines often applying on a “per-claim” basis.
  • Costs and Attorneys’ Fees – Providers and businesses found guilty of health care fraud may also be required to pay the government’s cost of prosecution.

Speak with a Federal Health Care Fraud Defense Lawyer at Oberheiden, P.C.

If you are being targeted by federal authorities, contact us for your free and confidential initial case assessment. To speak with a member of our federal health care fraud defense team as soon as possible, call 888-519-4897 or tell us how to reach you online now.

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