5 Mistakes People Make When Choosing a Healthcare Fraud Defense Lawyer

Regardless of whether you are an individual or an executive working on behalf of a healthcare organization or provider, making the decision to hire a lawyer to represent you because you are being accused of committing healthcare fraud is a big moment in your life. It means that the legal threat of civil or even criminal liability has gotten so real that you have realized that you might not be able to handle it on your own.

That realization is a huge one. It can also be very scary.

What you do next will make a big difference in the outcome of your case. If you choose the right lawyer to hire for your situation, the odds that your defense will be a successful one will increase dramatically. If you do not choose the right lawyer, though, you may find your legal representative making bad moves that expose you to the very liability that you are trying to avoid.

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Dr. Nick Oberheiden
Dr. Nick Oberheiden



John W. Sellers
John W. Sellers

Former Senior Trial Attorney
U.S. Department of Justice

Local Counsel

Joanne Fine DeLena
Joanne Fine DeLena

Former Assistant U.S. Attorney

Local Counsel

Joe Brown
Joe Brown

Former U.S. Attorney & Former District Attorney

Local Trial & Defense Counsel

Amanda Marshall
Amanda Marshall

Former U.S. Attorney

Local Counsel

Aaron L. Wiley
Aaron L. Wiley

Former Federal Prosecutor

Local Counsel

Roger Bach
Roger Bach

Former Special Agent (OIG)

Michael Koslow
Michael Koslow

Former Supervisory Special Agent (FBI)

Chris Quick
Chris Quick

Former Special Agent (FBI & IRS-CI)

Kevin M. Sheridan
Kevin M. Sheridan

Former Special Agent (FBI)

Ray Yuen
Ray Yuen

Former Supervisory Special Agent (FBI)

Dennis A. Wichern
Dennis A. Wichern

Former Special Agent-in-Charge (DEA)

The healthcare fraud defense lawyers at the national law firm Oberheiden P.C. have represented clients from the very beginning of their pressing legal situations, as well as others who have pulled our law firm on board because their first choice of attorneys failed them. Here are five mistakes that we have found that people tend to make when looking for a healthcare fraud defense team.

1. Deciding Not to Hire One

One of the biggest mistakes that healthcare providers and individuals make when threatened with allegations of healthcare fraud is to decide that they do not actually need the legal representation of a skilled lawyer. Healthcare fraud claims are serious, and carry steep financial penalties and potentially even prison time.

Nevertheless, lots of people and healthcare organizations decide that they can handle it on their own. Some common reasons for making this decision include:

  • Thinking that the costs of paying for a defense lawyer are not worth it
  • Not being able to afford a defense attorney
  • Underestimating the severity of the charges
  • Not understanding how quickly a minor legal situation can escalate into a very serious one

Taking this route is perilous. The vast majority of people who find themselves in this position have never been in it before. Without an understanding of the law and an appreciation for how quickly cases of fraud can evolve and escalate, these defendants and suspects end up moving forward almost blindly. In the meantime, investigators and prosecutors are putting together evidence against you, often without your knowledge, usually in spite of your best efforts to show your innocence, and frequently from your own voluntarily provided words and conduct.

In many cases, the decision not to hire a lawyer ends up only being a temporary one. People who decide that they do not have to get legal representation often end up letting the case continue to unfold for months until something catastrophic happens, like an arrest. They then realize that they need a lawyer, and that they needed one months ago.

The healthcare fraud defense lawyers have fielded frantic calls from numerous clients who have made this mistake in their decision to hire a lawyer.

2. Delaying for Too Long

Similarly, there are people who delay for too long before hiring an attorney. The difference is that these suspects and potential defendants have often known all along that they were going to need legal representation in order to fend off the allegations that had been percolating. Rather than initially deciding that they would be fine on their own, though, these people said, “not yet.”

We see a couple of reasons why people delay for too long before hiring a healthcare fraud defense lawyer:

  • They want to cut down on the costs of having legal representation
  • They do not see the value of having a lawyer on hand for the preliminary stages of a healthcare fraud investigation
  • They do not appreciate how advanced the investigation has become
  • They do not appreciate how quickly investigators can turn a weak suspicion of healthcare fraud into the probable cause that is necessary to make an arrest
  • They do not want to admit that the allegations of fraud have enough substance to them to warrant the need for calling a lawyer

The reality is that getting a lawyer involved in your case as soon as you can is a great way to not only protect yourself from legal liability, but also to potentially reduce your legal expenses in the long run.

In many cases, a lawyer can invoke your rights and protect your interests in ways that prevent a preliminary investigation from escalating any further. In healthcare fraud cases, for example, a lawyer’s vigorous defense in the lead up to an audit and during the inspection can make the difference between the audit uncovering incriminating evidence and that evidence getting shielded behind a legal privilege. This outcome can quash the case against you and save you thousands of dollars in legal fees.

Needless to say, it can also avoid legal liability, which can be far more expensive than even the highest paid attorney that you can find.

3. Hiring a Friend, Acquaintance, Family Member, or Associate

Another mistake that people frequently make when looking for a healthcare fraud defense lawyer is to hire a lawyer solely because he or she is a friend, family member, or personal associate. This mistake is generally done for one of two reasons:

  1. Convenience, or
  2. Trust.

Lots of people hire a lawyer that they know personally in order to represent them in a healthcare fraud case because calling someone that they know is easier than vetting lawyers that they do not know. Not only can you get a lawyer on your side more quickly, but you can also get someone that you already trust and that you know will have your best interests at heart.

This is a great decision to make, if your attorney friend has extensive experience in defending against allegations of healthcare fraud. Odds are, though, that they focus their practice in a different field of law.

This creates not one, but two serious problems:

  1. Your attorney friend is out of his or her element, and
  2. You trust that they have everything under control.

In many cases, this has a disastrous outcome. Your attorney struggles to advocate on your behalf and defend your interests and you are left in the dark because you trust them completely to do their job. It is not until the healthcare fraud investigation takes a serious turn that it becomes clear that your rights and interests were not being adequately protected.

Sadly, the healthcare fraud defense lawyers at Oberheiden P.C. have been called by defendants who have found themselves in this position more than once in the past.

By this time, the unforced errors made by your friend – who may very well be an excellent attorney in a different practice area – have exposed you to serious liability. In many cases, the best that can be done is to mitigate the damage.

To make matters even worse, your friend’s failure is often enough to seriously damage your personal relationship, as well.

4. Falling for a Law Firm’s Marketing

But even people who do set out to find a lawyer or law firm that handles healthcare fraud cases can still make the mistake of getting distracted or persuaded by the law firm’s marketing rather than their attorneys’ background and prior case results.

Law firms are businesses, too. They attract clients by marketing themselves, online and elsewhere. While there are strict rules about what they can and cannot say in those marketing materials – such as whether they can call themselves “experts” or “specialists” in a given field of law – attorneys and marketers have become adept at trumpeting the firm’s credentials without using any prohibited terms or promises.

In many cases, though, a firm’s marketing can make its attorneys seem much more qualified than they really are. In fact, for most attorney marketing ventures, that is the point.

Unfortunately, it can be very difficult to see through the exaggerations in a law firm’s marketing materials and judge just how good of a fit its lawyers will be for your situation. After all, most of what you will read when you vet law firms before making a hiring decision will be carefully chosen by the firm, itself.

Because of this, it is important to put far more value on the concrete details surrounding prior case results and the backgrounds of the lawyers at the firm. These can give you a sense of how good a particular lawyer really is, rather than how good they say they are.

5. Hiring a Firm or Lawyer Who Does Not Specifically Practice in Healthcare Fraud Defense

Finally, many people who need a healthcare defense lawyer make the mistake of presuming that any criminal defense lawyer will do.

That is not the case.

Defending against allegations of fraud, and particularly healthcare fraud, is very different than defending against most other criminal charges. While criminal defense is always very fact-intensive, the evidence in violent and property crimes tends to focus on witnesses whose testimony will show who did what and when they did it. For allegations of fraud, the evidence is document-heavy, requiring a completely different approach. While white collar crime defense lawyers will be familiar with what it takes to defend your rights and interests, a general criminal defense attorney may struggle.

But even general white collar crime defense attorneys can quickly find themselves in over their heads in healthcare fraud defense cases. The healthcare system in the United States is a labyrinth of public agencies and private companies, each with its own oversight structure that frequently overlaps with its counterpart. Without a thorough understanding of how everything fits together, a general white collar crime defense firm will struggle to fully insulate you or your healthcare company from legal liability.

While it is a bigger mistake to not get a lawyer on your side as early in the process as possible, it is still a mistake to hire an attorney or law firm that does not have extensive experience defending clients – both individuals and companies – against allegations of healthcare fraud.

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